FDA Says It's Safe to Eat Tomatoes

(HealthDay News) -- U.S. health officiaSls on Thursday dropped their warning against eating fresh tomatoes, as the toll in the ongoing salmonella outbreak reached 1,220 confirmed cases, with at least 242 people hospitalized.

"As of today, FDA officials believe that consumers may now enjoy all types of fresh tomatoes available on the domestic market without concern about becoming infected with Salmonella saintpaul bacteria," Dr. David Acheson, associate commissioner for foods at the U.S. Food and Drug Administration, said during a Thursday afternoon teleconference.

But the warning against jalapeno and serrano peppers remains in effect for the largest foodborne outbreak in the United States in more than a decade, he said.

"We still do not know where the original contamination was," Acheson acknowledged during the teleconference.

Dr. Robert Tauxe, deputy director of the Division of Foodborne, Bacterial and Mycotic Diseases at the U.S. Centers for Disease Control and Prevention, said the outbreak may be winding down.

"The large salmonella outbreak is continuing with 20 to 30 new cases being reported each day," Tauxe said. "Although it appears that the outbreak is ongoing, and we do not have evidence that it's over, it does appear to have decreased in intensity beginning in mid-June."

When the outbreak began in April, early signs pointed to raw tomatoes -- particularly raw round, red tomatoes, plum or Roma tomatoes -- as the likely source of contamination. But Acheson said the ban was lifted Thursday, because it's highly unlikely that any tomatoes that were on the market at the start of the outbreak remain on the market. The FDA has found no samples of salmonella in tomatoes on any of the farms or in any of the packing houses investigated, he said.

As later cases of salmonella infection came in, more evidence seemed to point to peppers. As a result, the FDA, in cooperation with Mexican officials, has dispatched inspectors to a specific packer in Mexico that receives peppers from several farms, Acheson said.

According to the CDC, people stricken during the outbreak have ranged in age from under 1 to 99 years old, and 50 percent are female. The rate of illness has been highest among those 20 to 29 years old; it is lowest among adolescents 10 to 19 years old and people over 80.

According to the CDC's latest count as of July 16, the breakdown by state of ill people shows: Alabama (2 persons), Arkansas (16), Arizona (54), California (9), Colorado (16), Connecticut (4), Florida (2), Georgia (28), Idaho (6), Illinois (113), Indiana (16), Iowa (2), Kansas (18), Kentucky (1), Louisiana (1), Maine (1), Maryland (32), Massachusetts (26), Michigan (24), Minnesota (22), Mississippi (2), Missouri (17), New Hampshire (5), Nevada (11), New Jersey (12), New Mexico (102), New York (32), North Carolina (23), Ohio (10), Oklahoma (25), Oregon (10), Pennsylvania (12), Rhode Island (3), South Carolina (2), Tennessee (9), Texas (456), Utah (2), Virginia (31), Vermont (2), Washington (17), West Virginia (1), Wisconsin (13), and the District of Columbia (1). Five ill persons are from Canada; four appear to have been infected while traveling in the United States, and one individual remains under investigation.

CDC officials say that people at risk of infection, including infants and elderly people, should avoid eating jalapeno and serrano peppers. Raw jalapeno peppers are often used in the preparation of salsa, pico de gallo, and other dishes.

Salmonella is a bacteria that can cause bloody diarrhea in humans. Some 40,000 cases of salmonellosis are reported in the United States each year, although the CDC estimates that because milder cases aren't diagnosed or reported, the actual number of infections may be 30 or more times greater. Approximately 600 people die each year after being infected.

However, the strain of Salmonella saintpaul had been previously considered rare. In 2007, according to the CDC, there were only three people infected in the country during April through June.

Meanwhile, an Associated Press-Ipsos poll has found that the salmonella outbreak has unnerved many consumers, with nearly half of Americans saying they're worried they could get sick from eating contaminated food. And they're avoiding foods they'd normally buy.

