The Centers for Disease Control and Prevention has declared that a Salmonella Oranienburg outbreak traced to pistachio cream is over.

The CDC identified four patients in the outbreak, one in Minnesota and three in New Jersey. One of the patients required hospitalization. The last illness onset was May 19. 

There were likely many more sick people in the outbreak because the CDC reports that for every documented patient in Salmonella outbreaks, 29 go undetected. This is because some people do not seek medical attention, and others are not specifically tested for Salmonella infection.

The outbreak involved Emek Pistachio Cream manufactured by Emek Dogal Saglik Urunleri Iklim Gida Insaat San Tic Ltd Sti in Turkey. The company recalled the product on July 19. Whole genome sequencing of the product returned positive results for Salmonella. The recalled product should no longer be available for sale, according to the Food and Drug Administration.

There is concern that consumers may have unopened jars of the recalled product because it’s expiration date is not until Oct. 19, 2026. 

In addition to the testing and subsequent recall by the manufacturer, the Minnesota Department of Agriculture and the Maryland Department of Health collected samples of other Emek-brand products containing pistachio cream that were available for sale at World Market retail locations. The samples tested positive for Salmonella. In response, World Market initiated a recall of 9.7- oz Emek Spread Pistachio Cacao Cream with Kadayif. This product was sold in 9.7- oz glass jars with BATCH NO: 250401, UPC number 8 69652 10130 1, and a best-before date of April 1, 2027.

In addition to sampling conducted by state partners, the Food and Drug Administration collected import samples of Emek-brand products containing pistachio cream. Salmonella was detected in Emek Spread Pistachio Cacao Cream with Kadayif as well as Emek Pistachio Cream. 

Products from Emek Dogal Saglik Urunleri Iklim Gida Insaat San Tic Ltd Sti have been placed on Import Alert 99-43, and the FDA and state partners are conducting follow up activities with the firm and their importers to address this issue.

Ten more people are sick in Canada with Salmonella infections in an outbreak linked to pistachios and products containing pistachios.

The Public Health Agency of Canada reports that there are now 62 laboratory-confirmed patients, up from 52 reported on Aug. 5. Ten of the patients have required hospitalization. The ages of the patients range from 2 to 89 years old.

Many people who became sick reported eating pistachios, and products containing pistachios, such as Dubai-style chocolate and pastry products before becoming ill. Bakalava products are also associated with the outbreak. 

The outbreak strains of Salmonella that made people sick were found in samples of the recalled Habibi brand pistachios and samples of the recalled Dubai brand Pistachio & Knafeh Milk Chocolate.

There have been several recalls associated with the outbreak. Those recalls are:

There are three serotypes of Salmonella involved in the outbreak, Salmonella Havana, Salmonella Mbandaka and Salmonella Meleagridis. Patients are spread across four provinces with Quebec hit hardest with 45 patients. Other patients live in Ontario, which has 11 patients, British Columbia with five patients and Manitoba with one.

The patients became sick between early March and mid-August. More recent illnesses may continue to be reported because there is a period between when a person becomes sick and when the illness is reported to public health officials. It can take more than a month from the time someone gets sick, sees a doctor, gets tested, and has their results confirmed. For this outbreak, the illness reporting period is between 15 and 55 days after illness onset. 

This outbreak likely includes many more patients than have been reported. Many people have mild symptoms and don’t go to the doctor, so they aren’t tested. Others seek medical treatment but are not specifically tested for Salmonella infection. Researchers estimate that for each case of Salmonella reported to public health, there are 26 more cases that are not reported.