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Tuesday, January 30, 2024

CDC - Salmonella Outbreak Associated with Cantaloupes is Over, 407 Reported Cases

CDC released notice that the 2023 Salmonella outbreak linked to cantaloupes is over.  Cases were first identified in October 2023, with recalls being issued in November, 2023 by SOFIA PRODUCE, LLC, of Nogales, Arizona which does business under the name “Trufresh”.

FDA testing did link the company to the outbreak, but little additional information from the investigation was found.





https://www.cdc.gov/salmonella/sundsvall-11-23/index.html
Salmonella Outbreak Linked to Cantaloupes
January 19, 2024
This outbreak is over

Fast Facts
Illnesses: 407
Hospitalizations: 158
Deaths: 6
States: 44
Recall: Yes


Investigation status: Closed (first posted on November 17, 2023)

January 19, 2024

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Salmonella (Sundsvall and Oranienburg) infections.

Epidemiologic, laboratory, and traceback data showed that cantaloupes were contaminated with Salmonella made people sick.

As of January 19, 2024, this outbreak is over.

Epidemiologic Data

A total of 407 people infected with one of the outbreak strains of Salmonella were reported from 44 states (see map). Illnesses started on dates ranging from October 15, 2023, to December 25, 2023 (see timeline). Of 362 people with information available, 158 (44%) were hospitalized. Six deaths were reported

The true number of sick people in this outbreak was likely much higher than the number reported, and the outbreak may not have been limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella.

Public health officials collected many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provided clues to help investigators identify the source of the outbreak.

The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).

Demographics InformationTable of demographic information (n is the number of people with information available)

Age
(n=404) Range from <1 to 100 years
Median age of 60 years
26% are 5 years or younger
47% are 65 years or older

Sex
(n=406) 45% male
55% female

Race
(n=321) 84% White
10% African American/Black
4% Asian
1% Native American or Alaska Native
<1% reported more than one race

Ethnicity
(n=328) 85% non-Hispanic
15% Hispanic

State and local public health officials interviewed people about the foods they ate in the week before they got sick. Of the 197 people interviewed, 135 (69%) reported eating cantaloupe. This percentage was significantly higher than the 19.6% of respondents who reported eating cantaloupe in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. Of the 134 people who reported eating cantaloupe, 67 people specifically reported eating pre-cut cantaloupe and 40 reported eating whole cantaloupe. Fifty-two people resided at long-term care facilities when they got sick. Among 24 of these people interviewed, 12 reported eating cantaloupe. Forty-four children attended childcare centers when they got sick. Of 34 children with information available, 19 ate cantaloupe.

Laboratory Data

WGS analysis of bacteria from 405 people’s samples did not predict resistance to any antibiotics. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.

Canada also investigated this Salmonella outbreak and linked the illnesses to cantaloupes. The strain that caused illnesses in Canada was the same strain as the U.S. illnesses.

Public Health Action

Several recalls of cantaloupe products were issued as a result of this investigation:
On November 1, 2023, Malichita brand cantaloupes were recalled in Canada.
On November 8, Trufresh recalled Malichita brand whole cantaloupes that were sold to US businesses between October 16 and October 23.
On November 15, Trufresh expanded their recall to include additional whole cantaloupes.
On November 14, Vinyard Fruit and Vegetable Company recalled pre-cut fruit products and ALDI recalled [PDF – 2 pages] its whole cantaloupe, cantaloupe chunks, and pineapple spears.
On November 22, 2023, Trufresh expanded their recall again to include all Malichita brand and Rudy brand whole cantaloupes. Crown Jewels recalled Malitchita brand whole cantaloupes. CF Dallas recalled pre-cut fruit products containing recalled cantaloupes.
On November 27, 2023, Kwik Trip recalled pre-cut cantaloupe and fruit mixes.
On November 28, Bix Produce recalled pre-cut fruit cups.
On November 29, GHGA recalled pre-cut cantaloupe products sold at Kroger, Sprouts Farmers Market, and Trader Joe’s.
On November 30, Cut Fruit Express recalled pre-cut cantaloupe products with use-by dates from November 4 through November 6.
On December 5, TGD Cuts recalled pre-cut cantaloupe products with use-by dates from November 2 through November 24.
Stop & Shop recalled cantaloupes purchased from October 23 through November 11.

https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-salmonella-cantaloupes-november-2023
Outbreak Investigation of Salmonella: Cantaloupes (November 2023)
Current Update
January 19, 2024

The FDA and CDC, in collaboration with Canadian, state and local partners, investigated an outbreak of Salmonella infections linked to recalled cantaloupe.

As part of this investigation, FDA and industry partners worked together to collect and analyze samples of cantaloupe. Two of the samples were positive for Salmonella Sundsvall, and Whole Genome Sequencing (WGS) analysis confirmed that the strain of Salmonella found in isolates associated with these two samples matched the same strain of Salmonella found in ill people. One isolate tested positive for Salmonella Newport; however, it was not associated with the outbreak. Industry’s cooperation in collecting and sharing samples with FDA for further analysis provided additional information that helped resolve this outbreak. 

As of January 19, 2024, CDC announced that the outbreak is over. CDC reports a total of 407 illnesses in 44 states. There has been a total of 158 hospitalizations and 6 deaths associated with this incident. The last illness onset was December 25, 2023. FDA’s investigation is complete.

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