The US Centers for Disease Control and Prevention (CDC) said since its last update in mid-October, 71 more ill people have been reported from 23 states.
It said the number of reported illnesses has declined since the peak of illnesses in August and September but has not returned to the number expected (about five every month).
Salmonella Poona infections have led to 165 hospitalizations and four deaths from Arizona (1), California (1), Oklahoma (1), and Texas (1).
Among people for whom information is available, illnesses range from July 3 to November 1.
CDC advice
CDC said although it is unlikely recalled cucumbers are still in homes, restaurants or grocery stores, they should not be eaten, served, or sold.
“Consumers who purchased recalled cucumbers should wash and sanitize drawers or shelves in refrigerators where cucumbers were stored.
“Restaurants and retailers that received recalled cucumbers should any crates or other containers where the cucumbers were held or sold.”
Investigations identified cucumbers imported from Mexico and distributed by Andrew & Williamson Fresh Produce as a likely source of the infections.
Gene Grabowski, partner at kglobal, public affairs/public relations, said it seems clear that there must be cross-contamination of Salmonella from cucumbers bought and consumed months ago.
“This usually happens in a refrigerator, kitchen bin or on a cutting board where the contaminated cucumbers were stored or prepared and where other food items later came into contact. Cross-contamination is far more frequent than most consumers realize,” he said.
“In fact, studies have shown that at least two-thirds of food borne illness occurs in home kitchens, where either cross-contamination happens or the bacteria originates.”
Grabowski said it is also possible that at least some of the reported illnesses are linked to other contaminated products or are the result of exaggeration on the part of people affected by illness.
“I have worked on several foodborne illness cases over the years where it was determined long after the fact that a product thought to be the source of contamination was actually not because of faulty data collection or physicians conceding to patient insistence regarding a diagnosis. Most of those cases are exposed if and when victims pursue litigation.”
Traceback investigation
The FDA traceback investigation determined Rancho Don Juanito de R.L. de C.V. n Baja, Mexico was the primary source of cucumbers shipped to Andrew & Williamson.
Nevada, Arizona and Montana health have isolated one of the outbreak strains of Salmonella Poona from cucumbers in retail locations.
San Diego County Health and Human Services Agency isolated one of the outbreak strains from cucumbers at the Andrew & Williamson Fresh Produce facility.
FDA added cucumbers from Rancho Don Juanito in Baja, Mexico to a second Import Alert in September based on appearance that cucumbers from the firm appeared to have been prepared, packed, and held under insanitary conditions.
Chipotle update
Meanwhile, the outbreak of Shiga toxin-producing E. coli O26 infections linked to Chipotle Mexican Grill restaurants has risen to 45.
The update includes four additional states: California (2), Minnesota (2), New York (1) and Ohio (1).
An investigation has not identified what specific food is linked to illness, said CDC.
Steve Ells, chairman and co-CEO of Chipotle, said it is committed to taking actions to make sure its food is safe and it is working with the health agencies.
“We offer our sincerest apologies to those who have been affected,” he said.
“We will leave no stone unturned to ensure the safety of our food – from enhancing the safety and quality assurance program for all of our fresh produce suppliers, to examining all of our food safety procedures from farm to restaurant, and expanding testing programs for produce, meat and dairy items before they are sent to our restaurants.”