An outbreak of salmonella stemming from an unknown food source has expanded to four more states and the number of new infections reported to public health officials has more than doubled.
The Centers for Disease Control and Prevention announced in its latest case count that as of Sept. 23 at least 279 people have been sickened by the salmonella oranienburg strain resulting in 26 hospitalizations. A week earlier, the agency reported in a notice published Sept. 17 that it had identified 127 people across 25 states infected with the salmonella. No deaths have been attributed to the potentially deadly bacteria.
The outbreak has spread across 29 states, with the most cases reported in Texas (81), followed by Oklahoma (40), Illinois (23) and Virginia (22). Other states impacted by the outbreak include Massachusetts, New York, New Jersey, Pennsylvania, Florida, Connecticut, California, Maryland, Minnesota, Kansas, New Mexico, North and South Dakota, Iowa, Missouri, Arkansas, Michigan, North and South Carolina, Nebraska, Utah, Oregon, Wisconsin, Indiana and Tennessee.
The CDC said it believes the true number of infections may be much higher than reported because many people recover from a salmonella infection without seeking medical care and are not tested for the bacteria.
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The agency also said it takes three to four weeks to conclude if a sick individual is part of an outbreak, so some recent illnesses may not yet be reported.
Public health officials have yet to determine the exact cause of the infections and are continuing to interview people about the foods they ate in the week prior to their first symptoms. However, they appear to be closing in on a possible source, according to its latest investigation update. The CDC reported the strain of salmonella oranienburg was found in a sample taken from a takeout condiment cup containing cilantro and lime. The sick person reported that the condiment container also contained onions, but none were left in the cup when it was tested.
"Because multiple food items were present in the container and in the sample that was tested, it is not possible to know which food item was contaminated," the CDC said in a statement. "We are using this information in conjunction with other available information to help narrow the list of possible foods linked to illness."
Some groups of people who ate at the same restaurant prior to their illness have been identified in multiple states, which may help identify common food items they ate.
The ages of the sick range from less than 1 to 89 years old and 59% are female.
The CDC is encouraging individuals who have symptoms of salmonella to contact their healthcare provider and report any illness to the health department.
Symptoms of salmonella include diarrhea, fever higher than 102 degrees Fahrenheit, stomach cramps, excessive vomiting and signs of dehydration. In most cases, people recover without medical care after four to seven days. Some serious cases require hospitalization.
To avoid getting sick with salmonella, the CDC recommends four safety measures when preparing food: washing hands, utensils and surfaces, separating raw food, using a food thermometer and refrigerating perishables within two hours.
Every year, salmonella causes about 1.35 million illnesses, 26,500 hospitalizations, and 420 deaths in the United States, according to the CDC.