The outbreak of Salmonella illnesses traced to eating sushi containing contaminated raw yellowfin tuna known as Nakaochi scrape has grown to encompass 200 confirmed illnesses in 21 states and the District of Columbia. Vermont was the latest state to be added to the list.

There is no longer even the slightest shadow of a doubt that the scrape yellowfin – which resembles ground tuna – is the source of this outbreak. Both FDA and the state of Wisconsin have confirmed the Salmonella Bareilly outbreak strain in food samples.

Two days ago, Wisconsin’s Department of Agriculture Trade and Consumer Protection laboratory reported confirming the presence of the outbreak strain of Salmonella Bareilly in the recalled yellowfin tuna and in a spicy tuna roll made with the recalled tuna. The DNA fingerprinting of the Salmonella was carried out by the Wisconsin State Laboratory of Hygiene, located at the University of Wisconsin – Madison.

Earlier today, FDA chimed in with its own announcement. FDA labs reported finding the Salmonella Bareilly outbreak strain in a sample of Nakaochi scrape yellowfin tuna obtained from a distributor of the raw fish product. The same sample contained a strain of Salmonella Nchanga that was indistinguishable from bacteria isolated from an additional cluster of 10 infections in 5 states. FDA also recovered Salmonella Bareilly from a sample of Nakaochi scrape yellowfin tuna obtained from a different distributor.

As a result of FDA’s lab findings, CDC has expanded its definition of the outbreak to include both Salmonella Bareilly and Salmonella Nchanga.

The raw tuna product was imported from India. On April 19th, FDA’s New Delhi office initiated a seafood (HACCP) inspection of the manufacturer’s facility (Moon Fishery Pvt Ltd, Aroor, India). The agency was informed that April 12, 2012 was the last day of tuna processing at the firm due to the seasonal nationwide ban on tuna harvest from the Indian Ocean. FDA has promised to post the inspection results once the report has been finalized.

CDC advises retailers and establishments not to serve raw recalled frozen raw yellowfin tuna product, known as Nakaochi Scrape, from Moon Marine USA Corporation. Establishments and retailers should check with their suppliers to confirm the source of the tuna product.

CDC offers the following Advice to Consumers

• Do not eat the recalled frozen raw yellowfin tuna product, known as Nakaochi Scrape, from Moon Marine USA Corporation. This product is tuna backmeat that is scraped from the bones of tuna and may be used to make sushi, particularly “spicy tuna” sushi.
• If you purchase “spicy tuna” or other sushi, sashimi, ceviche, or similar dishes that might contain Nakaochi Scrape tuna product from a restaurant or grocery store, check with the establishment to make sure that it does not contain raw recalled product from Moon Marine USA Corporation. When in doubt, don’t eat it.
• Persons who think they might have become ill from eating possibly contaminated raw Nakaochi Scrape tuna product should consult their healthcare providers.
• Infants, older adults, pregnant women, and persons with impaired immune systems are more likely than others to develop severe illness and should not eat raw or partially cooked fish or shellfish. If you are unsure of your risk, ask your healthcare provider.

Wisconsin’s Department of Agriculture Trade and Consumer Protection lab has recovered Salmonella from a sample of recalled tuna and from a spicy tuna roll made with the recalled tuna. The state’s Laboratory of Hygiene confirmed that the Salmonella found in both of these samples matches the DNA fingerprint of the outbreak strain of Salmonella Bareilly that has sickened more than 160 people in 20 states and the District of Columbia.

Moon Marine USA Corporation recalled 58,828 lbs of Nakaochi Scrape AA or AAA – a frozen raw yellowfin tuna product – on April 13th after epidemiological and traceback investigations carried out by federal, state and local authorities linked the product to a multistate outbreak of Salmonella Bareilly illnesses. The raw tuna product, which resembles ground tuna, was imported into the USA from India. FDA also issued two Import Alerts (#16-81 and #16-133) authorizing the detention without physical examination of fresh and frozen tuna from Moon Fishery India Pvt Ltd, the producer of the contaminated tuna meat.

The recalled product was not distributed for retail sale to consumers, but may have been used to make sushi, sashimi, ceviche and similar dishes available in restaurants and grocery stores. While the company name and “Nakaochi Scrape AA or AAA were printed on boxes of product supplied to distributors, the tuna may not be readily identifiable by consumers as being from implicated lots.

News of the Salmonella Bareilly outbreak first broke on April 3rd. As of the CDC’s last update (April 20th), 26 people are known to have been hospitalized out of the 160 confirmed case patients. Reported onset dates for illnesses range from January 28th to April 10th. The youngest outbreak victim is 4 years of age; the oldest is 78 years old. Two-thirds of the confirmed case patients are female.

Confirmed cases of Salmonella Bareilly illnesses have been reported mainly from the eastern half of the continental USA; the westernmost cases are in Texas. Wisconsin has confirmed 15 cases in three counties, including Milwaukee (6 cases), Washington (2 cases) and Waukesha (7 cases). Three Wisconsin residents were hospitalized; all 15 have recovered from their illnesses.

FDA has this advice for consumers:

• Because raw seafood is not fully cooked to assure that pathogens are destroyed, it is not considered as “safe” as cooked seafood. The handling of raw seafood can also affect the safety of the product. Because the tuna may have been broken into unmarked sublots and may not be readily identifiable, consumers should take precautions in choosing to eat raw Nakaochi Scrape and be sure that it is not from the implicated lots.
• If you purchase “spicy tuna” or other sushi, sashimi, ceviche, or similar dishes that might contain Nakaochi Scrape from a restaurant or grocery store, check with the establishment to make sure that it does not contain raw recalled product from Moon Marine USA Corporation, also known as MMI. When in doubt, don’t eat it.
• Consumers who think they might have become ill from eating possibly contaminated raw Nakaochi Scrape should consult their health care providers.