Three deaths have been reported in the United States, two from Minnesota and one from Oregon. Five deaths have been reported in Canada.

In the United States, as of December 6, 230 people infected with one of the outbreak strains of Salmonella have been reported from 38 states. Illnesses started on dates ranging from October 16, 2023, to November 20, 2023. Of 185 people with information available, 96 (52%) have been hospitalized. Ages of ill  has been less that 1 to 100 years of age. 

Illnesses in the following states: Alaska 1, Arkansas 1, Arizona 15, California 8, Colorado 8, Georgia 5, Iowa 8, Illinois 11, Indiana 5, Kansas 2, Kentucky 7, Massachusetts 1, Maryland 2, Michigan 2, Minnesota 20, Missouri 14, Mississippi 1, Montana 2, North Carolina 4, Nebraska 7, New Jersey 3, New Mexico 2, Nevada 5, New York 7, Ohio 8, Oklahoma 3, Oregon 5, Pennsylvania 5, Rhode Island 1, South Carolina 6, South Dakota 1, Tennessee 5, Texas 16, Utah 9, Virginia 5, Washington 4, Wisconsin 18 and West Virginia 3.

Twenty-four people resided at long-term care facilities when they got sick. Of 12 interviewed, 9 reported eating cantaloupe.

Twenty-three children attended childcare centers when they got sick. Of 20 children with information available, 13 ate cantaloupe.

In Canada, as of December 7, there have been 129 laboratory-confirmed cases of Salmonella Soahanina, Sundsvall and Oranienburg illness linked to this outbreak in the following provinces: British Columbia (15), Ontario (17), Quebec (91), Prince Edward Island (2), New Brunswick (2), and Newfoundland and Labrador (2). 

Individuals became sick between mid-October and mid-November 2023. Forty-four (44) individuals have been hospitalized. Five deaths have been reported. Individuals who became ill are between 0 to 100 years of age. Most of the individuals who became sick are children 5 years of age or younger (35%), or adults 65 years of age or older (45%).

Recalled Cantaloupe

Malichita and Rudy brand whole cantaloupes

Pre-cut fruit products made with recalled whole cantaloupes 

  • Kwik Trip cantaloupe cups, mixed fruit cups, and fruit tray with sell-by dates from November 4 through December 3
  • TGD Cuts cantaloupe chunks, mixed fruits, and fruit trays with use-by dates from November 2 through November 24
  • Freshness Guaranteed and RaceTrac cantaloupe chunks, seasonal blend, melon mixes, and fruit mixes with best-by dates from November 7 through November 12
  • Vinyard cantaloupe cubes, melon medleys, and fruit medleys sold in Oklahoma stores from October 30 through November 10
  • Kroger, Sprouts Farmers Market, and Trader Joe’s cantaloupe chunks, mixed melons, fruit medleys, and fruit trays with best-by dates from October 28 through November 8
  • Cut Fruit Express cantaloupe chunks, melon mixes, and fruit mixes with use-by dates from November 4 through November 6
  • ALDI [PDF – 2 pages] whole cantaloupes, cantaloupe chunks, and pineapple spears with best-by dates from October 27 through October 31
  • Bix Produce cantaloupe fruit cups and mixed fruit cups with sell-by dates of October 25 and October 26
  • All cantaloupe recalls are listed on FDA’s cantaloupe recall website.

Salmonella:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Salmonella outbreaks. The Salmonella lawyers of Marler Clark have represented thousands of victims of Salmonella and other foodborne illness outbreaks and have recovered over $850 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Salmonella lawyers have litigated Salmonella cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, tomatoes, ground turkey, salami, sprouts, cereal, peanut butter, and food served in restaurants.  The law firm has brought Salmonella lawsuits against such companies as Cargill, ConAgra, Peanut Corporation of America, Sheetz, Taco Bell, Subway and Wal-Mart.  

If you or a family member became ill with a Salmonella infection, including Reactive Arthritis or Irritable bowel syndrome (IBS), after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Salmonella attorneys for a free case evaluation.

Additional Resources:

blood-on-hands

8 dead from cantaloupe – 359 sickened – those numbers will rise. Bring back the MDP!

In the United States, as of December 6, 230 people infected with one of the outbreak strains of Salmonella have been reported from 38 states. Illnesses started on dates ranging from October 16, 2023, to November 20, 2023. Of 185 people with information available, 96 (52%) have been hospitalized. Ages of ill  has been less that 1 to 100 years of age. Twenty-four people resided at long-term care facilities when they got sick. Twenty-three children attended childcare centers when they got sick.

In Canada, as of December 7, there have been 129 laboratory-confirmed cases of Salmonella Soahanina, Sundsvall and Oranienburg illness linked to this outbreak in the following provinces: British Columbia (15), Ontario (17), Quebec (91), Prince Edward Island (2), New Brunswick (2), and Newfoundland and Labrador (2). Individuals became sick between mid-October and mid-November 2023. Forty-four (44) individuals have been hospitalized. Five deaths have been reported. Individuals who became ill are between 0 to 100 years of age. Most of the individuals who became sick are children 5 years of age or younger (35%), or adults 65 years of age or older (45%).

