Salmonella Tomato Outbreak Biggest Ever

Source of Largest Salmonella Outbreak in U.S. History May Never Be Found, Says FDA

From the WebMD Archives

June 27, 2008 -- The salmonella outbreak in tomatoes isn't over and it's already the largest salmonella outbreak the CDC has ever tracked, in terms of lab-confirmed reported illness.

Since the outbreak began in April, the CDC has gotten reports of 810 people in 36 states and Washington, D.C., sickened by Salmonella saintpaul, the outbreak's rare strain of salmonella.

The most recent onset of illness was June 15, and that may not be the last case, since the CDC gets reports of illness about 16 days after an illness starts, says Patricia Griffin, MD, chief of the CDC's enteric diseases epidemiology branch.

Griffin notes that in 1985, a salmonella outbreak in milk sickened more than 16,000 people, but those cases weren't all confirmed by lab tests, unlike the number of cases in the current salmonella tomato outbreak.

Salmonella infection (salmonellosis) can cause diarrhea (which may be bloody), fever, nausea, vomiting, and abdominal pain. Symptoms typically start 12-72 hours after infection.

Salmonella Tomato Source Unknown

The FDA hasn't found the source of the tomato salmonella outbreak -- and they admit they may never find it.

On June 20, the FDA sent investigators to several farms in Florida and Mexico. Those investigators were assigned to probe not only the farms, but the entire distribution chain from plant to plate.

"It's important to control expectations and it's possible that this investigation may not provide a smoking gun that enables us to pinpoint the source of the contamination," David Acheson, MD, the FDA's associate commissioner for foods, said at a news conference today.

Part of the problem, Acheson says, is a practice called "repacking," in which suppliers or distributors repack boxes of tomatoes to fit customers' requests. That leads to tomatoes from various sources, domestic and imported, getting mixed together in the repacked boxes, making it hard to trace where the tomatoes have been and where the contamination may have occurred.

So far, the FDA teams have collected about 1,700 samples for testing -- none of which have shown any signs of Salmonella saintpaul.

Acheson says it's "not that unusual" for the source of tomato outbreaks to elude investigators.

"We've dealt with a number in the past and it's not that infrequent for us to be unable to actually trace back specifically to the source," says Acheson. "The whole repacking issue is one of the major reasons why this is so difficult."

Health officials are also looking at products such as salsa and guacamole that contain raw tomatoes, according to media reports.


Safe Tomato List

Officials are still searching for the source of the salmonella tomato contamination. Meanwhile, not all tomatoes are off limits.

Cherry tomatoes, grape tomatoes, and tomatoes sold while still on the vine, and homegrown tomatoes -- from any area -- have been on the "safe" list all along.

If you're looking for raw red round tomatoes, raw red plum tomatoes, or raw red Roma tomatoes, the FDA recommends only eating those from the following sources, which haven't been linked to the outbreak:

  • Alabama
  • Alaska
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida from the counties of: Jackson, Gadsden, Leon, Jefferson, Madison, Suwannee, Hamilton, Hillsborough, Polk, Manatee, Hardee, DeSoto, Sarasota, Highlands, Pasco, Sumter, Citrus, Hernando, and Charlotte
  • Georgia
  • Hawaii
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • Ohio
  • Oklahoma
  • Pennsylvania
  • South Carolina
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Belgium
  • Canada
  • Dominican Republic
  • Guatemala
  • Israel
  • Mexico (from the states of Aguascalientes, Baja California Norte, Baja California Sur, Campeche, Colima, Chiapas, Chihuahua, Distrito Federal, Durango, Guanajuato, Guerrero, Hidalgo, México, Michoacán, Morelos, Nayarit, Nuevo León, Oaxaca, Puebla, Querétaro, Quintana Roo, San Luis Potosí, Sonora, Tobasco, Tamaulipas, Tlaxcala, Veracruz, Yucatán, and Zacatecas
  • Netherlands
  • Puerto Rico

The FDA has been updating this list frequently. You can check for updates on the FDA's web site.

Keep in mind that even if you live in a state that's on the "safe" tomato list, the tomatoes in your stores may not have come from your local area. What matters is where the tomatoes were grown and harvested, not where they were sold.

WebMD Health News Reviewed by Brunilda Nazario, MD on June 27, 2008



David Acheson, MD, associate commissioner for foods, FDA.

Patricia Griffin, MD, chief, Enteric Diseases Epidemiology Branch, CDC

FDA: "Salmonellosis Outbreak in Certain Types of Tomatoes."

WebMD Health News: "Salmonella Tomato Update: Farms Probed."

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