If any of the recalled cucumbers were still available, they would have spoiled by that time. WGS results from illnesses which occurred after the end of September suggested they shared a common source with the illnesses during the peak of the outbreak in August and September. State and local public health officials interviewed 46 of these ill people. Interviews did not identify any additional food items potentially linked with illness. Investigations were unable to determine if the illnesses could be explained by cross-contamination within the distribution chain for the recalled cucumbers, such as in shipping containers or at retail locations.
Since the last update on January 26, , 19 more ill people were reported from eight states. Since the last update on November 19, , 50 more ill people have been reported from 16 states. Illnesses that occurred after December 21, might not be reported yet.
A series of events occurs between the time a person is infected and the time public health officials can determine that the person is part of an outbreak. This means that there will be a delay between when a person gets sick and confirmation that he or she is part of an outbreak. This takes an average of 2 to 4 weeks. As of January 21, , people infected with the outbreak strains of Salmonella Poona have been reported from 39 states. Among people for whom information is available, illnesses started on dates ranging from July 3, to January 6, Ill people range in age from less than 1 year to 99, with a median age of Forty-nine percent of ill people are children younger than 18 years.
Fifty-six percent of ill people are female. Six deaths have been reported from Arizona 1 , California 3 , Oklahoma 1 , and Texas 1. These results also included isolates from people who became ill in October and November. The number of reported illnesses has declined substantially since the peak of illnesses in August and September; however, it has not returned to the number of reported illnesses that we would expect to see about 1 every month during this time of year.
One hundred and six illnesses started after September 24, , when recalled cucumbers should have no longer been available in stores or restaurants.
State and local public health officials have interviewed 38 of these ill people. Interviews have not identified any additional food items potentially linked with illness. The investigation into the source of these recent illnesses is ongoing.
WGS results from recent illnesses suggest they share a common source with the illnesses during the peak of the outbreak in August and September. Investigations are under way to determine if cross-contamination within the distribution chain for the recalled cucumbers could explain recent illnesses.
Since the last update on October 14, , 71 more ill people have been reported from 23 states. Illnesses that occurred after October 21, might not be reported yet. As of November 18, , people infected with the outbreak strains of Salmonella Poona have been reported from 38 states.
Among people for whom information is available, illnesses started on dates ranging from July 3, to November 1, Fifty percent of ill people are children younger than 18 years. Fifty-seven percent of ill people are female.
Four deaths have been reported from Arizona 1 , California 1 , Oklahoma 1 , and Texas 1. The number of reported illnesses has declined substantially since the peak of illnesses in August and September; however, it has not returned to the number of reported illnesses that we would expect to see about 5 every month. Since the last update on October 6, , 35 more ill people have been reported from 14 states. Illnesses that occurred after September 15, might not be reported yet.
Also, cucumbers have a shelf life of up to 14 days. Some people may not have known about the recall and eaten the contaminated cucumbers after the recall. As of October 13, , people infected with the outbreak strains of Salmonella Poona have been reported from 36 states. Among people for whom information is available, illnesses started on dates ranging from July 3, to September 29, Fifty-five percent of ill people are female.
Since the last update on September 29, , 61 new ill people have been reported from 24 states. It can take up to a week from the time people eat food contaminated with Salmonella before they get sick. It is not unexpected to continue to see illnesses reported after the recalls.
As of October 5, , people infected with the outbreak strains of Salmonella Poona have been reported from 35 states. Among people for whom information is available, illnesses started on dates ranging from July 3, to September 25, November 8, By Carla Gillespie. Copyright Pritzker Hageman, P. November 14, Salmonella Outbreak: How are Cucumbers Contaminated?
September 6, by Linda Larsen. So how does bacteria get onto cucumbers in the first place? There are several ways this happens. Chicken and Salmonella Infantis, the Neverending Outbreak? Return to top of page. Report Your Food Poisoning Case. The peak of cases occurred in August and September , after the number of cases declined.
However, it took several months to return to the baseline level of Salmonella infections, with cases continuing until February The cause of the ongoing cases is unclear, as cucumbers have a short shelf life and the infected produce was no longer available for purchase during this time.