It reminded me of another post of nearly a decade ago when we were in the middle of yet another cantaloupe mess – here is the post:  By Bill Marler on November 30, 2018

FDA and industry and Congress all need to step up and do something.

The do nothing made me think of an editorial column by Dan Flynn, my friend for nearly 41 years – and, you thought I didn’t have any.

Here is Dan Flynn’s editorial from Food Safety News from Spring 2012:

Big Fresh has the blood on its hands.

The big fruit and vegetable lobby managed to kill a little food safety program that cost this $3 trillion government a grand total of $5 million annually. Chump change.

Big Fresh meanwhile has its snout so far up the 2012 Farm Bill trough that it’s going to reap hundreds of millions of dollars worth of business for fruit and vegetable growers, thanks to the federal government’s willingness to take our money and put us further in debt.

But nothing for the little “trip wire” that was out there catching pathogens in fruits and vegetables – not even after last year’s (2011) cantaloupe-caused Listeria incident that killed more people than any other foodborne illness outbreak in a century.

Big Fresh, also known as the United Fresh Produce Association, through its paid lobbyists, gets the credit for the kill.

But as my more objective colleagues Helena Bottemiller and Gretchen Goetz have reported over the past few months, it was President Obama who zeroed out USDA’s 11-year old Microbiological Data Program in the fiscal year 2013 budget.

Back in February, U.S. Rep. Rosa DeLauro, D-CT, grilled Secretary of Agriculture Tom Vilsack over the bone-headed move. The Secretary hemmed and hawed about the MDP being inconsistent with the mission of USDA’s Agricultural Marketing Service.

Actually, that’s true. The AMS has never really been much concerned about food safety, nor is Big Fresh.

Rep. DeLauro probably would have been more effective if she’d pointed out that 7 of the 11 state laboratories involved in MDP are located in swing states and it really does not look good for the president to putting those “lab rats” out of work.

Sadly, other than the heroic stand DeLauro did make, the rest of the Congress complied. It means the states involved will be shutting down the program in July when their laboratories get their last payment.

Speaking of payments, it will be interesting to see how much money Obama and members of Congress on the relevant committees will be collecting before this year is out from those who put fruits and vegetables on their employment line.

While putting its foot on the oxygen tube for the only program testing produce for pathogens, Big Fresh is racking up millions upon millions for fruit and vegetable growers in the 2012 Farm Bill games.

The Fresh Fruit and Vegetable line item alone is said to be approaching $200 million. Big Fresh wants that money, for sure, but nothing for testing fresh produce for pathogens.

From 2002-2011, the MDP conducted tests in 42 states on 120,887 samples of fruits and vegetables, including cantaloupe, celery, green onions, hot peppers, leaf lettuce, romaine lettuce, bagged lettuce, parsley, peanut butter, spinach, bagged spinach, alfalfa sprouts and tomatoes.

By my calculation, these tests were completed at a cost of something north of about $200 each. Believe me, Big Fresh spilled more on the floor of their last congressional reception than that.

Leave it to Washington D.C. to kill a tiny cost-effective food safety program while being clueless about fiscal responsibility in general.

Let’s give credit to where credit is due. Big Fresh gets credit for:

– Killing the nation’s only produce surveillance program.

– Turning Congress against the only program to collect data on the prevalence of foodborne pathogens in domestic and imported produce.

– Leaving the Food and Drug Administration (FDA), federal Centers for Disease Control and Prevention (CDC), and state health departments in the dark about the incidence of pathogens in fresh produce commodities.

Under the MDP program, positive test results were immediately reported to FDA, CDC and state health agencies. MDP testing was responsible for 23 produce recalls during 2010 and 2011 alone, and 15 of those involved human illnesses.

Like I said, MDP testing has been a trip wire. If Big Fresh came with a brain, it would be able to figure out on its own that a system that catches problems early is best for fruit and vegetable growers.

Big Fresh, however, does not have clue. As recently as last week, a bagged organic spinach recall for Salmonella was because an MDP lab detected the contamination.

Yes, fresh produce gets consumed pretty quickly, often before test results are known. But that was no reason to kill MDP. We should be going back to places where contamination has occurred and find out what’s going on.

Had there been an early test of Jensen Farms cantaloupe, maybe some government inspector – state or federal – might have paid a visit and said: “Hey! Isn’t that a potato washer?”

Such a discovery might have saved as many as 36 lives that poisoned cantaloupes took last growing season. That blood is not on Big Fresh’s hands. Next time, we’ll see.

romainetesting1200x680

In the last weeks we (and the cantaloupe industry) have been subjected to increasing numbers of illnesses and deaths linked to this popular fruit.

In the United States, as of December 6, 230 people infected with one of the outbreak strains of Salmonella have been reported from 38 states. Illnesses started on dates ranging from October 16, 2023, to November 20, 2023. Of 185 people with information available, 96 (52%) have been hospitalized. Ages of ill  has been less that 1 to 100 years of age. Twenty-four people resided at long-term care facilities when they got sick. Twenty-three children attended childcare centers when they got sick.

