66 Cases in Six Arizona Counties Reported

State health officials are working with federal and local partners to investigate 66 cases of Salmonella Poona infections that appear to be linked to eating garden variety cucumbers grown outside of the United States. Andrew & Williamson Fresh Produce of San Diego, CA initiated a voluntary recall of all cucumbers sold under the Limited Edition label during the period from August 1, 2015 through September 3, 2015 because they may be contaminated with Salmonella. People who bought these cucumbers should throw them away and consumers with questions may view the A&W website. Other cucumber suppliers are currently under investigation. Arizona and US grown cucumbers have not been implicated or associated with this outbreak.

“State and local health departments have been working around the clock with federal partners to rapidly identify the source of this outbreak so we can inform the public,” said Dr. Cara Christ, director of the Arizona Department of Health Services. “Today, the state lab made a preliminary identification of the source and it is urgent to get the message out to prevent any more exposure to children and adults.”

The ongoing investigation of at least 66 cases in six counties around the state is part of a larger multi-state investigation of 285 cases in 27 states. In Arizona, about 75% of the cases are children 17 and under. Around 35% of the Arizona cases have been hospitalized for this disease and no deaths have been reported in Arizona.

The 66 cases include residents of Apache (1), Coconino (2), Maricopa (49), Pima (10), Pinal (2), and Yuma (2) counties. All of the illnesses have been confirmed by the Arizona State Public Health Laboratory with the outbreak strain of Salmonella Poona bacteria, and the vast majority of persons became ill on or after July 13, 2015 and reported eating garden variety cucumbers from a restaurant or grocery store. Garden variety cucumbers are the thick-skinned unwrapped cucumbers and do not include the long thin wrapped cucumbers (English cucumbers) or the small pickle-shaped cucumbers (Persian cucumbers). Arizona grown cucumbers have not been associated with this outbreak.

The Arizona State Public Health Laboratory tested cucumber samples to identify products involved in the outbreak and Salmonella was identified from one cucumber specimen. State and local health departments continue to interview confirmed cases to provide as much information as possible to CDC and FDA so that all affected cucumbers can be removed from the market.

Illness for Salmonella infection lasts about 4-7 days. “For the vast majority of people, Salmonella is uncomfortable but not serious and goes away without treatment,” said Dr. Rebecca Sunenshine, medical director for the Disease Control Division at Maricopa County Department of Public Health.

“Individuals with symptoms such as nausea, diarrhea and abdominal cramping, should seek medical attention if they develop bloody diarrhea or cannot drink enough fluids to keep hydrated,” she added. Healthcare providers are advised to get stool cultures from patients who they think may have Salmonella. Antibiotics are rarely necessary to treat Salmonella and in most cases patients will recover without any specific treatment. The elderly, very young and those who have weakened immune systems are at higher risk for severe illness associated with Salmonella.

Nationwide, 285 cases have been identified in 27 states. The median age is 15 and about 32% have been hospitalized with one death reported outside of Arizona. The national investigation has also pointed to garden variety cucumbers as the source of this outbreak.

To prevent illness, thorough hand washing with soap and water prior to food preparation or consumption and after using the toilet is recommended. Wash fruits and vegetables before eating or cutting them up. Salmonella can be killed by cooking foods to an internal temperature of 165°F.