Trace-back and laboratory investigations isolated the outbreak serotype from cucumbers in stores, as well as from the distributing facility A total of 14 people from 8 states, three of who were hospitalised, became ill between March 21 and April 9, The outbreak spread across three states and Persian cucumbers were identified as the source. A traceback investigation identified two common suppliers from Canada, linked to three different growers in Mexico, Canada and the Dominican Republic.
No one grower was identified as the source. Laboratory testing of samples conducted one month after the outbreak found no traces of Salmonella. As this was the fourth outbreak since in the USA, the Food and Drug Administration has initiated enhanced surveillance of cucumbers The most recent outbreak occurred in five provinces in Canada, with the onset date from mid-June to late-October A total of 56 laboratory-confirmed cases of Salmonella Infantis were reported, the majority centred on British Columbia.
Although English cucumbers were the primary suspected vehicle, laboratory testing of samples found no positive trace of Salmonella This outbreak was possibly related to another outbreak in the Washington state of the USA, which shares a border with British Columbia, in which six Salmonella infections were also linked to English cucumbers The UK had the most cases , followed by Finland Human samples were analysed using the core genome multilocus sequence typing scheme and were found to be genetically close with a maximum difference of 2 alleles , suggesting a common source.
Although Salmonella food isolates from cucumbers 17 isolates were found to be genetically linked to the human serotype, pointing to cucumbers as a possible vehicle of contamination, there was inefficient epidemiological information to definitively prove this hypothesis.
These isolates were found in both cucumbers during processing before and after washing and ready-to-eat products, but all contaminated samples were from separate production chains, and thus there was no concrete evidence of where contamination might have taken place. This report highlights the challenges of traceback investigations, especially in navigating complex production chains where multiple processing stages take place in different countries The association found between Salmonella outbreaks and cucumbers is new.
To the best of our knowledge, there are no outbreaks of Salmonella associated with cucumbers in the literature prior to the first USA multistate outbreak in Whilst cucumbers are a novel vehicle, outbreaks of Salmonella are also associated with other types of fruit and vegetables have previously been identified as the cause of Salmonella outbreaks globally, including leafy vegetables, papayas, tomatoes, melons, sprouts, shredded coconut, peas and hazelnuts Major identified outbreaks are summarised in Table 1 below.
Summary of outbreaks linked to other fruits and vegetables beside cucumbers Identified sources of Salmonella outbreaks with known sources in Australia, , 15 , Outbreak data was thus incomplete for accurate comparison from Identified sources of multistate Salmonella outbreaks in the USA, — Whilst there have been no Salmonella outbreaks associated with cucumbers reported in Australia to date, outbreaks of Salmonella associated with fruit and vegetables appear to be increasing in recent years.
Data from and was reported for outbreaks in which a single food source was identified as the cause of an outbreak. More recent annual national data in relation to foodborne outbreaks does not appear to be published. The increase in fruit and vegetable-related Salmonella outbreaks has also been shown in the USA. A review of data from the USA showed that from to showed the proportion of foodborne outbreaks occurring linked to fruit and vegetables had increased in this time from 0. The most commonly identified bacteria associated with these outbreaks was Salmonella.
A number of different food vehicles were identified, but of these the most common identified were lettuce, sprouts, melon, and berries A review of melon associated outbreaks in the USA showed that from to showed that the rate of melon associated outbreaks was found to increase over this time period from 0.
The majority of contamination was also identified to occur during the production process at different stages including during the growing, harvesting, processing and packaging stages Salmonella contamination has been identified in cucumbers globally. In April , the U. The company was informed and a recall was put in place. There was no associated illness reported with these contaminated cucumbers Salmonella has also been found in cucumbers in Japan as a result of its National Food Surveillance System, which was initiated in following three major outbreaks in linked to radish sprouts from school lunches.
Data from to shows that Salmonella was detected in approximately 0. Traditionally, global epidemiology of salmonellosis tends to be dominated by a few Salmonella serotypes. These serotypes, especially Enteritidis, were associated with eggs and poultry, thus making these food groups the target of food surveillance programmes and control measures by public health authorities Among outbreaks caused by fruits and vegetables in , some were caused by typical serotypes, such as Salmonella Newport 22 , 38 , 45 , 58 , Infantis 26 , 38 and Typhimurium 31 , 43 , 59 , However, many other outbreaks were associated with less common serotypes.