In Canada, as of December 7, there have been 129 laboratory-confirmed cases of Salmonella Soahanina, Sundsvall and Oranienburg illness linked to this outbreak in the following provinces: British Columbia (15), Ontario (17), Quebec (91), Prince Edward Island (2), New Brunswick (2), and Newfoundland and Labrador (2). Individuals became sick between mid-October and mid-November 2023. Forty-four (44) individuals have been hospitalized. Five deaths have been reported. Individuals who became ill are between 0 to 100 years of age. Most of the individuals who became sick are children 5 years of age or younger (35%), or adults 65 years of age or older (45%).

It reminded me of a post of over a decade ago when we were in the middle of yet another cantaloupe mess – here is the post: By Bill Marler on August 11, 2012

I was going to take the weekend off.  It has been a long few weeks of long days, and more than a few nights, working on putting the cases together of the 22 injured people and the families of 20 who died in the 2011 Listeria cantaloupe outbreak that I represent.  We have a court imposed deadline of September 14 (ironically, one year to the date of the recall) to present every client’s story.  Every person and family has a story – all of them quite horrible and heroic – that they would take up every page of Food Safety News through the end of the year.  But, let my tell you one fact – these families collectively have incurred to date over $8,000,000 in medical bills.  If you count in future medical bills and lost wages, you are now well into eight figures.  If you then add in the pain of the loss of a spouse or living your life with the after effects of Listeria meningitis, you are talking real money.  And, that is only 42 of the 147 the CDC counted.

After 20 years of doing this kind of work it is easy to estimate that this one tragedy from last summer will cost business, government and the victims well over $100,000,000.

So, I really was going to take the weekend off and then Food Safety News reporter Helena Bottemiller (a.k.a. Lois Lane) wrote a story for this morning about this summer’s cantaloupe, and now honeydew recall prompted by the Microbiological Data Program (MDP).

Burch Equipment LLC in North Carolina is expanding its recent recall of nearly 189,000 cantaloupes to now include all of this growing season’s cantaloupes and honeydew melons distributed in 18 states because they may be contaminated with Listeria monocytogenes.

In the U.S. Food and Drug Administration update, issued very early Saturday morning, the agency noted that here have been no illnesses reported to date — the recall expansion is based on FDA’s recent finding of Listeria monocytogenes on a honeydew melon grown and packed by Burch Farms.

The original recall of cantaloupes was initiated on July 28 after a MDP in New York found contaminated cantaloupe. Two days later, the recall was greatly expanded and the FDA warned the public to not eat the recalled melons after agency officials reported unsanitary conditions at the company’s packing shed. 

Now, more than 10 days later, the company and FDA are casting a wider net on the potentially-contaminated melons, including honeydew, which were not previously part of the recall. Earlier this week, the company clarified that although it had originally identified Athena cantaloupes as the variety it was recalling, it was actually recalling Caribbean Gold variety. 

So as Food Safety News Editor, Dan Flynn, said a few months ago, let us thank United Fresh Produce Association for:

–       Killing the nation’s only (real) produce surveillance program (it is on life support until the years end and FDA has a small program).

–       Turning Congress against the only (real) program to collect data on the prevalence of foodborne pathogens in domestic and imported produce.

–       Leaving the Food and Drug Administration (FDA), federal Centers for Disease Control and Prevention (CDC), and state health departments in the dark about the incidence of pathogens in fresh produce commodities.

–       Keeping tainting products in the marketplace – MDP testing has been responsible for 23 produce recalls during 2010 and 2011 alone, and 15 of these involved human illnesses.

Did I tell you that the MDP costs us taxpayers only $5,000,000 per year?

Marler Clark has been in the lead for all the Cantaloupe Outbreaks Lawsuits over the last decades. Here is a sampling:

Cantaloupe

MPR reports that Minnesota health officials say there are now 20 confirmed cases of salmonella in the state linked to contaminated cantaloupe — including two deaths. 

The U.S. Food and Drug Administration first issued a national recall of some brands of whole and pre-cut cantaloupe on Nov. 9; that recall has since been expanded.

The Minnesota Department of Health is working with the state Department of Agriculture, the FDA and the Centers for Disease Control and Prevention to investigate the outbreak. 

“Currently we are still in the middle of the investigation trying to determine where people were exposed who became ill,” Carlota Medus, supervisor for MDH’s foodborne diseases unit, said late last week. “Were they exposed by the initial cantaloupe that was contaminated, or were they exposed and ate cantaloupe that was not the recall cantaloupe or was a cross-contamination event or some other situation?”

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San Diego – 12 with Salmonella: County of San Diego health officials are reporting three additional cases of Salmonella illness linked to unpasteurized or “raw” milk from a producer in Fresno, CA.   

This brings the total number of local cases to 12, including three people who were hospitalized. The cases began in late September and the most recent person became ill on Oct. 17. 

