Image by Mike Ljung from Pixabay
The U.S Food and Drug Administration (FDA) is currently investigating a Salmonella outbreak involving the rare Salmonella Africana strain. Today, a recall was announced for certain whole cucumbers due to “possible health risk” – Salmonella.
Could these two announcements be related?
Most people think poultry when the topic of Salmonella contamination comes up. But surprisingly, cucumbers and Salmonella have been linked to several outbreaks in the last ten years.
It is not a stretch then, for cucumbers to be linked to this outbreak.
Currently, the FDA is investigating this possible connection.
Very limited information is available for the active Salmonella Africana outbreak investigation. When the outbreak was first announced on May 22, 2024, 100 cases were identified.
A recent update increased the associated case count to 141. So far, the FDA says that while these cases are linked, the illnesses are not yet linked to an identified product. The investigation, however, is reported as “ongoing” and still within the FDA Traceback Initiation phase.
This status could possibly change as more information comes in about the samples from a new cucumber recall.
Fresh Start Produce Sales Inc, of Delray, Florida issued a recall on May 31, 2024 for select whole cucumbers due to potential contamination with the harmful bacterium, Salmonella.
The recalled product consists of bulk cartons of dark green cucumbers. Affected products were shipped between May 17, 2024, and May 21, 2024, directly to retail distribution centers, food service distributors, and wholesalers in select states.
These include:
These cucumbers are dark green, and measure approximately 5 – 9 inches in length and around 1.5 – 2.0 inches in diameter. No mini cucumbers or English cucumbers are included in this recall.
The announcement indicates that these recalled products are unlikely to be in the marketplace. Likely because they were primarily shipped to retailers, food service distributor, and through distribution networks that presumably have already been notified and removed from commerce.
However, any consumer who does have recalled product should not consume it. If you are unsure if the cucumbers you have purchased are recalled, reach out to your retailer or place of purchase to confirm before eating. If you have a suspicious product, store it separately from other food in your home.
Recalls happen for a reason. Most of the time, the manufacturer or producer suspects there is something potentially dangerous going on with the product. This could be due to internal investigations or observed deviations from protocol. When this happens, the company can issue a voluntary recall to remove it from the marketplace and prevent additional adverse events or illnesses.
In some cases, however, routine testing by governmental agencies prompts a recall.
This was the case for the Fresh Start Produce Sales, Inc. whole cucumber recall.
Fresh Start Produce Sales, Inc. was notified of a positive screening result during routine sampling activities by the Pennsylvania Department of Agriculture. Samples obtained from their whole cucumbers were positive for the harmful bacteria, Salmonella.
Additional laboratory analysis to determine the genetic fingerprint of that bacteria was referred to the FDA. This specific genetic information can be used to link closely related patient samples to the contaminated cucumber samples.
Could this be related to the current Salmonella Africana outbreak? These agencies seem to think so.
“The FDA is conducting whole genome sequencing to determine if this sample is related to an ongoing Salmonella outbreak investigation.”
What exactly is Salmonella? How do you know if you have it? What can you do if you do have it?
We’ve got answers to your most asked questions.
While the specific strain of Salmonella Africana is quite rare, Salmonella as a whole, is fairly common.
The CDC estimates that Salmonella bacteria is the source for about 1.35 million illnesses in the United States each year. This results in around 26,500 hospitalizations and around 420 deaths.
The most common source?
Food.
Common sources of Salmonella infections:
Symptoms of salmonellosis, the illness associated with Salmonella Africana infection, often includes the typical diarrheal symptoms.
Common symptoms include:
People usually begin feeling sick anywhere from 6 hours to 6 days after exposure. These symptoms usually last about a week (around four to seven days).
Certain groups of people are at greater risk of infection if exposed to Salmonella bacteria or more likely to become seriously ill and experience complications.
Those at greater risk of infection when exposed include:
Those at greater risk of serious illness or complications include:
Additionally, certain people with stomach or bowel disorders may be more vulnerable to infection if exposed. The body is designed to produce strong stomach acids to kill many types of harmful bacteria, such as Salmonella Africana. However, certain medical conditions or medications to treat medical conditions can negate these innate defenses.
Contributing factors may include:
Certain preexisting medical conditions and medications can weaken your immune system, leaving you more vulnerable to Salmonella infection or subsequent complications. Immune issues impact your body’s natural response to infection and disease.