For example, Salmonella Anatum, which was implicated in multistate outbreak in Australia 29 and multi-state outbreaks in the US 39 , had been previously popular in Asia, Africa and South America, but had not been reported in North America from Similarly, serotypes St Paul, Poona, Oslo and Agona were behind major outbreaks associated with cucumbers in the USA and Europe 21 , 23 , 25 , 28 , although they have not been featured in the top 5 common serotypes in these regions from There is growing evidence which shows the ways in which Salmonella can contaminate produce during growing, process, transport and storage.
The rising number of Salmonella infections caused by fruit and vegetables has led to investigations into the mechanisms by which produce can become contaminated with Salmonella.
These include produce grown close to water sources which have been contaminated by excretion from cattle and wildlife, exposure in fields to wild animals and their waste materials, sewage, and the use of contaminated fertiliser In addition, a review of the literature investigated associations between contaminated fruit and vegetables, predominantly leafy greens and tomatoes, and growing practices.
The study identified risks that increase the likelihood of contamination include growing produce in clay-type soil, the use of contaminated water and untreated manure, and the use of contaminated irrigation water Contamination can also occur during storage and distribution if storage facilities and transport vehicles are not using appropriate hygiene and disinfectant procedures Reina, et al.
The most important of these are higher temperatures, higher concentration and longer length of exposure to contaminated water. The study also highlighted the importance of using appropriately treated water One popular theory of contamination of fruit and vegetables currently being explored in the internalisation theory.
This suggests that Salmonella may be able to enter and replicate within produce. A recent study found that Salmonella can internalise in cucumbers when introduced in the early stages of growth via the flowers of the plant. Other studies have investigated the length of time Salmonella can survive on the outside of fruit and vegetables.
Evidence shows that once introduced on the surface of tomatoes, Salmonella can grow and live for up to 18 days depending on temperature. Higher concentration of the Salmonella was shown in the first seven days Tomatoes have also been shown to internalise Salmonella.
This can occur when tomatoes are washed in water that is contaminated and a lower temperature than the tomatoes, which causes the produce to draw in water, along with the contaminants Data from 21 farms growing produce in New York State show that Salmonella can be found in irrigation and non-irrigation water, 6. A buffer zone of 5 metres or more from potential risks such as animals or contaminated water was associated with a decreased risk of Salmonella contamination The increase in outbreaks associated with fruit and vegetables may be due to several factors including changes in the diet of populations.
The US population have increased their per capita consumption of fruits and vegetables from 95kg per capita in to kg per capita in , according to statistics from the Food and Agriculture Organisation There are also different issues which need to be considered with fruit and vegetables such as cucumbers.
These include the facts that the typical shelf life of cucumbers is days 84 , and fruit and vegetables are often eaten raw, with no heating method to eliminate possible contamination. In addition, cucumbers specifically, may often be eaten with the skin on. Other factors which may contribute to the increase in produce-related outbreaks are changes in methods of food production, and an increase in the distance in which produce is transported With the number of outbreaks associated with fruit and vegetables, and cucumbers specifically, prevention is key to limiting the spread.
Methods of sanitising fruit and vegetables for consumers is limited. The illness usually lasts 4 to 7 days, and most people recover without treatment. It is important to note that this outbreak is caused by Salmonella Poona. Most people infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection.
In some people, the diarrhea may be so severe that they need to be hospitalized. In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless the person is treated promptly with antibiotics. Children are the most likely to get salmonellosis. The rate of diagnosed infections in children less than five years old is higher than the rate in all other people.
Children younger than 5 years of age, the elderly, and those people with weakened immune systems are more likely to have severe infections.
It is estimated that approximately persons in the United States die each year with acute salmonellosis. People who think they might have become ill from eating possibly contaminated cucumbers should talk to their health care providers.
Contact your healthcare provider if you have diarrhea that lasts for more than 3 days, or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine. Foodborne Pathogens. What are the Symptoms of Salmonella?
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