The California Department of Public Health (CDPH) issued a recall of Raw Farm milk and heavy cream Oct. 24, and a PDF that contains the specific product identification numbers with “best by” dates between Oct. 11 and Nov. 6. Additional raw milk products were not recalled.   

The County of San Diego Health and Human Services Agency urges anyone who may have recently purchased Raw Farm LLC raw milk to not consume it and discard the product. 

The illnesses have been caused by Salmonella bacteria, which is commonly found in human and animal intestines. The 12 San Diego County residents who became ill have reported consuming Raw Farm LLC raw milk the week before they became ill. Cases in other parts of the state are being tracked by CDPH and other local health departments. 

Orange County – 7 with Salmonella: The OC Health Care Agency (HCA) has identified seven cases of Salmonella illness in Orange County (OC) residents following consumption of unpasteurized or “raw” milk from Raw Farm LLC, which recently issued a recall of its raw whole milk and raw heavy creams products.

The HCA urges those who may have purchased raw whole milk or raw heavy cream products from Raw Farm LLC to not consume the products and discard them immediately. Anyone who becomes ill after consuming raw milk or products made from raw milk, particularly products from Raw Farm LLC, should seek medical care immediately.

All confirmed cases had illness onset within the past 30 days, with affected individuals ranging in age from one to 20 years old. The HCA continues to investigate the situation in coordination with the California Department of Public Health (CDPH) and the California Department of Food and Agriculture (CDFA). The HCA is also reaching out to stores in the county who may be selling these products to assure that they are aware of the recall.

Salmonella:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Salmonella outbreaks. The Salmonella lawyers of Marler Clark have represented thousands of victims of Salmonella and other foodborne illness outbreaks and have recovered over $850 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Salmonella lawyers have litigated Salmonella cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, tomatoes, ground turkey, salami, sprouts, cereal, peanut butter, and food served in restaurants.  The law firm has brought Salmonella lawsuits against such companies as Cargill, ConAgra, Peanut Corporation of America, Sheetz, Taco Bell, Subway and Wal-Mart.  

If you or a family member became ill with a Salmonella infection, including Reactive Arthritis or Irritable bowel syndrome (IBS), after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Salmonella attorneys for a free case evaluation.

Additional Resources:

As of December 1, there have been 117 people infected with one of the outbreak strains of Salmonella have been reported from 34 states. Illnesses started on dates ranging from October 17, 2023, to November 14, 2023. Of 103 people with information available, 61 (59%) have been hospitalized. Two deaths have been reported from Minnesota. States impacted and the number of ill: Alaska 1, Arkansas 1, Arizona 7, California 1, Colorado 3, Georgia 3, Iowa 5, Illinois 6, Indiana 2, Kansas 1, Kentucky 5, Massachusetts 1, Maryland 1, Michigan 1, Minnesota 14, Missouri 9, Mississippi 1, North Carolina 2, Nebraska 4, New Jersey 3, Nevada 2, New York2, Ohio 8, Oklahoma 2, Oregon 2, Pennsylvania 1, Rhode Island 1, South Carolina 3, Tennessee 4, Texas 5, Utah 3, Virginia 2, Washington 1, Wisconsin 10.

As of December 1, there have been 66 laboratory-confirmed cases of Salmonella Soahanina, Sundsvall and Oranienburg illness linked to this outbreak in the following provinces: British Columbia (13), Ontario (13), Quebec (35), Prince Edward Island (2), New Brunswick (1), and Newfoundland and Labrador (2). Additional Salmonella infections are under investigation and more illnesses associated with this outbreak may be confirmed. Individuals became sick between mid-October and mid-November 2023. Nineteen individuals have been hospitalized. One death has been reported. Individuals who became ill are between 0 to 100 years of age. The majority of the individuals who became sick are children 5 years of age or younger (39%), or adults 65 years of age or older (39%). Half of the cases (50%) are male.

What is Salmonella?

It has long been said that, in 1885, pioneering American veterinary scientist, Daniel E. Salmon, discovered the first strain of Salmonella. Actually, though, Theobald Smith, research-assistant to Dr. Salmon, discovered the first strain of Salmonella—Salmonella Choleraesuis. But being in charge, Dr. Salmon received all of the credit.[1] Today, the number of known serotypes of Salmonella bacteria totals over two thousand. And in recent years, concerns have been raised, as particular strains of Salmonella have become resistant to traditional antibiotics.

There are two Salmonella species: Salmonella enterica (S. enterica) and Salmonella bongori (S. bongori). S. bongoristrains predominantly colonize cold-blooded reptiles, whereas S. enterica strains are capable of infecting both humans and mammals.[2] Based on factors such as morphology, structure, mode of reproduction, and other criteria, the two species are further classified into subgroups called serotypes or serovars. More than 2,600 serotypes have been described for Salmonella, and they are characterized by the type(s) of animal they are found in or by the clinical symptoms they cause.[3] Of these, less than 100 are responsible for most human Salmonella infections.[4]

Where Does Salmonella Come From?

