The United States is experiencing several major salmonella outbreaks connected to food and pets. Hundreds of people have gotten sick in dozens of states, and one death has been reported. The U.S. Centers for Disease Control and Prevention estimates that salmonella causes about 1.35 million infections every year, with about 420 deaths. Food is most often to blame, but pets can be a problem, too. What’s causing salmonella outbreaks this summer? One ongoing outbreak involves eggs that were produced in Texas and were sold in bulk and in grocery stores. Midwest Poultry Services has recalled more than 1.5 million dozen containers of shell eggs due to possible contamination. However, the U.S. Food and Drug Administration says (FDA) the producer does not account for all the illnesses, so it’s investigating to determine what the other sources may be. Another outbreak involves recalled jalapeno peppers grown in Sinaloa, Mexico, and distributed by Coast Citrus Distributors. There are also several outbreaks tied to animals: eight multistate outbreaks linked to contact with backyard chickens and ducks, as well as a much smaller outbreak tied to children handling pet veiled chameleons. Where are the outbreaks happening? Eggs In the outbreak linked with eggs, 98 cases with 26 hospitalizations have been reported in 17 states. The eggs were sold at Kroger stores in Texas and Louisiana; Brookshire Grocery stores in Texas, Oklahoma, Arkansas and Louisiana, and smaller retail operations in these states and in New Mexico and Mississippi. The eggs were sold under several brand names including Simple Truth, Brookshire’s, Country Morning, Kroger and Cal-Maine, with “sell by” or “best used by” dates between July 20 and August 17. Jalapeño peppers As of August 5, the CDC says, there have been 345 cases of salmonella linked to jalapeño peppers in 27 states, with 36 known hospitalizations. The CDC says the true number of cases is “likely much higher” than what’s being reported. Workers are still interviewing sick people to determine what they ate, but most reported eating at a Mexican-style restaurant such as Chipotle or Qdoba at some point between June 14 and July 14. Both companies said they have since stopped serving those products. On Sunday, Taylor Farms recalled products made with fresh jalapenos from Coast Citrus Distributors due to potential salmonella contamination. The jalapenos were used in salsas, cheese dips and sandwiches and were sold at Hannaford, Kroger, Target, Trader Joe’s, Walmart and Whole Foods stores in dozens of states. The products have best buy dates through August 16. “To date, Taylor Fresh Foods is not aware of any reported illnesses linked to its products containing jalapeños,” the company said. Backyard poultry The outbreaks connected to backyard poultry involve 814 people in 44 states. The only states not reporting a salmonella outbreak related to backyard flocks are South Carolina, New Mexico, Arizona, Delaware, Rhode Island and Hawaii. A quarter of those who have gotten sick were children under age five. The largest of these outbreaks had what the CDC called an “unusually high number of people reporting contact with ducks.” As of July 27, 201 cases have been serious enough to require care from a hospital, and one person has died. Chameleons The outbreak that involved veiled chameleons started in February, and the investigation was declared over in June. The pets were bought from different stores, and the cases were all among children under the age of three. Two children got sick in Nebraska, and single cases were reported in Iowa, Oklahoma and Texas. Two of the children had to be hospitalized, according to the CDC. How fast does salmonella set in? Salmonella symptoms typically start six hours to six days after someone comes into contact with the bacteria through contaminated food or drink, or by interacting with an animal or surface that is contaminated. People tend to get sicker faster with exposure to greater amounts of the bacteria. Salmonella on produce tends to be a lower dose than in prepared foods, which often are at high risk of cross-contamination and may be stored at incorrect temperatures for longer, allowing more of the bacteria to grow. What are the symptoms of salmonella? People who get salmonella typically develop stomach cramps, fever, nausea or vomiting, and they may have bloody diarrhea. They may also have painful, swollen joints or severe back pain. Some might feel the need to urinate more frequently and may have pain with urination. Night sweats, general discomfort and chest pain have also been reported. Symptoms typically last four to seven days. What should I do if I catch salmonella? Most people fully recover without treatment. More severe symptoms can