Twenty-one people are dead, one woman has lost her baby, and 109 illnesses are confirmed by CDC to be the result of Listeria monocytogenes – contracted by eating contaminated cantaloupes. Illnesses relating to this outbreak now have been confirmed in 23 states.

And now, this outbreak has claimed the life of an unborn child in Iowa.

What was the source of the contamination – the “root cause” that FDA is investigating? One month after Jensen recalled its cantaloupes, the agency still doesn’t know – or isn’t saying.

Which supermarkets, grocery stores, and restaurants were supplied with the recalled cantaloupes? One month after the recall, all FDA can say is “ask your grocer.”

That’s not good enough!

Consumers should not have to play detective in order to find out whether or not they have been exposed to the risk of infection from a recalled food. They should not have to rely on blogs like eFoodAlert for information on where a recalled food was sold.

In the interests of consumer safety, FDA MUST release the results of its trace-back investigations to the public. When public health is concerned, commercial confidentiality be damned! USDA manages to release a retail distribution list within a week of every Class I (highest risk)  food safety recall, and updates the information as more retailers are identified. Why can’t FDA do the same?

Listeria monocytogenes has a relatively long incubation period, and most – or all – of the illnesses reported so far likely were contracted before Jensen Farms’ September 14th recall. But that is on the verge of changing. We are rapidly approaching the cross-over point where infections could have been prevented if consumers were given prompt information on where the recalled cantaloupes were sold. From now on, newly developing illnesses should rest very heavily on the collective conscience of policy-makers in FDA – the “powers-that-be” who tell consumers to ask their grocers.

It’s all very well for FDA to complain that the agency is underfunded. It’s all very well for the Commissioner to complain that funding has not been appropriated for the Food Safety Modernization Act. But underfunding does not excuse FDA’s refusal to release information that could prevent more consumers from developing a potentially deadly illness.

When this outbreak was first reported, it was limited to 15 people in four states.

Now, it has spread to 109 people in 23 states, and has claimed 22 innocent lives.

Listeria monocytogenes has an incubation period that can be as long as 70 days.

How many more people are nervously noting every little symptom and twinge, wondering whether the cantaloupe they purchased from a local grocer or enjoyed at their favorite restaurant was contaminated with Listeria monocytogenes?

How many more people have to suffer before FDA recognizes its responsibility to the citizens of this country?

And how many more will die?

Updated 10/9/2011

FDA and CDC held a teleconference for the media on September 28th; however, it was more noteworthy for what information was not provided than for any real news.

FDA – in response to repeated questions – specifically declined to provide a list of retailers who were supplied with the recalled cantaloupes. “I think it’s a lot more accurate,” Dr. Hamburg (FDA Commissioner) explained, “for the consumer to actually ask their retailer in terms of the ability to get that information out and, of course, when you put stuff on the web site, not everybody accesses it. So I think it is an important message that if people are uncertain to ask their retailer.”

Here is a consolidated “State of the States” listing, which summarizes the outbreak status and the recall information for each state.

• Alabama:- One case.
• Alaska:- No cases. None of the cantaloupes were shipped to Alaska.
• Arizona:- No outbreak cases. One cases of Listeria that is unrelated to the outbreak.
• Arkansas:- One case.
• California:- One confirmed case. According to the California Department of Public Health, none of the recalled cantaloupes were distributed in California (FDA’s news releases include California in the distribution list).
• Colorado:- Thirty (32) confirmed cases; 5 deaths.
• Connecticut:- No cases.
• Delaware:- No cases.
• Florida:- One case.
• Georgia:- No cases.
• Hawaii:- No cases. No recalled cantaloupes were shipped to Hawaii.
• Idaho:- One confirmed case  – a Jerome County woman in her 60s, who became ill in early September and was hospitalized but has recovered.
• Illinois:- One confirmed case (female in her 80s from Cook County). No additional cases under investigation.
• Indiana:- Two cases. One death.
• Iowa:- One case – a Northwest Iowa woman who was pregnant at the time she became ill and subsequently suffered a miscarriage.
• Kansas:- Seven (7) confirmed cases, including two deaths.
• Kentucky:- No outbreak cases. Three unrelated cases in the state this year.
• Louisiana:- The Louisiana Department of Health and Hospitals (DHH) is investigating two Listeria deaths – an 87-year-old Baton Rouge woman and  and an 81-year old woman in a Shreveport hospital. DHH epidemiologists have determined that the Shreveport woman was infected with a same strain of Listeria monocytogenes that was found in the recalled Jensen Farms cantaloupes. The Baton Rouge Listeria strain is still under investigation.
• Maine:- No cases.
• Maryland:- One case (patient died at the end of August). The victims was a resident of central Maryland, and had eaten cantaloupe. Traceback is continuing, according to the State.
• Massachusetts:- No cases.
• Michigan:- No cases.
• Minnesota:- No cases.
• Mississippi:- No cases.
• Missouri:- Three (3) confirmed case (94-year old individual); one death. The “immediate” cause of death was not a Listeria infection.
• Montana:- One confirmed case in Yellowstone County. One case under investigation in Gallatin County.
• Nebraska:- Six (6) confirmed cases; one death (a man in his 80s from the western part of the state. No additional cases under investigation. The six victims – all of them more than 75 years old – were residents of five different counties: Douglas (2), Gage, Hitchcock, Seward, and Cherry.
• Nevada:- No cases.
• New Hampshire:- No cases.
• New Jersey:- No cases.
• New Mexico:- Thirteen (13) confirmed cases; 5 deaths. According to a Sept 29th news release, the five fatal cases include a 93-year-old man from Bernalillo County, a 61-year-old female from Curry County, a 63-year-old man from Bernalillo County, a 77-year-old man from McKinley County and a 96-year-old female from Lea County. The other New Mexico cases have come from Bernalillo, Chaves, Otero, De Baca, and Valencia counties. The cases range in age from the 43 to 96 and include 7 men and 6 women. No additional cases are under investigation at this time.
• New York:- One case. One fatality. The patient was an elderly woman in Ontario County in western New York State.
• North Carolina:- No cases.
• North Dakota:- One confirmed case – a 60+ year old woman who was hospitalized in early September. The recalled cantaloupes were supplied to Walmart stores in North Dakota.
• Ohio:- No cases.
• Oklahoma:- Eleven (11) confirmed cases, including one death. Outbreak victims are residents of nine different counties: Oklahoma (3), Canadian, Choctaw, Cleveland, Custer, Kay, Love, McCurtain, and Payne. The first Oklahoma patient developed symptoms on August 30th; the most recent on September 15th. The youngest outbreak victim is 61 years old, and the eldest is 96. Nearly three-fourths of the case-patients are male.
• Oregon:- One case.
• Pennsylvania:- No cases.
• Rhode Island:- No cases.
• South Carolina:- No cases.
• South Dakota:- One case.
• Tennessee:- No cases.
• Texas:- Fourteen (16) confirmed cases, including 2 deaths. The investigation continues, but no specific details are being provided on suspect cases.
• Utah:- No cases.
• Vermont:- No cases.
• Virginia:- One case.
• Washington State:- No cases.
• West Virginia:- One case. The recalled cantaloupes were not sold in West Virginia.
• Wisconsin:- Two (2) cases.
• Wyoming:- Three confirmed cases. One death. Illnesses were reported from Laramie and Sheridan counties. Onset dates of illnesses range from August 31st to September 15th.

