SUSHI WATCH - 19 STATES IN U.S.

CDC: No Source Confirmed in Outbreak That Has Sickened 93

Sushi or sashimi suspected

by Mary Rothschild | Apr 04, 2012

Ninety-three illnesses linked to an outbreak of Salmonella Bareilly have been reported from 19 states and the District of Columbia, the Centers for Disease Control and Prevention confirmed Wednesday, but CDC officials said a specific food has not been identified as the source of the infections.

However, many of those infected recalled eating sushi, sashimi or a raw dish such as ceviche, in the days before they became ill, according to the public health agency.

In an investigation report released Wednesday afternoon, the CDC revealed the states reporting illnesses: Alabama (2), Arkansas (1), Connecticut (4), District of Columbia (2), Georgia (4), Illinois (8), Louisiana (2), Maryland (8), Massachusetts (4), Mississippi (1), Missouri (1), New Jersey (6), New York (23), North Carolina (2), Pennsylvania (2), Rhode Island (4), South Carolina (3), Texas (3), Virginia (5) and Wisconsin (8).

The CDC's message follows an internal U.S. Food and Drug Administration email on the outbreak investigation that was inadvertently circulated beyond the agency. That emailed summary did not list all the affected states.

And although the FDA email said investigators were looking at sushi as a possible source of the illnesses, and singled out spicy tuna roll sushi as "highly suspect," the CDC said no food item has been conclusively identified.

"On initial interviews, many of the ill persons reported consuming sushi, sashimi or similar foods in a variety of locations in the week before becoming ill," the CDC stated Wednesday. State health officials are continuing to interview outbreak patients about what they ate, the CDC said.

According to the outbreak report, of 51 outbreak-related patients who provided food histories to public health investigators, 37 (69 percent) recalled eating sushi or sashimi during the week before their symptoms began. That compares with a control survey of healthy individuals in which only 5 percent said they'd eaten sushi, sashimi or ceviche in the 7 days before they were interviewed. 

At this time, however, the CDC said it is not advising people to avoid any specific foods or specific restaurants, and will alert the public if additional information becomes available.

According to the CDC, the outbreak-related illnesses were reported from January 28 to March 23, 2012. Those ill range in age from 4 to 78 years old; median age is 31.

Illnesses that occurred after March 4 may not yet be included in the outbreak count because of the lag time -- an average of 2 to 3 weeks -- between when a person becomes ill and and when the illness is reported to health authorities.

In the effort to figure out where this outbreak started, data collected by the states and the agency's district offices have focused on 6 restaurant clusters where diners later reported illness. Those clusters are in Texas, Maryland, Rhode Island and Connecticut, and two are in Wisconsin, according to the FDA email, which did not identify specific restaurants. 

The traceback efforts to find the source of the contamination, according to the FDA email, include looking at menu items ill diners consumed, ingredients, brands, preparation and suppliers in the cases associated with the restaurant clusters. If the outbreak source is sushi, investigators will be trying to determine what part of the sushi was contaminated.

People who think they have become ill from a contaminated food product should consult their health care provider, the CDC noted. The way to confirm a Salmonella infection is through stool specimen analysis.

Most people infected with Salmonella bacteria develop diarrhea, fever and abdominal cramps at least 12 hours and up to three days after consuming contaminated food, so often the last food they ate is not the food that made them sick.

S. Bareilly is a relatively rare type of Salmonella in the U.S., with some estimates indicating it is responsible for only 1 percent of Salmonella infections.

S. Bareilly has been associated with raw sprout contamination in previous outbreaks. In the UK in 2010, there were 241 cases of Salmonella Bareilly infection in an outbreak linked to bean sprouts germinated from contaminated seeds.

CDC Outbreak Map

This article was updated to include new information from the CDC.