Salmonella are widely distributed in nature and are found in the intestinal tract of wild and domesticated animals and in humans. Salmonella poisoning can occur when a person ingests contaminated fecal particles transmitted by another infected human or animal.[5]

Salmonella enterica serotypes Typhi, Sendai, and Paratyphi A, B, or C are found exclusively in humans. These serotypes, collectively referred to as typhoidal Salmonella, cause enteric fever (also known as typhoid or paratyphoid fever if caused by serotypes Typhi or Paratyphi, respectively).[6] Most often, enteric fever is acquired through ingestion of food or water contaminated with human feces. Most U.S. residents who are diagnosed with typhoidal Salmonella are infected while traveling abroad in areas where typhoid fever and paratyphoid fever are common. Three types of vaccines against S. Typhi are commercially available, although there is still not a single licensed vaccine available against S. Paratyphi A.[7]Persons planning to travel outside of the United States are advised to find out if a vaccine for typhoid fever is recommended (see www.cdc.gov/travel). 

Most Salmonella infections are caused by eating contaminated food. One study found that 87% of all confirmed cases of Salmonella are foodborne. Foods of animal origin, including meat, poultry, eggs, or dairy products can become contaminated with Salmonella. Eating uncooked or inadequately cooked food—or food cross contaminated with uncooked or undercooked products—can lead to human infections. As explained in a comprehensive report issued by the U.S. Department of Agriculture’s Economic Research Service:

Salmonella contamination occurs in a wide range of animal and plant products. Poultry products and eggs are frequently contaminated with S. Enteritidis, while beef products are commonly contaminated with S.Typhimurium. Other food sources of Salmonella may include raw milk or other dairy products and pork.

In the past two decades, consumption of produce, especially sprouts, tomatoes, fruits, leafy greens, nuts, and nut butters, has been associated with Salmonella illnesses.[8] The surface of fruits and vegetables may be contaminated by human or animal feces. Changes in food consumption and production, as well as the rapid growth of international trade in agricultural products, have facilitated the transmission of Salmonella associated with fresh fruits and vegetables. 

In the United States, Salmonella is the second most commonly isolated bacterial pathogen when laboratory diagnosis of diarrhea is sought.[9] However, passive laboratory surveillance, which uses voluntary reporting by health care providers and facilities, captures only a fraction of illnesses that actually occur. Furthermore, only a small proportion of illnesses are confirmed by laboratory testing and reported to public health agencies. Thus, researchers rely on quantitative statistical modeling to estimate the incidence of foodborne illness. These estimates are used to direct policy and interventions.

What are the Symptoms of Salmonellosis?

Salmonella infections can produce a broad range of disease, from no symptoms to severe illness. The most common clinical presentation is acute gastroenteritis. Symptoms commonly include diarrhea and abdominal cramps, often accompanied by fever of 100°F to 102°F (38°C to 39°C). More serious infections may also involve bloody diarrhea, vomiting, headache, and body aches.[10]

The Incubation period, or the time from Ingestion of the bacteria until the symptoms start, is generally 6 to 72 hours; however, there is evidence that in some situations the incubation can be longer than 10 days. People with salmonellosis usually recover without treatment within three to seven days. Nonetheless, Salmonella bacteria can persist in the intestinal tract and stool for many weeks after the resolution of symptoms—on average, one month in adults and longer in children.[11]

Treatment of Salmonellosis

S. Typhi and S. Paratyphi are capable of causing systemic illness if they invade the bloodstream (termed “bacteremia”). “Septicemia” or “sepsis” (bloodstream infection or “blood poisoning”) occurs if the bacteria multiply in the blood and cause the immune system to respond by activating inflammatory mechanisms. This may result in the development of “systemic inflammatory response syndrome,” or “SIRS.” By definition, SIRS includes tachycardia, tachypnea, fever, and abnormal white blood cell count. When the bacteria involved are S. Typhi or S. Paratyphi, this serious illness is called enteric typhoid, or paratyphoid fever. Symptoms may start gradually and include fever, headache, malaise, lethargy, and abdominal pain. In children, it can present seemingly innocuously as a non-specific fever. The incubation period for S.Typhi is usually 8 to 14 days, but it can range from three to 60 days. For S. Paratyphi infections, the incubation period is similar to that of nontyphoidal Salmonella—one to 10 days.[12]

Medical treatment is acutely important, though, if the patient becomes severely dehydrated or if the infection spreads from the intestines. Persons with severe diarrhea often require re-hydration, usually with intravenous (IV) fluids. But antibiotics are not necessary or indicated unless the infection spreads from the intestines, at which time the infection can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin. Unfortunately, though, some Salmonella bacteria have become resistant to antibiotics, largely as a result of the use of antibiotics to promote the growth of feed animals.[13]