As of October 7th, CDC and various states are reporting a total of 109 confirmed cases, 21 deaths and one miscarriage.

Many consumers across the US have asked me whether any of the recalled cantaloupes were shipped to their state or carried by their local supermarket. FDA reports that the recalled cantaloupes were distributed to the following 24 states: Arizona, Arkansas, Colorado, Idaho, Illinois, Indiana, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Dakota, Oklahoma, Pennsylvania, South Dakota, Tennessee, Texas, Utah, Wisconsin, and Wyoming. Secondary and tertiary distribution to other states cannot be ruled out. Jensen did not export any of the recalled cantaloupes.

For information on retail distribution of the recalled Jensen Farms cantaloupes, go to: Did Your Supermarket Sell Colorado Cantaloupes?

Eighteen people are dead and 100 individuals from 20 states have been diagnosed with listeriosis, according to the latest numbers released today by CDC. Four different strains of Listeria monocytogenes bacteria have been recovered from outbreak patients.

Most (92%) of the outbreak victims reported having eaten cantaloupe in the month before they developed their symptoms.

The outbreak is blamed on cantaloupes supplied by Jensen Farms, Inc., a Colorado grower and packer. Jensen recalled its cantaloupes on September 14th, after they were implicated in the Listeria monocytogenes outbreak.

Outbreak-related deaths occurred in Colorado (5), Kansas (2), Maryland (1), Missouri (1), Nebraska (1), New Mexico (5), Oklahoma (1), and Texas (2). The 100 confirmed illnesses were reported from Alabama (1), Arkansas (1) California (1), Colorado (30), Idaho (1), Illinois (1), Indiana (2), Kansas (7), Maryland (1), Missouri (3), Montana (1), Nebraska (6), New Mexico (13), North Dakota (1), Oklahoma (11), Texas (14), Virginia (1), West Virginia (1), Wisconsin (2), and Wyoming (2).

Additional cases of Listeria monocytogenes infections (i.e., listeriosis) – including additional fatal cases – remain under investigation by CDC and state and local health agencies. We can expect the case count and death toll to increase further.

The recalled cantaloupes were produced from the end of July to September 10th, according to FDA. They were shipped directly to consignees in 24 states: Arizona, Arkansas, Colorado, Idaho, Illinois, Indiana, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Dakota, Oklahoma, Pennsylvania, South Dakota, Tennessee, Texas, Utah, Wisconsin, and Wyoming. Secondary and tertiary distribution to other states cannot be ruled out. Jensen did not export any of the recalled cantaloupes.

On September 19th, FDA confirmed having found at least one  of the four Listeria monocytogenes outbreak strains in cantaloupes and environmental samples from the Jensen Farms packing facility. As of today, the agency still is conducting its “root-cause” investigation to determine how the cantaloupes became contaminated. FDA will report its findings once its investigation is complete.

During the past several days, more information has become available on the retail distribution of the recalled cantaloupes; most notably, several supermarket chains have posted notices on their websites to assure customers that they had NOT sold recalled cantaloupes.

While the Jensen Farms cantaloupes are nearing – or have reached – the end of their marketable shelf life, some consumers may still have recalled melons in their homes. People who are at high risk of listeriosis – including the elderly, the very young, pregnant women, and those with weakened immune systems – should be especially careful to avoid eating the compromised cantaloupes.

CDC offers the following advice to those who purchased – or think they purchased – cantaloupes that were implicated in this outbreak:

• Dispose of cantaloupes in a closed plastic bag placed in a sealed trash can. This will prevent people and animals from eating them. Do not attempt to wash off the Listeria, as it is possible the cantaloupe contains Listeria on the inside as well.
• Wash the inside walls and shelves of the refrigerator, cutting boards and countertops; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water;
• Dry with a clean cloth or paper towel that has not been previously used.
• Wipe up spills in the refrigerator immediately and clean the refrigerator regularly.
• Always wash hands with warm water and soap following the cleaning and sanitation process.

For more information on this outbreak and on Listeria monocytogenes, click on the Listeria Outbreak tab on the navigation bar at the top of the eFoodAlert blog.