Three-quarters of those polled said they remain confident about the overall safety of foods. But the poll also found that 86 percent of consumers back the idea of a "tracing" system for produce. This would allow for the labeling of produce so it could be tracked from the farm, through packers and shippers, to supermarkets. The lack of such a system has hampered federal officials in their efforts to determine the cause of the salmonella outbreak.

Meat and poultry have long been subject to enforceable federal safeguards, but fruits and vegetables are not, although produce increasingly is being implicated in outbreaks, the AP said.

More information
Visit the FDA for more on the salmonella outbreak.

Salmonella Illnesses Now Top 1,000

(HealthDay News) -- The number of people sickened in the ongoing salmonella outbreak has now surpassed 1,000, and while certain types of tomatoes remain the suspected cause, U.S. health officials on Wednesday added hot peppers and cilantro as potential suspects.

"We continue to get new reported cases every day," Dr. Robert Tauxe, deputy director of the division of foodborne, bacterial and mycotic diseases at the U.S. Centers for Disease Control and Prevention, said during a late afternoon teleconference. "This is the largest foodborne outbreak in the United States."

Since the outbreak began in April, 1,017 people in 41 states, the District of Columbia and Canada have fallen ill, and at least 203 people have been hospitalized. One death -- a Texas man in his 80s -- has been associated with the outbreak. Also, a man in his 60s who died in Texas from cancer had a Salmonella Saintpaul infection at the time of his death, the CDC reported Wednesday on its Web site.

In addition, according to the CDC, 300 of those people became ill after June 1.

An initial investigation of the outbreak, in New Mexico and Texas, suggested raw tomatoes as the likely source of the contamination. But a larger, nationwide study comparing persons who were ill in June found that those who were sickened were likely to have recently eaten raw tomatoes, as well as fresh jalapeno and serrano peppers, and fresh cilantro. These foods are typically consumed together, the CDC said.

Recently, many clusters of illnesses have been identified involving people who had eaten in restaurants. In one cluster, illnesses were linked to consumption of an item containing fresh tomatoes and fresh jalapeno peppers. In another two clusters, illnesses were linked to a food item containing fresh jalapeno peppers, leading federal officials to believe that jalapeno peppers caused some of the reported illnesses, the CDC said.

However, "at this we have not found any samples of tomatoes or peppers positive for Salmonella Saintpaul," Steve Sundlof, director of the U.S. Food and Drug Administration's Center for Food Safety and Applied Nutrition, told reporters at the teleconference.

Tauxe added, "Neither tomatoes nor jalapenos explain the entire outbreak at this point. We're presuming that both of them cause illness."

When it comes to tomatoes, officials said the advice to consumers remains the same: Avoid raw red plum, red Roma, round red tomatoes, and products containing these raw tomatoes.

On Wednesday, Tauxe added that people at risk of infection, including infants and elderly people, should avoid eating jalapeno peppers.

Salmonella is a bacteria that can cause bloody diarrhea in humans. Some 40,000 cases of salmonellosis are reported in the United States each year, although the CDC estimates that because milder cases are not diagnosed or reported, the actual number of infections may be 30 or more times greater. Approximately 600 people die each year after being infected.

However, the strain of Salmonella Saintpaul had been previously considered rare. In 2007, according to the CDC, there were only three people infected in the country during April through June.

More information
Visit the CDC for more on the salmonella outbreak.

Tomatoes May Not Be Only Source of Salmonella Outbreak

(HealthDay News) -- Experts at the U.S. Centers for Disease Control and Prevention now say they're no longer sure that the nationwide salmonella outbreak is due to tomatoes alone, or some other food source.

"Whatever this produce item is that's causing illness is probably still out there making people sick," Dr. Patricia Griffin, chief of the Enteric Diseases Epidemiology Branch at the CDC, told reporters late Friday at a special press teleconference. She did not say what source other than tomatoes, if any, might be suspected.

The number of people sickened in the outbreak has now jumped to 810 across 36 states, according to the latest CDC numbers presented Friday.

Health officials said the most recent reported case of infection with Salmonella Saintpaul occurred June 15. However, more illnesses may be waiting to be identified: According to experts, it typically takes an average of 16 days before doctors can pinpoint the onset of an infection.