Conditions or medications that impact the immune system include:
While Salmonella infections aren’t usually life-threatening, certain life-threatening complications can result from infection. Dehydration, bloodstream infections, and reactive arthritis are among the top complications that can arise from Salmonella Africana (or any other strain of Salmonella) infection.
With illnesses involving diarrhea and vomiting, dehydration is a huge issue. When you can’t drink enough fluid to replace what you are losing from diarrhea, you may become dehydrated.
Look out for dehydration warning signs.
These warning signs may include:
If Salmonella bacteria leaves the intestines and enters your bloodstream, it can move throughout your body and affect other tissues. This can happen when tissues in the intestinal lining become inflamed or compromised.
Complications from bacteremia may impact your:
In some cases, Salmonella infections can lead to a condition known as reactive arthritis or Reiter’s syndrome.
This complication can cause:
Reactive arthritis affects the collagen in the joints, but there is also collagen in the eyes. This is why people experiencing reactive arthritis often have eye irritation. Reactive arthritis can also cause inflammation in the urethra, which is responsible for the painful urination symptom.
These symptoms can persist for months, or even years.
Most people do not need medical intervention to recover from Salmonella infections. However, certain circumstances warrant a trip to the doctor.
Call you doctor if:
Most healthy people are not recommended to take antibiotics for minor illnesses to reduce the risk of perpetuating antibiotic resistant strains. Symptom severity, however, can vary from person to person.
In some cases, people may become so sick that they need hospitalization. The very young, the very old, and those with a compromised immune system are the most vulnerable to infection after exposure and experiencing more serious illness.
If this Salmonella Africana outbreak turns out to be linked to cucumbers, it will join a short list of cucumber Salmonella outbreaks in the United States.
The first ever Salmonella outbreak linked to cucumbers in the United States occurred in 2013. An initial cluster of 6 related strains of Salmonella Saintpaul prompted an outbreak investigation.
Patients reported falling sick starting January 12, 2013, with the last reported illness onset starting on April 28, 2013.
In total, at least 84 cases were linked to this outbreak. There were 17 cases serious enough to require hospitalization. There were no deaths associated with the outbreak.
Traceback data consisting of patient interviews pointed to cucumbers as the most likely source of the outbreak. However, a specific source could not be narrowed down. Multiple types of cucumbers from several purchase locations were indicated.
However, shortly after, the FDA placed a Mexican grower on an Import Alert, restricting free access to the country.
Up next in historical cucumber Salmonella outbreaks is the 2014 Salmonella Newport outbreak linked to cucumbers grown in the Delmarva region.
People started falling sick around May 20, 2014. The outbreak was identified in August 2014 when cases with the same strain of Salmonella Newport were linked.
By the conclusion of the outbreak, a total of 275 cases across 29 states plus the District of Columbia were linked. There were 48 cases severe enough to require hospitalization. One death was reported in connection with this outbreak.
The last reported cases included in this outbreak showed symptom onset on September 30, 2014.
Strong traceback evidence based on patient interviews and product sampling linked cucumbers from the Delmarva growing region to this outbreak. Several distributors linked to outbreak patients reported a common grower in Maryland’s Eastern Shore in the Delmarva region.
Samples were taken on the farm, including areas where the cucumbers were grown, harvested, and packed. However, no samples were positive. These samples were taken several months after the harvest, so there is no way to know if earlier sampling activities would reveal the same result.
According to records and interviews, the farm used poultry litter fertilizer approximately 120 days before harvest. But that too was unavailable for testing.
The next in line of cucumber Salmonella outbreaks took place between 2015 and 2016.
In September 2015, the FDA announced a multistate outbreak of Salmonella Poona. People began falling sick as early as July 3, 2015. The last reported illness associated with this outbreak reported symptoms on February 29, 2016.
By the end of the outbreak, at least 907 people were infected with the outbreak strains of Salmonella Poona across 40 states. Nearly a third (204 cases) were serious enough to require hospitalization. Six deaths were reported for this outbreak. However, the California Department of Public Health indicated that of the three deaths reported from the state, Salmonella infection was considered as a contributing factor in just one of them.
Based on traceback investigation data involving geographical clusters of cases, the offending food was determined to be “slicer” cucumbers from the supplier, Andrew & Williamson Fresh Produce of San Diego, California. These “slicer” cucumber, also known as “American” cucumbers were grown in Baja, Mexico.