happen in people with underlying conditions, those who are pregnant, the elderly, small children and those with suppressed immune systems. Some people with severe cases – with a high fever or incapacitating diarrhea that is bloody – may need to get care at a hospital. Antibiotics are not typically recommended for salmonella because the drugs can make you carry the bacteria longer, according to Dr. Elie Saade, an infectious disease specialist at University Hospitals in Cleveland. Patients “may get better, but the salmonella stays in their belly or their body for a longer time, so they remain infectious for a longer time,” Saade said. If the disease is severe, if it’s spread to the blood or if the patient has a weakened immune system, adults may get the antibiotics ciprofloxacin, azithromycin or ceftriaxone. Children are treated with amoxicillin or trimethoprim-sulfamethoxazole. Antidiarrheals like Imodium A-D can relieve cramping, but the medicine may also prolong diarrhea, so many doctors recommend sticking with rest and drinking lots of fluids. How can doctors tell if I have salmonella versus cyclosporiasis? Symptoms of salmonella can sometimes resemble those of cyclosporiasis, another foodborne illness that’s been making headlines lately. If there’s blood in the diarrhea, Saade says, that’s more likely salmonella. “Cyclospora usually will last more than more than a few days, and it’s usually on and off. In cyclospora, they will get better and then get diarrhea again,” he said. “With salmonella, they usually get really sick, and then they get better. It’s not on and off, and it’s just a few days.” Doctors can also do lab tests on a stool sample, but diagnosing an infection with cyclospora requires a specific molecular test that isn’t always included in routine stool cultures. Salmonella can spread among people, but cyclospora can’t. Doctors will ask whether a patient has had close contact with someone else who was diagnosed with salmonella. How do you prevent salmonella? “Clean, separate, cook and chill” are the words you want to remember to avoid salmonella. Clean your hands with soap and water for at least 20 seconds before and after handling food and pets like chickens, turtles and reptiles, which can carry the bacteria. In the kitchen, clean counters, cutting boards and utensils, particularly after touching raw meat or eggs. Wash vegetables like lettuce and jalapenos before using. Keep raw poultry, eggs, seafood and meat away from ready-to-eat foods like fruits and vegetables. You can cook salmonella out of food, but it must be thoroughly cooked – no runny or raw eggs. Use a food thermometer to make sure poultry is cooked to 165 F and ground meats or egg dishes to 160 F. If you’re cooking with chicken or eggs, Saade said, don’t then handle vegetables without washing your hands, to avoid cross-contamination. And if you get sick with salmonella, don’t cook for other people, because you can make them sick, too. Chill foods like eggs and meat. Get leftovers and other perishable foods into the refrigerator within two hours, and keep your refrigerator at 40 F or colder. As far as salmonella infections from pets, the CDC recommends that children under age 5 not have contact with chameleons. The agency also urges keeping backyard poultry and chameleon supplies and habitats clean, and suggests that no one of any age kiss or snuggle their chameleons or chickens. Why are there so many foodborne illnesses? Cases of salmonella have remained relatively stable over the past decade, according to a study of data from the U.S. Department of Agriculture’s Food Safety and Inspection Service. Salmonella bacteria is an organism that is a part of many animals’ natural flora. It doesn’t cause disease in them, but it can harm humans when our food or water comes into contact with those animals, or when humans directly interact with them. “The unfortunate reality of so many of our foodborne disease outbreaks is fecal contamination of our food, and that can come from a lot of different sources,” said Dr. Haley Oliver-Jischke, an expert in food safety who also serves as senior vice provost for academic and student success at Purdue University. Historically, there is a seasonality to foodborne illnesses, she said. “There’s cyclospora season, the season no one ever has ever wanted. Go away, cyclospora season. But that’s associated with temperature, so warmer weather,” Oliver-Jischke said. “We see a number of foodborne illnesses that actually track with warmer weather, and that’s its growing season, too. If the water’s warmer, the organisms like salmonella can grow in the warmer water, so they can get to higher numbers. So it’s really about the environment that the organisms are living in along with us.”
