Salmonella Outbreak Grows. Cantaloupes Recalled

The number of people infected with Salmonella Typhimurium in the USA’s most recent produce-related outbreak has increased to 178, according to data released this morning by CDC. Sixty-two people have been hospitalized. The death toll remains at two – both of them from Kentucky.

Twenty-one states have reported at least one illness – up from the previous total of twenty. Salmonella Typhimurium infections due to the outbreak strain were documented in Alabama (13), Arkansas (3), California (2), Georgia (3), Illinois (21), Indiana (18), Iowa (7), Kentucky (56), Massachusetts (2), Michigan (6), Minnesota (4), Mississippi (5), Missouri (12), New Jersey (2), North Carolina (3), Ohio (4), Pennsylvania (2), South Carolina (3), Tennessee (6), Texas (2), and Wisconsin (4).

Salmonella Typhimurium outbreak. Cases reported by state (from CDC)

Investigations by CDC, FDA and local and state agencies have concluded that cantaloupe originating from Chamberlain Farm Produce, Inc. of Owensville, Indiana is a likely source of this outbreak. Late yesterday, Chamberlain Farm Produce, Inc. announced a voluntary recall of all of its cantaloupes from the 2012 growing season that may remain in the marketplace. This follows a prior market withdrawal of cantaloupes initiated by Chamberlain on August 16th and 17th.

Chamberlain’s cantaloupes were marketed to four retail grocery stores with outlets in Vanderburgh, Warrick, Gibson, and Dubois County, Indiana, and Wabash County, Illinois during the period of June 21, 2012 to August 16, 2012; four wholesale purchasers in Owensboro, Kentucky, St. Louis, Missouri, Peru, Illinois, and Durant, Iowa also procured cantaloupes from Chamberlain during that same period. According to FDA, the cantaloupes were initially shipped to Indiana, Kentucky, Missouri, Tennessee, Ohio, Illinois, and Wisconsin, with further distribution likely.

Although the names of the retail and wholesale consignees have not been released, Wal-Mart has been named as the source of cantaloupes consumed by two outbreak victims from one family in Michigan, and by one of the Mississippi outbreak victims.

While FDA and CDC have identified “a source” of this outbreak, the investigation is continuing in order to determine whether there are other possible sources. The outbreak strain of Salmonella Typhimurium is a common one, and is typically the source of 10 to 15 “background” cases each month across the USA. Only 75% of the outbreak victims interviewed during the initial investigation reported having consumed cantaloupe before becoming ill.

Updated CDC Advice to Consumers, Retailers, and Others

Contaminated cantaloupe may still be in grocery stores and in consumers’ homes.

Consumers who recently purchased Chamberlain Farms cantaloupes are advised not to eat them and discard any remaining cantaloupe.
- Based on the available information, consumers can continue to purchase and eat cantaloupes that did not originate from Chamberlain Farms Produce, Inc.
- Many cantaloupes have the growing area identified with a sticker on the fruit. If no sticker is present, consumers should inquire about the source. When in doubt, throw it out.
- Consumers who are buying or have recently bought cantaloupe should ask their retailer if the cantaloupe originated from Chamberlain Farms Produce, Inc.
Cantaloupes should be disposed of in a closed plastic bag placed in a sealed trash can. This will prevent people or animals from eating them.
Dispose of any cantaloupes that you think may be contaminated. Washing them will not completely eliminate the contamination. Cutting, slicing and dicing may also transfer harmful bacteria from the fruit’s surface to the fruit’s flesh.
Retailers and food service operators should not sell or serve Chamberlain Farms cantaloupe.
Persons who think they might have become ill from eating possibly contaminated cantaloupes should consult their health care providers.

Salmonella Victim Bought Cantaloupe at Wal-Mart

Two Mississippi residents are among the 141 victims of this year’s cantaloupe-linked Salmonella Typhimurium outbreak. Only one of the Mississippians reported having consumed cantaloupe prior to becoming ill, according to Jim Newkirk of the Mississippi State Department of Health’s Office of Communications.

And that person purchased whole cantaloupe from Wal-Mart.

Bloomberg news reported on August 18th that Wal-Mart had withdrawn Indiana cantaloupes from its stores.

Neither of the two Mississippi outbreak victims was hospitalized, and no additional cases are currently under investigation in that state. The confirmed cases were reported from Rankin and Itawamba counties. Rankin County is east of Jackson, in the center of the state; Itawamba County is in Mississippi’s northeast corner.

As of August 17th, CDC reported that 141 outbreak cases of Salmonella Typhimurium had been documented in 20 US states. The agency expects to update those numbers later this week, according to CDC spokesperson Lola Russell.

While all of the 141 outbreak victims were infected with the same strain of Salmonella Typhimurium, only 75% (18 of 24) of those interviewed reported having consumed cantaloupe before becoming ill. Neither California victim was exposed to cantaloupe – or to other melons – and neither travelled to the hardest hit states (Kentucky, Indiana, Illinois). Only two of Iowa’s seven outbreak victims ate cantaloupe.