The exact source of the outbreak remains unknown. Tomatoes are still considered the most probable cause, stressed Dr. David Acheson, the U.S. Food and Drug Administration's associate commissioner for food protection.

"The most recent case appeared to have onset just 12 days ago, and that raises the question is there something still out there that people are consuming that is leading to illness," he said. "Just because the outbreak is ongoing doesn't mean it can't be the tomatoes. It certainly could be the tomatoes, there's nothing to indicate that we should be looking at anything else," he said.

"We have no evidence that the outbreak is over... I would say that the source of contamination has been ongoing at least through early June and we don't have any evidence that whatever the source is has been removed from the market," Griffin said.

One factor complicating the search for the cause of the outbreak is a common industry practice called "repacking."

"Repacking is a situation in which a supplier or a distributor will repack tomatoes to meet a specific customer's request," Acheson explained. "So, if a customer is wanting small, ripe tomatoes and the supplier does not have a box of small ripe tomatoes, then they will typically go through multiple boxes and pull out ones that meet customers' specifications and repack them. It's a very, very common practice. We've seen reports that it may be as common as 90 percent of tomatoes get repacked, but we don't have confirmation that the number is that high. Obviously this complicates the trace-back," Acheson said.

He also said that it was possible that tomatoes were contaminated at a packing and distribution center, not a particular farm. That means that produce from states that have been cleared may have gone through packing or distribution houses elsewhere, and become contaminated there.

The food poisoning scare ranks as the largest on record in terms of illnesses linked to tainted produce, the CDC said. "This is so far the biggest outbreak with this number of illnesses confirmed by culture," Griffin noted.

More than 300 of the total cases from the current outbreak come from Texas. Patient ages range from under 1 year old to 99 years old. Half the victims are women.

In addition, at least 95 people have been hospitalized; there have been no deaths, the CDC reported.

The FDA had sent teams of investigators to Florida and Mexico as of last weekend to inspect farms, packing houses and distribution centers. There has been no word yet on what has been found.

The increase in people sickened by salmonella was not unexpected. Three weeks ago, the count was below 200; it jumped to more than 380 a week later.

The CDC had predicted last week that for every reported case, there would be 30 more that had gone unreported.

And health officials had warned that the end was not yet in sight.

"The marked increase is not due to new infections, but mainly because some states improved surveillance in response to this outbreak, and laboratory identification of many other previously submitted strains has now been completed," said Casey Barton Behravesh, an epidemiologist with the U.S. Centers for Disease Control and Prevention, during a June 19 teleconference.

According to the numbers on the CDC's Web site -- which do not include the latest cases -- the victim count breaks down by state to: Arkansas (10 persons), Arizona (38), California (10), Colorado (6), Connecticut (4), Florida (1), Georgia (15), Idaho (3), Illinois (66), Indiana (11), Kansas (11), Kentucky (1), Maryland (25), Massachusetts (17), Michigan (4), Missouri (12), New Hampshire (3), Nevada (4), New Jersey (4), New Mexico (80), New York (18), North Carolina (5), Ohio (3), Oklahoma (17), Oregon (7), Pennsylvania (6), Rhode Island (3), Tennessee (6), Texas (330), Utah (2), Virginia (22), Vermont (1), Washington (4), Wisconsin (6), and the District of Columbia (1).

On June 20, Acheson said the investigation into the outbreak had zeroed in on "a number of farms" in both Florida and Mexico.

Health officials have said all along that the bulk of the tomatoes available at the start of the outbreak in mid-April had come from Mexico and parts of Florida.

Salmonella is a bacteria that can cause bloody diarrhea in humans. Some 40,000 cases of salmonellosis are reported in the United States each year, although the CDC estimates that because milder cases are not diagnosed or reported, the actual number of infections may be 30 or more times greater. Approximately 600 people die each year after being infected.

However, the strain of Salmonella Saintpaul had been previously considered rare. In 2007, according to the CDC, there were only three people infected in the country during April through June.

More information
Visit the CDC for more on the salmonella outbreak.