Reactive Arthritis

Formerly referred to as Reiter Syndrome, the term reactive arthritis refers to an inflammation of one or more joints, following an infection localized at a site distant from the affected joints. The predominant site of the infection is the gastrointestinal tract. And reactive arthritis can be post-infection, meaning that the infection may not be active when diagnosed. Several bacteria, including Salmonella, can cause reactive arthritis.[14]  And although the resulting joint pain and inflammation can resolve completely over time, permanent joint damage can occur.[15]

The symptoms of reactive arthritis include pain and swelling in the knees, ankles, feet, and heels. Less frequently, the upper extremities may be affected, including the wrists, elbows, and fingers. Tendonitis (inflammation of the tendons) or enthesitis (inflammation where tendons attach to the bone) can occur. Other symptoms may include prostatitis, cervicitis, urethritis (inflammation of the prostate gland, cervix, or urethra), conjunctivitis (inflammation of the membrane lining the eyelid), or uveitis (inflammation of the inner eye). Ulcers and skin rashes are less common. Symptoms can range from mild to severe and can occur anywhere from three days to six weeks after the antecedent infection and may involve one or more joints, though usually six or fewer. Although most cases recover within a few months, some continue to experience complications for years. Treatment focuses on relieving the symptoms.[16]

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract. The hallmark symptoms of IBS are abdominal pain and altered bowel habits, ranging from constipation to diarrhea, or alternating diarrhea and constipation. Abdominal pain is usually crampy in nature, but character and sites can vary. In some patients, the pain is relieved by defecation but, in others, defecation may worsen the pain. Additional symptoms may include bloating, straining at stools, and a sense of incomplete evacuation.

The observation that the onset of IBS symptoms can be precipitated by gastrointestinal infection dates back to the 1950s. Mechanisms are not known but include changes in the microbiome, use of antibiotics to treat the infection, and an increase in enteroendocrine cells.

Another consequence of infective gastroenteritis is the disruption of normal gut flora. Studies on postinfectious IBS have provided etiological insights into the pathogenesis of IBS. It is well documented that following infective gastroenteritis, more than 10% of affected individuals go on to develop postinfectious IBS.[17] The risk of postinfectious IBS appears greater with bacterial gastroenteritis compared to viral gastroenteritis.

Salmonella: Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Salmonella outbreaks. The Salmonella lawyers of Marler Clark have represented thousands of victims of Salmonella and other foodborne illness outbreaks and have recovered over $850 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation. Our Salmonella lawyers have litigated Salmonella cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, tomatoes, ground turkey, salami, sprouts, cereal, peanut butter, and food served in restaurants. The law firm has brought Salmonella lawsuits against such companies as Cargill, ConAgra, Peanut Corporation of America, Sheetz, Taco Bell, Subway and Wal-Mart. 

If you or a family member became ill with a Salmonella infection, including Reactive Arthritis or Irritable bowel syndrome (IBS), after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Salmonella attorneys for a free case evaluation.

[1]           Kass EH. (1987). A brief perspective on the early history of American infectious disease epidemiology. Yale J Biol Med. 60(4):341-8. 

[2]           Hernandez, A. K. C. Salmonella bongori. Poultry and Avian Diseases. Encyclopedia of Agriculture and Food Systems. https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/salmonella-bongori.

[3]           Boore AL, et al. (2015). Salmonella enterica Infections in the United States and Assessment of Coefficients of Variation: A Novel Approach to Identify Epidemiologic Characteristics of Individual Serotypes, 1996–2011. PloS One. 10(12): e0145416

[4]           Besser JM. (2018). Salmonella epidemiology: a whirlwind of change. Food Microbiol. 71:55-9.

[5]           Chiu, C.-H. (2019). Salmonella, Non-Typhoidal Species (S. Choleraesuis, S. Enteritidis, S. Hadar, S. Typhimurium). http://www.antimicrobe.org/b258.asp. 

[6]           Ohad eGal-Mor, Erin C Boyle, & Guntram A. Grassl. (2014). Same species, different diseases: how and why typhoidal and non-typhoidal Salmonella enterica serovars differ. Frontiers in Microbiology, 5. https://doi.org/10.3389/fmicb.2014.00391

[7]           Id.

[8]           National Typhoid and Paratyphoid Fever Surveillance Annual Summary, 2015.” Centers for Disease Control and Prevention, 6 Nov. 2018. Available at: https://www.cdc.gov/typhoid-fever/reports/annual-report-2015.html. 

[9]           “National Enteric Disease Surveillance: Salmonella Annual Report, 2016.” Centers for Disease Control and Prevention, 28 Feb. 2018. Available at: https://www.cdc.gov/nationalsurveillance/pdfs/2016-Salmonella-report-508.pdf. 

[10]         “Salmonella.” Centers for Disease Control and Prevention, 24 Jun. 2020. Available at: https://www.cdc.gov/salmonella/. 

[11]         Id.

[12]         Miller, S. and Pegues, D. “Salmonella Species, Including Salmonella Typhi” in Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, Sixth Edition, Chap. 220, pp. 2636-50 (2005).

