Sushi Suspected as Salmonella Sickens 93 in 19 States

by Daniel J. DeNoon

Sushi is suspected but not confirmed as the source of a salmonella food-poisoning outbreak that so far has sickened 93 people in 19 states and the District of Columbia.

Ten people have been hospitalized since the outbreak began on Jan. 28. There have been no deaths.

Linking the cases is an unusual salmonella subtype: Salmonella serotype Bareilly.

Cases have been reported in Alabama (2 cases), 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).

CDC and state health officials have interviewed 51 of the people sickened in the outbreak. Of the 51, 35 — 69% — reported eating “sushi, sashimi, or similar foods” in the week before illness onset. Only 5% of people typically report consuming raw seafood in a typical week.

Nevertheless, the outbreak has not yet been traced to any specific food item or ingredient. It’s not at all clear whether the fish, the rice, the seasoning, some other ingredient, or even some other kind of food is the source of contamination.

People who have fallen ill during the outbreak average 31 years of age, with an age range of 4 to 78 years. Just under half the cases (46%) are female.

Because it takes two to four weeks from the time a person falls ill until the illness is reported, people who have been sickened in the outbreak since March 4 may not yet be reported.

Symptoms of salmonella infection usually are diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. Illness usually lasts four days to a week. Most people recover fully without treatment. However, sometimes the diarrhea is very severe and requires hospitalization.

In cases of severe salmonella diarrhea, salmonella bacteria may escape the gut, enter the blood, and affect other organs. This kind of infection can be fatal and requires prompt treatment with antibiotics. Elderly people, infants, and people with impaired immune systems are most at risk.

Rarely, people with salmonella infection develop Reiter’s syndrome: painful joints, eye irritation, and painful urination. Reiter’s syndrome can last months or years and can leave a person with permanent arthritis.