The multistate outbreak of Salmonella Bareilly illness that was first reported yesterday now stands at 93 people infected in 19 states and the District of Columbia, according to an Investigation Announcement just released by CDC.

Illnesses have been confirmed in Alabama (2), Arkansas (1), Connecticut (4), District of Columbia (2), Georgia (4), Illinois (8), Louisiana (2), Maryland (8), Massachusetts (4), Mississippi (1), Missouri (1), New Jersey (6), New York (23), North Carolina (2), Pennsylvania (2), Rhode Island (4), South Carolina (3), Texas (3), Virginia (5), and Wisconsin (8). Ten outbreak victims have been hospitalized. Seventeen of the 23 New York cases were reported from outside of the New York City area.

The number of confirmed cases will grow. eFoodAlert already has been told by the Connecticut Department of Public Health that they have identified five victims (compared with the total of four victims reported by CDC in that state).  None of the Connecticut outbreak victims were hospitalized. Investigations and food trace back activities are still underway in a number of states, including California, which is not one of the 19 states to have reported cases.

Illness onset dates range from January 28 to March 23, 2012. The youngest confirmed patient is 4 years old; the oldest is 78. Among the people for whom a food history is available, 69% reported eating sushi, sashimi or similar foods in the week before illness onset. This compares with a survey of healthy people in which only 5% reported having consumed these types of food.

CDC reports that the investigation has not yet conclusively identified a food source. Federal, state and local health officials are continuing to identify and interview other outbreak victims.

At this stage in the investigation, CDC has no specific advice or recommendations for the public, and is not suggesting that consumers avoid eating any particular foods.

At least 90 people in 19 US states and the District of Columbia have been infected with a single outbreak strain of Salmonella Bareilly, according to a preliminary report released this morning by CDC.

The first illness occurred on January 28th, and many of the confirmed outbreak patients reported consuming sushi, sashimi or similar foods in a variety of locations in the week before becoming ill. The investigation, CDC says, has not “conclusively identified a food vehicle.” This is an ongoing investigation and state public health officials are continuing to interview outbreak victims.

The news leaked yesterday (April 3, 2012) via a memo that was inadvertently circulated throughout FDA, spokesperson Curtis Allen told JoNel Aleccia of msnbc.com.

A survey of state health agencies, combined with the information contained in the original FDA memo and today’s CDC news release has yielded the following information as of April 4, 2012:

1. Confirmed cases have been reported by Texas, the District of Columbia, Maryland, Rhode Island, Connecticut, Wisconsin, Missouri, New York State and Louisiana. The remaining eleven affected states have not yet been identified.
2. No confirmed cases have been reported, and no suspect cases are currently under investigation, in Alaska, Arizona, Hawaii, Idaho, Iowa, Maine, Minnesota, Nebraska, Nevada, New Hampshire, Oklahoma, or Utah.
3. Restaurant-associated illness clusters were identified in Texas, Wisconsin, Maryland and Connecticut. Illness clusters of this nature are often instrumental in determining the source of an outbreak strain.
4. New York State has confirmed 17 cases of Salmonella Bareilly, excluding cases that may have been detected in New York City, which is served by its own Department of Health. The earliest case reported to New York State (outside of NYC) became ill on March 1st. One of the 17 New York State cases was hospitalized; the victim has since been discharged and is recovering. No additional cases are under investigation by the state’s Department of Health.
5. Louisiana has reported two confirmed cases – one male and one female – both of whom were hospitalized and are described as “doing well.” No additional cases are under investigation in Louisiana at this time. Both Louisiana victims fell ill in mid February.
6. Connecticut has identified five outbreak-associated cases, according to Department of Public Health spokesman William Gerrish. The five victims fell ill in mid-February and early March. None of the Connecticut victims were hospitalized.

While early media reports have pointed an accusing finger at spicy tuna roll sushi, it is too early to conclude that this is the definitive source of the outbreak. Even if the sushi proves to be a common element, FDA will need to carry out a trace-back investigation to determine – if possible – which component of the sushi roll may have been contaminated.

New York State spokesman Peter Constantakes declined to comment on the possible association between the outbreak and the consumption of tuna roll sushi, preferring to defer to CDC, which is the lead investigating agency for the outbreak. Louisiana spokesperson Speakes confirmed that one of the two Louisiana victims reported having eaten spicy roll sushi; there was no food history available from the other victim.

CDC has “no specific advice to consumers” at this time. The public is NOT being advised to avoid any specific foods or restaurants.