2008 United States salmonellosis outbreak
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The 2008 United States salmonellosis outbreak was an outbreak of
salmonellosis Salmonellosis, more commonly known as food poisoning is a symptomatic infection caused by bacteria of the ''Salmonella'' type. It is also a food-borne disease and are defined as diseases, usually either infectious or toxic in nature, caused by a ...
across multiple
U.S. state In the United States, a state is a constituent political entity, of which there are 50. Bound together in a political union, each state holds governmental jurisdiction over a separate and defined geographic territory where it shares its sove ...
s due to ''
Salmonella enterica ''Salmonella enterica'' (formerly ''Salmonella choleraesuis'') is a rod-headed, flagellate, facultative anaerobic, Gram-negative bacterium and a species of the genus ''Salmonella''. A number of its serovars are serious human pathogens. Epidemi ...
''
serovar A serotype or serovar is a distinct variation within a species of bacteria or virus or among immune cells of different individuals. These microorganisms, viruses, or cells are classified together based on their surface antigens, allowing the ep ...
Saintpaul. Over the course of the outbreak, 1442 cases were identified across 43 U.S. states, the
District of Columbia ) , image_skyline = , image_caption = Clockwise from top left: the Washington Monument and Lincoln Memorial on the National Mall, United States Capitol, Logan Circle (Washington, D.C.), Logan Circle, Jefferson Memoria ...
, and
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by to ...
. The U.S. Centers for Disease Control and Prevention (CDC) investigation determined that jalapeño peppers imported from
Mexico Mexico (Spanish language, Spanish: México), officially the United Mexican States, is a List of sovereign states, country in the southern portion of North America. It is borders of Mexico, bordered to the north by the United States; to the so ...
as well as
Serrano pepper The serrano pepper ('' Capsicum annuum'') is a type of chili pepper that originated in the mountainous regions of the Mexican states of Puebla and Hidalgo. The name of the pepper is a reference to the mountains ('' sierras'') of these regio ...
s were major sources of the outbreak. Tomatoes may have been a source as well. The outbreak lasted from April to August, 2008.


Outbreak

From April 10 to August 31, 2008, ''Salmonella enterica'' serovar Saintpaul caused at least 1442 cases of
salmonellosis Salmonellosis, more commonly known as food poisoning is a symptomatic infection caused by bacteria of the ''Salmonella'' type. It is also a food-borne disease and are defined as diseases, usually either infectious or toxic in nature, caused by a ...
in 43 U.S. states, the
District of Columbia ) , image_skyline = , image_caption = Clockwise from top left: the Washington Monument and Lincoln Memorial on the National Mall, United States Capitol, Logan Circle (Washington, D.C.), Logan Circle, Jefferson Memoria ...
, and Canada.
New Mexico ) , population_demonym = New Mexican ( es, Neomexicano, Neomejicano, Nuevo Mexicano) , seat = Santa Fe, New Mexico, Santa Fe , LargestCity = Albuquerque, New Mexico, Albuquerque , LargestMetro = Albuquerque metropolitan area, Tiguex , Offi ...
and
Texas Texas (, ; Spanish: ''Texas'', ''Tejas'') is a state in the South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2020, it is the second-largest U.S. state by ...
had the greatest
prevalence In epidemiology, prevalence is the proportion of a particular population found to be affected by a medical condition (typically a disease or a risk factor such as smoking or seatbelt use) at a specific time. It is derived by comparing the number o ...
of disease with over 20 cases per million residents. The greatest number of reported cases occurred in Texas (559 reported cases), New Mexico (115),
Illinois Illinois ( ) is a state in the Midwestern United States. Its largest metropolitan areas include the Chicago metropolitan area, and the Metro East section, of Greater St. Louis. Other smaller metropolitan areas include, Peoria and Rock ...
(120), and
Arizona Arizona ( ; nv, Hoozdo Hahoodzo ; ood, Alĭ ṣonak ) is a state in the Southwestern United States. It is the 6th largest and the 14th most populous of the 50 states. Its capital and largest city is Phoenix. Arizona is part of the Fou ...
(59). Other significantly impacted states included
Georgia Georgia most commonly refers to: * Georgia (country), a country in the Caucasus region of Eurasia * Georgia (U.S. state), a state in the Southeast United States Georgia may also refer to: Places Historical states and entities * Related to the ...
(42 cases),
New York New York most commonly refers to: * New York City, the most populous city in the United States, located in the state of New York * New York (state), a state in the northeastern United States New York may also refer to: Film and television * '' ...
(41),
Maryland Maryland ( ) is a state in the Mid-Atlantic region of the United States. It shares borders with Virginia, West Virginia, and the District of Columbia to its south and west; Pennsylvania to its north; and Delaware and the Atlantic Ocean t ...
(39),
Oklahoma Oklahoma (; Choctaw: ; chr, ᎣᎧᎳᎰᎹ, ''Okalahoma'' ) is a state in the South Central region of the United States, bordered by Texas on the south and west, Kansas on the north, Missouri on the northeast, Arkansas on the east, New ...
(38),
Massachusetts Massachusetts (Massachusett: ''Muhsachuweesut Massachusett_writing_systems.html" ;"title="nowiki/> məhswatʃəwiːsət.html" ;"title="Massachusett writing systems">məhswatʃəwiːsət">Massachusett writing systems">məhswatʃəwiːsət'' En ...
(31), and
Virginia Virginia, officially the Commonwealth of Virginia, is a state in the Mid-Atlantic and Southeastern regions of the United States, between the Atlantic Coast and the Appalachian Mountains. The geography and climate of the Commonwealth are ...
(31). Five cases were reported in residents of
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by to ...
, four of whom appeared to have been infected after traveling to the United States. The outbreak resulted in at least 286 hospitalizations, and may have contributed to 2 deaths.


