Cucumber Salmonella Outbreak - Cases Now at 558 with 3 Deaths

CDC's last repost on the Salmonella outbreak associated with cucumbers had the case count at 558, with 112 requiring hospitalization and 3 deaths.  This number of cases per day has begun to decrease since the two associated recalls were issued on September 4th and September 11th, however looking at the EPI curve, this duration of this outbreak is close to 3 months.

The cucumbers were said to be imported from Mexico and were then packed by US produce companies for shipment across the county...resulting in illnesses in 33 states.

In 2014, there was a Salmonella outbreak associated with cucumbers from Maryland and in 2013, an outbreak of E.coli O157:H7 associated with slice cucumber on sandwiches.

The pH of cucumbers is approximately 6.  While there are limited studies on the growth of Salmonella on cut cucumbers, evidence suggests that there may be a slow increase in numbers when the product is stored at non-refrigerated temperatures.  This may compound the primary issue, which is that cucumbers are grown on or near the ground, and if that ground is contaminated, such as occurs when using improperly treated manure as a fertilizer, then that contamination is transferred to the cucumbers (via direct contact, hands, splashing water, little critters, etc) could adhere to the surface of the cucumber.  Using contaminated irrigation water can lead to contamination of the cucumbers.  Finally, cucumbers can become contaminated during handling and rinsing / hydrocooling.  Point source contamination issues in the packing house can spread that contamination to  a large number of cucumbers.  More study is needed on cucumbers and contamination issues associated with growing, harvesting, storage and consumer handling.
 

CDC News Release

http://www.cdc.gov/salmonella/poona-09-15/

Multistate Outbreak of Salmonella Poona Infections Linked to Imported Cucumbers

Posted September 22, 2015 3:15 PM ET

 

Highlights

Read the Recall & Advice to Consumers, Restaurants, and Retailers >>(http://www.cdc.gov/salmonella/poona-09-15/advice.html)

CDC, multiple states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Poona infections. This investigation is ongoing. CDC will provide updates when more information is available.

• 558 people infected with the outbreak strains of Salmonella Poona have been reported from 33 states, an increase of 140 cases since the last update on September 15.
• 112 ill people have been hospitalized, and three deaths have been reported from Arizona (1), California (1), and Texas (1).
• 52% of ill people are children younger than 18 years.
• Epidemiologic, laboratory, and traceback investigations have identified cucumbers imported from Mexico and distributed by Andrew & Williamson Fresh Produce as a likely source of the infections in this outbreak.
• Several recalls of cucumbers that may be contaminated with Salmonella have been announced as a result of this investigation.

On September 11, 2015, Custom Produce Sales voluntarily recalled all cucumbers sold under the Fat Boy label starting August 1, 2015. Unlabeled cucumbers packed into a black reusable plastic container, and sold in Nevada since August 1, 2015, are also covered by this recall. These cucumbers were sent to Custom Produce Sales from Andrew & Williamson Fresh Produce.

On September 4, 2015, Andrew & Williamson Fresh Produce voluntarily recalled all cucumbers sold under the “Limited Edition” brand label during the period from August 1, 2015 through September 3, 2015.

• Recalled cucumbers were distributed in the states of Alaska, Arizona, Arkansas, California, Colorado, Florida, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Minnesota, Mississippi, Montana, Nevada, New Jersey, New Mexico, North Dakota, Oklahoma, Oregon, South Carolina, Texas, and Utah. Further distribution to other states may have occurred.
• The type of cucumber that has been recalled is often referred to as a “slicer” or “American” cucumber and is dark green in color. Typical length is 7 to 10 inches. In retail locations the cucumbers are typically sold in a bulk display without any individual packaging or plastic wrapping.
• Photos of the packing cartons are available(http://www.cdc.gov/salmonella/poona-09-15/advice.html).

Consumers should not eat, restaurants should not serve, and retailers should not sell any of the recalled cucumbers.

If you aren’t sure if your cucumbers were recalled, ask the place of purchase or your supplier. When in doubt, don’t eat, sell, or serve them and throw them out.

CDC's National Antimicrobial Resistance Monitoring System laboratory conducted antibiotic resistance testing on clinical isolates collected from 6 ill people infected with the outbreak strains.

All (100%) were susceptible to all antibiotics tested on the NARMS panel.

CDC’s NARMS laboratory continues to conduct antibiotic resistance testing on additional isolates, and results will be reported when they are available

 

 

 

Washington Post

https://www.washingtonpost.com/news/to-your-health/wp/2015/09/23/another-person-dies-many-more-sickened-in-cucumber-salmonella-outbreak/

Another person dies, many more sickened in cucumber salmonella outbreak

 

By Elahe Izadi September 23

 

Three people have died and at least 558 people have been sickened in a salmonella outbreak linked to cucumbers imported from Mexico, federal health officials announced Tuesday.

 

Earlier this month, the Centers for Disease Control and Prevention announced two people had died and 418 people had been infected in the outbreak that has now been reported in 33 states.

 

Deaths occurred in Arizona, California and Texas, and more than half of the people sickened by salmonella poona are children, according to the CDC.

 

Laboratory tests have diagnosed additional infections after companies voluntary recalled garden cucumbers, the kind of dark green cucumbers typically sold in bulk display in grocery stores and measuring seven to 10 inches long.

 

[Can Twitter and Yelp really help spot a salmonella outbreak?]

 

On Sept. 11, Custom Produce Sales recalled cucumbers grown in Baja California and sold under the "Fat Boy" label and distributed in California, Colorado, Illinois, Iowa, Nevada, North Dakota, Oklahoma and Texas.

 

San Diego, Calif.-based Andrew & Williamson Fresh Produce announced a voluntary recall on Sept. 4. The cucumbers were distributed between Aug. 1 and Sept. 3, sold under the label "Limited Edition," and their cases indicated they were grown and packed by Rancho Don Juanito in Mexico.

 

Children, adults over 65 and people with weakened immune systems are most susceptible to getting severely ill from being exposed to the bacteria. Common systems include diarrhea, fever and abdominal cramps.

 

[Foodborne infections killed hundreds, hospitalized thousands last year]

 

The illness usually lasts between four and seven days, and many people don't require treatment, according to health officials. But salmonella can be deadly, particularly if a person doesn't receive antibiotics.

 

About 1.2 million people get sick and 450 die annually in the United States from salmonella exposure, according to CDC estimates.