Two nationwide salmonella outbreaks have occurred in
the past year. The first, in April through August 2008, involved
Salmonella Saintpaul. Although originally thought to be linked to
tomatoes, and causing an estimated $200 million loss in the tomato
industry, after months the outbreak was traced to contaminated imported
jalapeno and serrano peppers grown on a single farm in Mexico. Related
enteritis was diagnosed in 1,407 individuals in the U.S. and Canada; 2
deaths occurred in elderly patients.
On September 1, 2008, a second
food-related outbreak began, this time involving Salmonella
Typhimurium. More than 600 persons (see below) were
implicated by February 8, 2009. Further, for large salmonella
outbreaks, an estimated 38 additional unconfirmed cases likely occur,
suggesting that more than 20,000 people were likely affected. Hundreds of
patients have been hospitalized, and at least eight have died.
The outbreak was traced to contamination of peanut
butter from one producer in Georgia, the Peanut corporation of America.
Unfortunately, this producer provided bulk peanut butter or peanut paste
used in more than 1,790 products including cookies, crackers, candy, cereal,
ice cream and even pet food. Salmonella had been isolated during internal
quality-control sampling at this plant on at least 12 occasions in the past
year, with no action taken. As a result, the company is now under
criminal investigation.
Major national brands of jarred peanut butter found in
grocery stores are NOT affected and have NOT been recalled. To
determine whether a product has been recalled, check the FDA lookup tool
(above) or call the CDC's 24 hour line (1-800-CDC-INFO or 1-800-232-4636).
Symptoms of Salmonella infection include diarrhea, fever
and abdominal cramps. Symptoms began about 12 to 72 hours after
ingestion of the contaminated food and lasts 4 to 7 days. Hydration is
the focus of treatment in these cases. Infants, the elderly, and individuals
with impaired immune systems have a greater risk of developing a severe
infection that may spread from the intestines through the bloodstream to
other parts of the body. In severe cases, antibiotic treatment is
required.
An estimated 76 million U.S. residents will be
afflicted with a foodborne illness this year, causing 350,000
hospitalizations, 5,000 deaths, and $7 billion in health care expense.
While our food supply is highly regulated, we
can expect more. Promote
programs that:
Provide more effective monitoring of domestic and
imported food through adequate funding of federal and state inspection
programs.
Develop more sensitive and more rapid methods to
detect pathogens in food.
Require bar coding of all commercial foods to
permit rapid tracing from farm to processing plant to distribution
center.
Oppose the use of growth-promoting antibiotics
due to their association with increased antimicrobial resistance leading
to increased colonization of animals by enteropathogens.
Promote hygienic food-preparation through
education and increased local inspection and enforcement capacity.
Most importantly, promote routine
irradiation of eggs, milk, hamburger, poultry and raw vegetables.
Irradiation kills pathogens without affecting the nutritional value of
food. Despite public misconceptions, irradiation does
not make food toxic, does
not cause cancer, and does
not make food radioactive.
Reference:
Maki
DG: Coming to Grips with Foodborne Infection - Peanut Butter, Peppers, and
Nationwide Salmonella Outbreaks. N Engl J Med 2009; 10.1056.
