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Mystery Salmonella Outbreak Linked to Red Onions

Cases spread to 43 states as CDC warns against consuming 11 brands of onions

Close up of whole and sliced red onions.

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En español | The Centers for Disease Control and Prevention (CDC) has identified the likely cause of a multistate outbreak of salmonella infections as red onions. As of August 6, there were 640 cases across 43 states, resulting in 85 hospitalizations. No deaths have been reported.

The likely source of the red onions in this outbreak, according to the CDC, is Thomson International Inc., a Bakersfield, California, produce supplier. The CDC is warning consumers not to eat any onions – red, white, yellow or sweet – supplied by the company since all types of onions are grown and harvested in a similar manner and may be contaminated.

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States Affected by the Salmonella Outbreak

  • Alaska
  • Alabama
  • Arizona
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oregon
  • Pennsylvania
  • South Carolina
  • South Dakota
  • Tennessee
  • Utah
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming

Source: CDC

Any onions from this produce supplier should be thrown away. Look for the name of the supplier on packaging or on stickers affixed to individual onions. Also toss out any prepared foods made from those onions. People infected reported eating raw onions in salads, sandwiches, wraps, salsas and dips. The onset of illnesses reported so far occurred between June 19 and July 23.

Due to the risk of cross-contamination, Thomson International announced a voluntary recall of all varieties of onions it has shipped since May 1, according to the U.S. Food and Drug Administration (FDA), which is investigating the outbreak along with the CDC. Onions were distributed to wholesalers, restaurants, and retailers in all 50 states, the District of Columbia and Canada. The onions are sold under the following 11 brand names: Thomson Premium, TLC Thomson International, Tender Loving Care, El Competitor, Hartley’s Best, Onions 52, Majestic, Imperial Fresh, Kroger, Utah Onions and Food Lion.

At least two supermarket chains have issued recalls, according to the FDA. On August 1, Giant Eagle recalled onions and foods made with recalled onions sold in stores in Indiana, Maryland, Ohio, Pennsylvania and West Virginia. Publix recalled onions sold in bulk at stores in Alabama, Georgia, North Carolina, South Carolina, Tennessee and Virginia.

In the U.S., Salmonella bacteria, which lives in the intestines of many animals, causes about 1.35 million infections, 26,500 hospitalizations and 420 deaths annually, the CDC estimates. Food is the most common source for these illnesses. The current outbreak is tied to the Salmonella Newport strain of the bacteria, one of more than 2,000 known strains.

“For fruits and vegetables, Salmonella contamination typically occurs due to poor agricultural practices including the usage of improperly treated manure, contaminated irrigation water, food handlers don't wash hands, etc.," says John Gibbons, an assistant professor in the University of Massachusetts Amherst's Department of Food Science. Fecal contamination can also lead to Salmonella infections from consuming tainted meat products.

The CDC is currently investigating a separate Salmonella outbreak in 48 states that is tied to backyard poultry flocks including chickens and ducks.

Symptoms of an Infection

Most people who get salmonellosis, the intestinal infection caused by the bacteria, experience diarrhea, fever and stomach cramps. In severe cases, the infection can spread from the intestines to the urine, blood, bones, joints, spinal fluid or brain. Symptoms usually begin six hours to six days after infection and last up to seven days. However, in some instances, symptoms appear weeks after infection or symptoms persist for weeks, according to the CDC.

An infection is diagnosed with a lab test that looks for the bacteria in a person's stool, body tissue or fluids. Although most people can recover without antibiotics, an antibiotic is recommended for anyone with a severe illness. Antibiotics are also recommended for infected adults over 65 (or over 50 if an underlying condition such as heart disease is present), infants and those with weakened immune systems. The CDC's analysis of bacteria samples from the current outbreak does not indicate any antibiotic resistance.

"Older adults can have more serious symptoms because their immune systems are typically weaker,” says Gibbons. “Older adults are also at higher risk of having the infection spread to other organs."

How to Prevent Salmonella Infections

  • Frequently wash hands and surfaces; wash fruits and vegetables before eating, cutting or peeling.
  • Keep foods that don't require cooking before eating away from raw meat, poultry and seafood.
  • Make sure your food is heated to a temperature high enough to kill germs.
  • Refrigerate perishable foods within two hours (one hour if it's 90 degrees or warmer outside).

Source: CDC

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