title: Outbreak of Salmonella serotype Saintpaul infections associated with multiple raw produce items--United States, 2008.
abstract: On May 22, 2008, the New Mexico Department of Health (NMDOH) notified CDC about four persons infected with Salmonella Saintpaul strains that were indistinguishable from each other by pulsed-field gel electrophoresis (PFGE) and 15 other persons with Salmonella infections whose isolates had not yet been characterized. In the following weeks, cases continued to be reported, and the outbreak expanded to include 43 states, the District of Columbia (Figure 1), and Canada. This report is an interim summary of results from seven epidemiologic studies, traceback investigations, and environmental investigations related to the outbreak. Further data collection and analyses are ongoing. As of August 25, 2008, a total of 1,442 persons had been reported infected with the outbreak strain. At least 286 persons have been hospitalized, and the infection might have contributed to two deaths. The outbreak began late in April 2008, and most persons became ill in May or June. The outbreak appears to be over; however, CDC and state health departments are continuing to conduct surveillance for cases of infection with the outbreak strain. Preliminary epidemiologic and microbiologic results to date support the conclusion that jalapeño peppers were a major vehicle by which the pathogen was transmitted and serrano peppers also were a vehicle; tomatoes possibly were a vehicle, particularly early in the outbreak. Contamination of produce items might have occurred on the farm or during processing or distribution; the mechanism of contamination has not been determined. These findings indicate that additional measures are needed to enhance food safety and reduce illnesses from produce that is consumed raw.