[13]         Medalla, F., Gu, W., Mahon, B. E., Judd, M., Folster, J., Griffin, P. M., & Hoekstra, R. M. (2016). Estimated Incidence of Antimicrobial Drug-Resistant Nontyphoidal Salmonella Infections, United States, 2004-2012. Emerging infectious diseases, 23(1), 29–37. https://doi.org/10.3201/eid2301.160771

[14]         See “Reactive Arthritis.” Questions and Answers About. N.p., n.d. Web. 12 Nov. 2015.

[15]         Id.

[16]         “Reactive Arthritis.” National Institute of Arthritis and Musculoskeletal and Skin Diseases, Oct. 2016. Available at: https://www.niams.nih.gov/health-topics/reactive-arthritis. 

[17]         Ng, Q. X., Soh, A., Loke, W., Lim, D. Y., & Yeo, W. S. (2018). The role of inflammation in irritable bowel syndrome (IBS). Journal of inflammation research, 11, 345–349. https://doi.org/10.2147/JIR.S174982

The updated number in the United States:

• Illnesses: 117

• Hospitalizations: 61

• Deaths: 2

• States: 34

In Canada the numbers have been just updated – on December 1, 2023 it was 66 sick, 19 hospitalized and 1 death.

Since the last update on November 24, 18 more illnesses have been reported. As of November 28, 117 people infected with one of the outbreak strains of Salmonella have been reported from 34 states. Illnesses started on dates ranging from October 17, 2023, to November 14, 2023. Of 103 people with information available, 61 (59%) have been hospitalized. Two deaths have been reported from Minnesota. States impacted and the number of ill: Alaska 1, Arkansas 1, Arizona 7, California 1, Colorado 3, Georgia 3, Iowa 5, Illinois 6, Indiana 2, Kansas 1, Kentucky 5, Massachusetts 1, Maryland 1, Michigan 1, Minnesota 14, Missouri 9, Mississippi 1, North Carolina 2, Nebraska 4, New Jersey 3, Nevada 2, New York2, Ohio 8, Oklahoma 2, Oregon 2, Pennsylvania 1, Rhode Island 1, South Carolina 3, Tennessee 4, Texas 5, Utah 3, Virginia 2, Washington 1, Wisconsin 10.

As of December 1, there have been 66 laboratory-confirmed cases of SalmonellaSoahanina, Sundsvall and Oranienburg illness linked to this outbreak in the following provinces: British Columbia (13), Ontario (13), Quebec (35), Prince Edward Island (2), New Brunswick (1), and Newfoundland and Labrador (2). Additional Salmonellainfections are under investigation and more illnesses associated with this outbreak may be confirmed. Individuals became sick between mid-October and mid-November 2023. Nineteen individuals have been hospitalized. One death has been reported. Individuals who became ill are between 0 to 100 years of age. The majority of the individuals who became sick are children 5 years of age or younger (39%), or adults 65 years of age or older (39%). Half of the cases (50%) are male.

On November 22, 2023, more recalls for whole and pre-cut cantaloupes were issued. Trufresh expanded their recall again to include all Malichita brand and Rudy brand whole cantaloupes. Crown Jewels recalled Malitchita brand whole cantaloupes. CF Dallas recalled pre-cut fruit products containing recalled cantaloupes.

CFIA issued food recall warnings on November 1, November 14 and November 17 for Malichita brand cantaloupes sold between October 11 and November 14, 2023. On November 24, 2023, CFIA updated the food recall warning to also include Rudy brand cantaloupes sold between October 10 and November 24, 2023. Additional secondary recalls have been issued for products that were made using recalled cantaloupes and for produce items that were processed alongside recalled cantaloupes. 

Through the CFIA investigation the outbreak strains of Salmonella that made people sick were found in samples of the recalled Malichita brand cantaloupe.

More recent illnesses may be reported in the outbreak because there is a period between when a person becomes ill and when the illness is reported to public health officials. For this outbreak, the illness reporting period is between 2 and 4 weeks.

On November 1, 2023, Malichita brand cantaloupes were recalled in Canada.

On November 8, Trufresh recalled Malichita brand whole cantaloupes that were sold to US businesses between October 16 and October 23. On November 15, Trufresh expanded their recall to include additional whole cantaloupes.

Additional products containing Malichita brand cantaloupes were also recalled. On November 14, Vinyard Fruit and Vegetable Company recalled pre-cut fruit products and ALDI recalled [PDF – 2 pages] its whole cantaloupe, cantaloupe chunks, and pineapple spears.

CDC is advising people not to eat, sell, or serve recalled fruit.

Salmonella: Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Salmonella outbreaks. The Salmonella lawyers of Marler Clarkhave represented thousands of victims of Salmonella and other foodborne illness outbreaks and have recovered over $850 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation. Our Salmonella lawyers have litigated Salmonella cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, tomatoes, ground turkey, salami, sprouts, cereal, peanut butter, and food served in restaurants. The law firm has brought Salmonella lawsuits against such companies as Cargill, ConAgra, Peanut Corporation of America, Sheetz, Taco Bell, Subway and Wal-Mart. 