Subsequent recalls for nine Alaska Safeway and Carrs Stores deli sandwiches containing the recalled cucumbers were announced in tandem.
According to the Centers for Disease Control and Prevention (CDC), the outbreak was declared over on March 18, 2016.
The fourth in a line of cucumber Salmonella outbreaks since 2013 sickened at least 14 people with the same strain of Salmonella Oslo bacteria across eight states. Illness onset began on March 21, 2016, and the last report of illness onset was April 9, 2016.
Traceback interview data, along with retailer information narrowed the source to cucumbers. More specifically, “mini,” seedless, smooth skin Persian cucumbers.
While the investigation could not narrow down a single cucumber grower in this outbreak, two Canadian Persian cucumber suppliers were producers of interest in the investigation. Though growers from Mexico and the Dominican Republic could also have supplied the tainted produce.
Prior to this recent potential cucumber outbreak link, the last of the cucumber Salmonella outbreaks took place in 2018.
In October 2018, the Yakima Health District announced an outbreak of Salmonella Infantis outbreak likely linked to Costco three-pack (individually wrapped) English cucumbers. This was a result of a Washington State Department of Health Investigation into related illnesses.
Illnesses were reported as early as August 2018, with the last reported illness onset of September 15, 2018.
At least six cases with the same strain of Salmonella Infantis were linked to this outbreak.
Nearly all sick people reported buying and eating English cucumbers from various Costco stores in the state of Washington.
Two cases were serious enough to require hospitalization. No deaths were reported in connection with this outbreak.
If you have Salmonella symptoms it is possible you are part of the current Salmonella Africana outbreak. There are a few key steps you can take to help yourself feel better and potentially help the investigation. Helping the investigation not only helps investigators discover the link more quickly, but it also helps remove potentially harmful foods from the marketplace faster. This helps reduce the number of additional illnesses associated with a contaminated product.
First, stay hydrated. Drink plenty of fluids and avoid sugary drinks. Certain water additives can add electrolytes back into your system that may have been depleted from bouts of diarrhea or vomiting. You are made up of a significant amount of water. Losing that water balance can affect how your organs function. Extreme dehydration can be life-threatening. So, drink up!
If you have consumed cucumbers recently or some other product listed on the FDA’s recall website, check your pantry and fridge for recalled product. Be sure that no one in the house can consume the product to help prevent the spread of infection. However, it is a good idea to retain the product or its packaging in case it is needed to help determine or expand an existing product recall. Samples can be obtained from it and compared to the outbreak strain if bacteria are present.
Be sure to closely monitor symptoms. What starts as a minor illness can quickly ramp up to dangerous complications. Do not hesitate to see your healthcare provider if conditions worsen.
If you are in a higher risk group or your conditions have worsened, reach out to your healthcare provider right away. Specialized tests can determine if your illness is linked to the current Salmonella outbreak or cucumber recall, or potentially some other issue. Your healthcare provider may prescribe medications, such as antibiotics to help your recovery. In some cases, hospitalization is recommended for treating complications.
If you aren’t sick enough to receive medical treatment but have consumed recalled product or believe you are involved in the outbreak, reach out to your local health department. State and local health departments can sometimes accept samples and may have interview questions for you if your specimen is positive for the same strain as outbreak patients. The more information they can gather about what people ate, where they ate it, and where they have been in the weeks before they became sick, the better armed they are to investigate food manufacturers or facilities. So, make a list and be as thorough as possible.
If you have been impacted by a foodborne outbreak, you likely have your hands full with the hard work of getting better or taking care of a loved one. It can be a stressful time with more questions than answers. You may be wondering who is responsible for the medical bills? How will you cover expenses from time lost from work? How can you hold those responsible for your illness accountable for their liability? An experienced Salmonella lawyer can help you navigate the complicated legal process. Gathering evidence, researching your case, and representing you in mediation or court.
If you believe you are part of this Salmonella Africana outbreak or have become sick from consuming contaminated food, The Lange Law Firm, PLLC can help. The experienced Salmonella and food poisoning lawyers have helped many families going through this terrible experience receive millions of dollars from liable parties in an effort to hold them accountable where it gets their attention. Their bank accounts.
Call (833) 330-3663 for a free consultation and a compassionate member of the team will go over the details of your situation to determine if you have a legal case. You can also click here to email.
By: Heather Van Tassell (contributing writer, non-lawyer)
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