Ronald Owens of the California Department of Public Health offered this explanation when contacted by eFoodAlert:

It is not uncommon in these outbreak investigations to occasionally identify people who were infected by a similar strain of bacteria to the outbreak strain but who are considered “background” cases that are not related to an outbreak. The U.S. Centers for Disease Control and Prevention (CDC) estimates that there are about 10-15 background cases with this particular strain pattern that are detected each month.

This illustrates the difficulty faced by epidemiologists and public health officials in detecting and defining a foodborne disease outbreak that is caused by a relatively common genetic strain of bacteria. It’s far easier to recognize a needle in a haystack than to distinguish between two pieces of hay. In these circumstances, CDC defines an outbreak case as one that is a genetic match to the outbreak strain and falls within the outbreak timeframe.

Neither CDC nor FDA is yet prepared to identify the southwestern Indiana farm that is believed to be the source of the contaminated cantaloupes. No public recall has been announced.

CDC’s Advice to Consumers, Retailers and Others (as of August 17, 2012)

Contaminated cantaloupe may still be in grocery stores and in consumers’ homes.

Consumers who recently purchased cantaloupes grown in southwestern Indiana are advised not to eat them and discard any remaining cantaloupe.
- Based on the available information, consumers can continue to purchase and eat cantaloupes that did not originate in southwestern Indiana.
- Many cantaloupes have the growing area identified with a sticker on the fruit. If no sticker is present, consumers should inquire about the source. When in doubt, throw it out.
- Consumers who are buying or have recently bought cantaloupe should ask their retailer if the cantaloupe was grown in southwestern Indiana.
Cantaloupes should be disposed of in a closed plastic bag placed in a sealed trash can. This will prevent people or animals from eating them.
Dispose of any cantaloupes that you think may be contaminated. Washing them will not completely eliminate the contamination. Cutting, slicing and dicing may also transfer harmful bacteria from the fruit’s surface to the fruit’s flesh.
Retailers and food service operators should not sell or serve cantaloupe from southwestern Indiana.
Persons who think they might have become ill from eating possibly contaminated cantaloupes should consult their health care providers.

Salmonella Outbreak In 20 States Linked to Cantaloupe – Update

UPDATED August 17, 2012 @8:55pm with information released by CDC

Cantaloupes from Southwestern Indiana are believed to be the source of a Salmonella typhimurium outbreak that has sickened 141 people in 20 states. Thirty-one people have been hospitalized, and Kentucky has reported two outbreak-associated deaths.

The Minnesota Department of Health reports that an unnamed farm in southwestern Indiana has initiated a “voluntary market withdrawal” and has stopped harvest of cantaloupes, after receiving notification that cantaloupes grown on the farm tested positive for the outbreak strain of Salmonella.

FDA reports that outbreak illnesses occurred in Alabama (7), Arkansas (3), California (2), Georgia (1), Illinois (17), Indiana (13), Iowa (7), Kentucky (50), Michigan (6), Minnesota (3), Missouri (9), Mississippi (2), New Jersey (1), North Carolina (3), Ohio (3), Pennsylvania (2), South Carolina (3), Tennessee (6), Texas (1), and Wisconsin (2).

According to Charles Kendell with the Kentucky Department for Public Health, there were 137 reports of Salmonella in the state during July – twice the usual number for this time of year. Approximately 61% of confirmed cases reported exposure to cantaloupe and/or watermelon. Lab testing of clinical specimens from outbreak victims confirmed three different genetic strains of Salmonella typhimurium.

Tennessee’s six confirmed cases were scattered among several counties; three of the six victims in that state were hospitalized. The three Minnesota victims included one child and two adults over 70 years of age. No Minnesotans were hospitalized, and all three have recovered.

CDC reports that outbreak victims range in age from less than 1 to 92 years, with a median age of 49 years old. Illness onset dates are between July 7, 2012 to August 4, 2012. Nearly one-half (48%) of the people for whom information was available reported being hospitalized.

The pale blue shaded area in the Date of Illness Onset chart, provided by CDC, represents the time period within which illnesses may have occurred that have not yet been reported or confirmed by health authorities. THIS OUTBREAK IS FAR FROM OVER.

FDA offers the following advice to consumers:

Consumers who are buying or have recently bought cantaloupe should ask their retailer if the cantaloupe was grown in southwestern Indiana.
Throw away any cantaloupe from southwestern Indiana.
Do not try to wash the harmful bacteria off the cantaloupe as contamination may be both on the inside and outside of the cantaloupe. Cutting, slicing and dicing may also transfer harmful bacteria from the fruit’s surface to the fruit’s flesh.
WHEN IN DOUBT, THROW IT OUT!
Anyone who consumed cantaloupe and experiences any symptoms of Salmonella infection should consult a health care provider.