As of February 28, 2018, 40 people infected with the outbreak strain of Salmonella I 4,[5],12:b:- have been reported from 27 states.

Illnesses started on dates ranging from October 10, 2017 to February 13, 2018. Ill people range in age from 6 to 67 years, with a median age of 41. Sixty percent of ill people are male. Of 31 people with available information, 14 (45%) have been hospitalized. No deaths have been reported.

Illnesses that occurred after February 6, 2018, might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of two to four weeks.

Whole genome sequencing (WGS) analysis did not identify any predicted antibiotic resistance in bacteria isolated from five ill people. Testing of one clinical isolate using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory did not show any resistance.

Health officials are collecting various leftover and unopened kratom products to test for Salmonella contamination. The North Dakota[PDF – 2 pages] and Utahdepartments of health collected leftover kratom powder from ill people in their states. The outbreak strain of Salmonella I 4,[5],12:b:- was identified in both samples. The ill person in North Dakota purchased S.K. Herbalist brand kratom powder from the website The ill person in Utah purchased kratom powder from the website

State and local health officials continue to interview ill people to ask about the foods they ate and other exposures before they became ill. Seventeen (71%) of 24 people interviewed reported consuming kratom in pills, powder, or tea. Most people report consuming the powder form of kratom. For the 17 people who reported consuming kratom, 13 remembered where it was purchased. Three people reported purchasing kratom from retail locations in several states and 10 people reported purchasing kratom from various online retailers.

Despite the information collected to date about where ill people purchased kratom, a single common brand or supplier of kratom has not been linked to the outbreak. At this time, CDC recommends that people not consume kratom in any form because it could be contaminated with Salmonella and could make people sick. CDC’s recommendation may change as more information becomes available. This investigation is ongoing and we will provide updates as needed.