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An Update on the Produce-Associated Outbreak with Salmonella Saintpaul

What is the status of the outbreak?

The Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA) and state/local regulatory officials are working together to investigate an ongoing multi-state outbreak of Salmonella serotype Saintpaul. The initial epidemiologic investigation was linked to consumption of raw red plum tomatoes, red Roma tomatoes, round red tomatoes, and products containing these raw tomatoes. However, more recent illnesses have broadened the investigation to include other food ingredients as potential sources of the Salmonella (including jalapeño peppers, serrano peppers, and cilantro). Since mid-April, 1251 persons have become infected with Salmonella Saintpaul in 43 U.S. States, the District of Columbia, and Canada, and, 203 people have been hospitalized. The outbreak is ongoing and about 25-40 new cases are reported each day.    This is not the first documented outbreak linking Salmonella with tomatoes. Since 1990, 13 large, multi-state foodborne outbreaks and some small local outbreaks have been associated with different varieties of tomatoes. In the past decade, outbreaks involving contaminated tomatoes made up 17 percent of the total produce-related outbreaks. Salmonella has been the pathogen of concern most often associated with outbreaks involving tomatoes. To date, the economic impact to the fresh tomato industry exceeds $100 million.

 On July 21, 2008, there was a new breakthrough on this outbreak when FDA announced that the outbreak strain, Salmonella Saintpaul, was found on a jalapeño pepper sample at a produce distribution center in McAllen, Texas. The pepper was grown on a farm in Mexico, however, that does not mean that the pepper was contaminated in Mexico. The produce distribution center, Agricola Zaragoza, is working with FDA to voluntarily recall jalapeño  peppers the company distributed since June 30, 2008.   At this time, it is unclear whether peppers, tomatoes, or both have been involved in this multi-state outbreak.  

What is Salmonella?

Salmonella is a bacterium that is found in the intestinal tract of certain animals and humans. There is a widespread occurrence in animals, especially in poultry and swine. Environmental sources of the organism include water, soil, insects, food processing equipment surfaces, kitchen surfaces, animal feces, raw meats, raw poultry, and raw seafood. There are over 2300 different types of Salmonella and all of them can be potentially infectious to humans if consumed. Salmonella Saintpaul, the organism associated with the recent tomato outbreak, is very rare and is uncommonly associated with foods. 

People who have eaten food contaminated with Salmonella often have fever, diarrhea (which may be bloody), nausea, vomiting, and abdominal pain.  Symptoms can begin 6 to 48 hours after the contaminated food is consumed. In some cases, the bacterium can get into the bloodstream and cause more severe illness.  Illness is often more serious, and may be fatal, in young children, elderly people, and people with weakened immune systems.

How can tomatoes or peppers become contaminated?

For this outbreak, the source of contamination has not yet been determined. However, there are a wide variety of possible sources of contamination during growing, during distribution, and while in storage.   Since the original source of Salmonella is from animals (including humans), on-farm sources could include animal manure, people (during harvest operations and handling operations), water (from irrigation and washing sources), contaminated soil, and rodents. During handling operations, contamination could occur from people, from a variety of different water sources, and/or from contaminated equipment or transport vehicles. Once Salmonella has contaminated something, it can be spread very easily from surface to surface. The organism can survive on food surfaces, in the soil, and in water for months. 

What food safety programs are in place to prevent produce-related outbreaks?

Within the past decade, there has been a growing interest relative to produce safety from regulatory agencies and from the food industry. As a result, a wide variety of new food safety programs and guidance documents are available.   In 1998, the FDA published the Guide to Minimize Microbial Contamination of Fresh Fruits and Vegetables - now more commonly referred to as the “Good Agricultural Practices” (GAPs) (http://www.cfsan.fda.gov/~dms/prodguid.html). This document describes potential sources of microbial contamination in growing fields and packing houses and provides recommendations for how to reduce or minimize opportunities for contamination.

Educational programs for the food industry and guidance for safe handling practices are also available as part of the National GAPs program (http://www.gaps.cornell.edu/), led by a team of faculty at Cornell University and 27other universities. Specific recommendations for consumers and associated links can be found at a FDA website

 

In 2007, the FDA announced a Tomato Safety Initiative. The Initiative is a collaborative effort between the FDA and the state health and agriculture departments in Virginia and Florida, in cooperation with several universities and the produce industry. The Tomato Safety Initiative (http://www.cfsan.fda.gov/~dms/tomsafe2.html) seeks to identify practices or conditions that potentially lead to contamination of tomatoes, and what steps producers are taking to address these issues. Information from the Initiative will allow the FDA to continue to improve its guidance and policy on tomato safety. The Initiative supports an important goal in the 2004 FDA Produce Safety Action Plan  (http://www.cfsan.fda.gov/~dms/prodpla2.html) which is to minimize the incidence of foodborne illness associated with the consumption of fresh produce

 

Raw peppers are rarely involved in produce food safety outbreaks, and, no specific food safety initiatives has been developed specifically for the growing, harvesting, and handling of raw peppers.

What can consumer and retailers do to minimize their risk?

Initially, the focus was on tomatoes. FDA provided recommendations for  food-service providers, restaurants operations, other retailers, and consumers and suggested that they should discard raw red plum tomatoes, raw red Roma tomatoes, and raw red round tomatoes, unless they were grown, harvested, and packed in a region found not to be associated with the outbreak. An up-to-date list is being provided by FDA to help retailers and restaurant operations: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html#retailers.  Food containing any type of tomato, from any region, that has been heat processed, bottled, or canned within a food-processing facility (i.e. canned tomatoes, tomato juice, and salsa) is safe to consume.

Guidance was also been provided for the handling of fresh tomatoes not associated with the outbreak. All fresh tomatoes should be refrigerated at 41° F (5° C) or less.   This would include tomatoes used as ingredients for salsa, as an ingredient in salads, and those that are used on sandwiches. Refrigeration cannot be used to eliminate pathogenic bacteria like Salmonella, but it can be used to minimize the growth of pathogenic bacteria if they are present.   Retail food establishments and consumers should not attempt to cook tomatoes involved in this outbreak in an effort to kill Salmonella. Even though proper cooking would destroy Salmonella, the risk of cross-contamination during food preparation and service is high.   Retail food establishment and consumers should also not attempt to wash tomatoes in an effort to remove Salmonella. Salmonella attaches very firmly to the surface of tomatoes, and it is very difficult to remove. Therefore, traditional produce washing procedures are not likely to completely eliminate it.

Now the focus is on jalapeño peppers. FDA is currently working with the food industry to recall potentially contaminated  jalapeño peppers. However, since a food recall may not remove all potentially contaminated peppers, FDA is also recommending that consumers avoid eating raw jalapeño peppers or foods made from raw   jalapeño peppers until further notice. This recommendation is only for raw peppers and not cooked or pickled jalapeño peppers.   In addition, FDA is continuing to advise immune-compromised populations, (elderly, infants, pregnant women, people with impaired immune systems) to avoid eating raw serrano peppers or food made from raw serrano peppers.

Because the outbreak is still under investigation, updated information is being provided on a FDA website (http://www.fda.gov/oc/opacom/hottopics/tomatoes.html) and on a CDC website (http://www.cdc.gov/salmonella/saintpaul/). These are excellent sources of information for people who want to keep informed about future developments in the investigation of this outbreak.

 

 

Richard H. Linton, Ph.D.
Professor of Food Safety
Director of the Center for Food Safety Engineering

                                       Purdue University, West Lafayette, IN USA  

Original Posted Date of Article: July 8, 2008

Updated: July 21, 2008