Multistate Salmonella Outbreak Linked To Tuna Sushi; 400 Die Each Year From Acute Salmonellosis

The FDA, CDC, and state and local officials are investigating a multistate outbreak of Salmonella Paratyphi B variant L(+) tartrate(+) infections possibly linked to sushi made from raw tuna.


According to the CDC, 53 people infected with the outbreak strain have been reported from nine states: Arizona (10), California (31), Illinois (1), Mississippi (1), New Mexico (6), South Dakota (1), Virginia (1), Washington (1), and Wisconsin (1). Most of the ill people have been reported from states in the southwestern United States or reported travel to this area of the country. Among 46 persons with available information, ten (22%) have been hospitalized, and no deaths have been reported. At this time, the investigation has not conclusively identified a food source, but most ill people interviewed reported eating sushi containing raw tuna in the week before becoming ill. At this time, a common brand or supplier of raw tuna has not been identified.


While local and state health officials continue to interview patients, the FDA is increasing its monitoring of tuna. Additionally, the FDA is conducting a traceback investigation. The FDA is evaluating and analyzing records to determine whether there is a common source of tuna. In this effort, the FDA works with its investigational partners to identify clusters of people made ill in separate geographic areas and works to trace the path of food eaten by those made ill back to a common source. This is labor intensive and painstaking work, requiring the collection, review and analysis of hundreds and at times thousands of invoices and shipping documents.


If a specific food or source linked to the illnesses is identified, the FDA will work to remove it from the marketplace and alert consumers to avoid it.


Most people infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts four to seven days, and most people recover without treatment. It is important to note that this outbreak is caused by Salmonella Paratyphi B variant L(+) tartrate(+) bacteria. This type of bacteria does not cause typhoid fever, paratyphoid fever, or enteric fever.


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 five years of age, the elderly, and those people with weakened immune systems are more likely to have severe infections. It is estimated that approximately 400 persons in the United States die each year with acute salmonellosis. Children, older adults, pregnant women, and people with weakened immune systems should generally avoid eating raw fish of any kind.


At this time, a common brand or supplier of raw tuna has not been identified, and there are no specific steps for restaurants and retailers to take to protect their customers. The FDA is moving quickly to investigate this issue and learn as much as possible to prevent additional people from becoming ill. They recognize that people will be concerned about these illnesses, and will continue to provide updates and advice.


Consumers should always practice safe food handling and preparation measures. Wash hands, utensils, and surfaces with hot, soapy water before and after handling food. A healthcare provider should be contacted if a person’s diarrhea lasts for more than three days, or is accompanied by high fever, blood in the stool, or so much vomiting that the person cannot keep liquids down and passes very little urine.


See the FDA Announcement


See also Medical Law Perspectives, July 2012 Report: Foodborne Illness: When Grabbing a Bite Can Be Deadly