Contamination Source

In May, 2008 the CDC,
New Mexico Department of Health The New Mexico Department of Health (NMDOH) is the state agency charged with handling all medical and health related fields within the state of New Mexico in the United States. History In 1919, the first meeting of the State Board of Health o ...
,
Texas Department of Health Texas Department of State Health Services is a state agency of Texas. The department was created by House Bill 2292 of the 78th Texas Legislature in 2003 through the merging of four state agencies: the Texas Department of Health, Texas Department ...
, and the
Indian Health Service The Indian Health Service (IHS) is an operating division (OPDIV) within the U.S. Department of Health and Human Services (HHS). IHS is responsible for providing direct medical and public health services to members of federally-recognized Nativ ...
conducted a case-control study to identify foods associated with the disease outbreak. They found that salmonellosis was significantly associated with consuming raw tomatoes, but not with consuming salsa, guacamole, or any other food item. In June, a cluster of 33 cases associated with a restaurant-chain in Texas prompted the CDC and Texas Dept. of Health to conduct a second case-control study. Here they found illness to be significantly associated only with consuming a salsa containing canned tomatoes and raw jalapeño peppers, but not raw tomatoes. As other clusters of illness were identified, case-control studies were again performed to investigate the outbreak source. A multi-state case-control study in late June, 2008 associated illness with consumption of
pico de gallo ''Pico de gallo'' (, ), also called ''salsa fresca'' ('fresh sauce'), ''salsa bandera'' ('flag sauce'), and ''salsa cruda'' ('raw sauce'), is a type of salsa commonly used in Mexican cuisine. It is traditionally made from chopped tomato, onio ...
,
corn tortillas In North America, a corn tortilla or just tortilla (, ) is a type of thin, unleavened flatbread, made from hominy, that is the whole kernels of maize treated with alkali to improve their nutrition in a process called nixtamalization. A simple ...
, or fresh salsa. Another in
Minnesota Minnesota () is a state in the upper midwestern region of the United States. It is the 12th largest U.S. state in area and the 22nd most populous, with over 5.75 million residents. Minnesota is home to western prairies, now given over t ...
around the same time found that only raw jalapeño peppers were associated with illness. Additionally, in
Colorado Colorado (, other variants) is a state in the Mountain West subregion of the Western United States. It encompasses most of the Southern Rocky Mountains, as well as the northeastern portion of the Colorado Plateau and the western edge of the ...
, the outbreak strain was isolated from jalapeño peppers in the home of a man who had recently been ill. At this point, tomatoes and jalapeño peppers were considered the most likely source of the outbreak, however a similar study conducted by the North Carolina Division of Public Health found that illness in a cluster of 13 cases was associated with consumption of a guacamole which did not contain jalapeño peppers, but instead contained serrano peppers. In July, 2008 the CDC isolated the outbreak strain of ''Salmonella'' from jalapeño peppers at a distributor that distributed to restaurants associated with the outbreak, and found that the peppers had likely been imported from a farm in
Tamaulipas Tamaulipas (), officially the Free and Sovereign State of Tamaulipas ( es, Estado Libre y Soberano de Tamaulipas), is a state in the northeast region of Mexico; one of the 31 states which, along with Mexico City, comprise the 32 Federal Entiti ...
, Mexico. Later that month, the outbreak strain was isolated from serrano peppers from another farm in Tamaulipas. The outbreak strain could not be isolated from tomato samples from either of these farms, or any distributor that the CDC investigated. From all of this, the CDC concluded that the major sources of contamination were jalapeño peppers and serrano peppers, while tomatoes may have been an additional source early in the outbreak. The Mexican Agriculture Ministry had contested the findings of the CDC, claiming that the CDC samples were invalid as they were taken after the harvest.


Response

On June 3, in response to early case-control studies, the U.S.
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
(FDA) issued an advisory recommending that consumers in New Mexico and Texas avoid eating some types of raw tomatoes. On June 7, they expanded this advisory to include consumers nationwide. On July 9, the FDA issued a similar nationwide advisory not to consume raw jalapeño peppers. On July 30, this recommendation was narrowed to peppers grown or packed in Mexico. In response to the outbreak and the FDA and CDC investigations, some distributors recalled affected produce items. On July 19, Grande Produce, LTD announced a recall of jalapeño peppers, serrano peppers, and avocados which has been distributed between May 17 and July 17. Soon thereafter, on July 21 Agricola Zaragoza, Inc. of Texas announced a recall of jalapeño peppers distributed after June 30.


See also

*
Salmonellosis Salmonellosis, more commonly known as food poisoning is a symptomatic infection caused by bacteria of the ''Salmonella'' type. It is also a food-borne disease and are defined as diseases, usually either infectious or toxic in nature, caused by a ...
* 1985 United States salmonellosis outbreak *
List of foodborne illness outbreaks This is a list of foodborne illness outbreaks. A foodborne illness may be from an infectious disease, heavy metals, chemical contamination, or from natural toxins, such as those found in poisonous mushrooms. Deadliest * List of foodborne illness ...


References

{{Consumer Food Safety 2008 disease outbreaks Disease outbreaks in the United States Salmonellosis 2008 disasters in the United States