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Health officials warned consumers Sunday about an outbreak of salmonella in raw tomatoes, after the illness of one woman in Contra Costa County and 144 other infections nationwide.
The source of the tomatoes is still unknown, but officials believe that large tomatoes, including Roma and round red, are carrying the strain, Salmonella sereotype Saintpaul, that has infected 145 people since mid-April. Red plum tomatoes also may be affected, according to a statement by the U.S. Food and Drug Administration.
The FDA is recommending limiting raw tomato consumption to those that are not the likely source of the outbreak, including cherry tomatoes, grape tomatoes, tomatoes sold with their vine attached and homegrown tomatoes.
No one has died from the recent outbreak, though at least 23 people have been hospitalized. The majority of the infections have occurred in New Mexico and Texas, but cases also have been reported in Arizona, Colorado, Connecticut, Idaho, Illinois, Indiana, Kansas, New Mexico, Oklahoma, Oregon, Utah, Virginia, Washington and Wisconsin.
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Red Plum/Red Roma tomatoes
implicated in outbreak.
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Round red tomato
implicated in outbreak.
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 The Contra Costa resident was not identified, but county health officials said Friday she is older than 35, did not have to be hospitalized and has recovered. Investigators are working to determine whether the woman contracted the illness locally or elsewhere. She recently traveled to a state where several other cases have been reported, according a release issued by Contra Costa Health Services spokeswoman Kate Fowlie.
The department's communicable disease program chief, Francie Wise, sought to downplay the significance of the illness in a statement released Friday, noting that the county normally averages about 123 cases every year.
Nevertheless, officials of the Center for Disease Control and Prevention said in a statement Saturday that only three people were known to be infected with this particular strain of salmonella in 2007. Because the strain was so rare in past years, officials believe that the infected tomatoes were distributed through much of the United States, and that there are probably many more infections than the 145 reported.
Salmonella is characterized by diarrhea, fever and abdominal cramps that occur within 12 to 72 hours of infection. The illness lasts four to seven days and is usually diagnosed by culturing a stool sample. While most people do not need treatment, the disease can be dangerous to infants, elderly people and those with impaired immune systems. Officials recommend consulting a health care provider if diarrhea lasts longer than two days in an adult, one day in a child younger than 4, or eight hours in an infant.
For more information on the salmonella outbreak, visit:
Advice to Consumers
From the Centers for Disease Control and Prevention: http://www.cdc.gov/salmonella/saintpaul/#advice
At this time, FDA is advising U.S. consumers to limit their tomato consumption to those that are not the likely source of this outbreak. These include cherry tomatoes; grape tomatoes; tomatoes sold with the vine still attached; tomatoes grown at home; and raw red Roma, red plum, and round red tomatoes from specific sources listed at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html. Consumers should be aware that raw tomatoes are often used in the preparation of fresh salsa, guacamole, and pico de gallo, are part of fillings for tortillas, and are used in many other dishes.
Customers everywhere are advised to:
- Refrigerate within 2 hours or discard cut, peeled, or cooked tomatoes.
- Avoid purchasing bruised or damaged tomatoes and discard any that appear spoiled.
- Thoroughly wash all tomatoes under running water.
- Keep tomatoes that will be consumed raw separate from raw meats, raw seafood, and raw produce items.
- Wash cutting boards, dishes, utensils, and counter tops with hot water and soap when switching between types of food products.
 
KidsHealth.org
Reviewed by: Barbara P. Homeier, MD
Date reviewed: June 2005
Originally reviewed by: Steven Dowshen, MD, and Samir Midani, MD
A salmonella infection is a foodborne illness caused by the salmonella bacteria carried by some animals, which can be transmitted on kitchen surfaces and in water, soil, animal feces, raw meats, and eggs. Salmonella infections typically affect a child's intestines, causing vomiting, fever, and other symptoms that usually resolve without medical treatment.
You can help prevent salmonella infections by not serving any raw meat or eggs, and by not keeping reptiles as pets, particularly if you have very young children. Hand washing is a powerful way to guard against salmonella infections, so it's essential to teach children to wash their hands, particularly after trips to the bathroom and before handling food in any way.
Salmonella Basics
Not everyone who ingests salmonella bacteria will become ill. Children, especially infants, are the most likely candidates to get sick from it. About 50,000 cases of salmonella infection are reported in the United States each year and about one third of those are in children 4 years old or younger.
The type of salmonella most commonly associated with infections in humans is called nontyphoidal salmonella. It is carried by chickens, cows, and reptiles such as turtles, lizards, and iguanas.
Another, rarer form of salmonella, typhoidal salmonella, is carried only by humans and is usually transmitted through direct contact with the fecal matter of an infected person. This kind of salmonella infection can lead to typhoid fever, which causes high fever, abdominal pain, headache, malaise, lethargy, skin rash, constipation, and delirium. It occurs primarily in developing countries without appropriate systems for handling human waste.
Signs and Symptoms
A salmonella infection generally causes nausea, vomiting, abdominal cramps, diarrhea (sometimes bloody), fever, and headache. Because many different kinds of illnesses can cause these symptoms, most doctors will take a sample of a child's stool to make an accurate diagnosis.
Symptoms of most salmonella infections usually appear within 3 days of contamination and typically go away without any medical treatment.
In cases of typhoid fever caused by salmonella bacteria, early symptoms are the same. But in the second week, the liver and spleen can become enlarged, and a distinctive "rose spotted" skin rash may appear. From there, the infection can cause other health problems, like meningitis and pneumonia.
People at risk for more serious complications from a salmonella infection include those who:
- have compromised immune systems (such as people with HIV)
- take cancer-fighting drugs
- have sickle cell disease or an absent or nonfunctioning spleen
- take chronic stomach acid suppression medication
In these higher-risk groups, most doctors will treat an infection with antibiotics to prevent it from spreading to other parts of the body and causing additional health problems.
Prevention
You have many ways to help prevent salmonella bacteria from making your child sick. Most salmonella bacteria appear in animal products and can be killed by the heat from cooking. So it's important to make sure that your child does not eat raw or undercooked eggs, poultry, or meat.
Because salmonella bacteria can contaminate even intact and disinfected grade A eggs, avoid serving your child poached eggs or eggs that are served sunny-side up.
Salmonella also can be spread through cross-contamination, so when you're preparing meals, try to keep uncooked meats away from cooked and ready-to-eat foods. In addition, it's important to thoroughly wash your hands, cutting boards, counters, and knives after handling uncooked foods.
Some foods may contain unrecognized raw-food products and should be avoided. Caesar salad dressing, the Italian dessert tiramisu, homemade ice cream, chocolate mousse, eggnog, cookie dough, and frostings can contain raw eggs. Unpasteurized milk and juices also can be contaminated with salmonella.
Fecal matter is often the source of salmonella contamination, so hand washing is extremely important, particularly after using the toilet and before preparing food.
Take care to avoid contact with the feces of family pets - especially reptiles. Wash your hands thoroughly after handling an animal and ensure that no reptiles are permitted to come into contact with an infant. Even healthy reptiles (especially turtles and iguanas) are not appropriate pets for small children and should not be in the same house as an infant.
Treatment
If your child has a salmonella infection and a healthy immune system, your child's doctor may let the infection go away without treatment. But any time your child develops a fever, headache, or bloody diarrhea, call the doctor to rule out any other problems.
If your child is infected and has a fever, you may want to give acetaminophen to reduce his or her temperature and relieve cramping. As with any infection that causes diarrhea, it's important to give your child plenty of liquids to avoid dehydration.
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