If you or a family member became ill with a Salmonella infection, including Reactive Arthritis or Irritable bowel syndrome (IBS), after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Salmonella attorneys for a free case evaluation.

Marler Clark has been in the lead for all the Cantaloupe Outbreaks Lawsuits over the last decades. Here is a sampling:

We have had the honor to represent hundreds of those sickened and their families. Here are just a few examples.

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FDA: If you cannot tell if your cantaloupe, including pre-cut cantaloupe or products containing pre-cut cantaloupe is part of the recall, do not eat or use it and throw it away.

Most current information:

Total Illnesses: 117
Hospitalizations: 61    
Deaths: 2
Last Illness Onset: 11/14/2023      
States with Cases: AK, AR, AZ, CA, CO, GA, IA, IL, IN, KS, KY, MA, MD, MI, MN, MO, MS, NC, NE, NJ, NV, NY, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, WA, WI      
Product Distribution: Nationwide and Canada

Recalled whole cantaloupe from the following brands:

  • Whole fresh cantaloupes with a label on the cantaloupe that says “Malichita” or “Rudy”, “4050”, and “Product of Mexico/produit du Mexique”.
  • Retailers and wholesalers would have received recalled whole melons from Crown Jewels Produce in boxes labeled “Malichita/Z Farms” or from Sofia Produce doing business as TruFresh in boxes labeled “Malichita” or “Rudy”, or from Pacific Trellis in corrugated cartons with certain lot codes.

Recalled pre-cut cantaloupe and products containing pre-cut cantaloupes (these products are made from recalled whole cantaloupes):

  • ALDI cantaloupe, cut cantaloupe, and pineapple spears in clamshell packaging with Best-by dates between October 27 and October 31 and sold in IL, IN, IA, KY, MI, and WI.
  • Vinyard cantaloupe chunks and cubes, fruit mixes, melon medleys, and fruit cups containing cantaloupe. Most have a “Vinyard” label, and some have a red label with “Fresh” sold between October 30 and November 10 in Oklahoma stores.
  • Freshness Guaranteed (sold at select Walmart stores) seasonal blend, melon trio, melon mix, fruit blend, fruit bowl, seasonal fruit tray, fruit mix, and cantaloupe chunks; and RaceTrac fruit medley sold in clear square or round plastic containers. Recalled products were sold at select retail stores in IN, MI, OH, KY, NC, TN, VA, IL, TX, and LA (see recall announcement for lot codes and “best by” dates).
  • KwikTrip 6-oz mixed fruit cup, 6-oz cantaloupe cup, and 16-oz fruit tray distributed to Kwik Trip, Kwik Star, Stop-N-Go, Tobacco Outlet Plus Grocery, and Tobacco Outlet Plus convenience stores in WI, MN, IA, MI, IL, and SD.
  • Bix Produce 5.75-oz Created Fresh! cantaloupe Grab N’ Go fruit cups, Created Fresh! Grab N’ Go mixed fruit cups, and Jack & Olive mixed fruit cups sold in MN, ND, SD, and WI.
  • GHGA pre-cut products containing cantaloupe branded as Sprouts Farmers Market, Trader Joes, and unbranded products sold at Kroger. Recalled products were distributed to Kroger stores in AL and GA, Sprout’s Farmers Market stores in AL, GA, NC, and SC, and Trader Joe’s stores in AL, FL, GA, SC, and TN (see recall for lot codes and “sell-by” dates).

FDA has compiled a list of recalls being conducted by companies that received and used recalled melons to make pre-cut cantaloupe or products containing pre-cut cantaloupes. This list will be updated as the agency receives notifications of new recalls.

Salmonellae are widely distributed in nature and are found in the intestinal tract of wild and domesticated animals and in humans. Salmonella poisoning can occur when a person ingests contaminated fecal particles transmitted by another infected human or animal.[1]

Salmonella enterica serotypes Typhi, Sendai, and Paratyphi A, B, or C are found exclusively in humans. These serotypes, collectively referred to as typhoidal Salmonella, cause enteric fever (also known as typhoid or paratyphoid fever if caused by serotypes Typhi or Paratyphi, respectively).[2] Most often, enteric fever is acquired through ingestion of food or water contaminated with human feces. Most U.S. residents who are diagnosed with typhoidal Salmonella are infected while traveling abroad in areas where typhoid fever and paratyphoid fever are common. Three types of vaccines against S. Typhi are commercially available, although there is still not a single licensed vaccine available against S. Paratyph A. [3] Persons planning to travel outside of the United States are advised to find out if a vaccine for typhoid fever is recommended (see www.cdc.gov/travel). 

Most Salmonella infections are caused by eating contaminated food. One study found that 87% of all confirmed cases of Salmonella are foodborne. Foods of animal origin, including meat, poultry, eggs, or dairy products can become contaminated with Salmonella. Eating uncooked or inadequately cooked food—or food cross contaminated with uncooked or undercooked products—can lead to human infections. As explained in a comprehensive report issued by the U.S. Department of Agriculture’s Economic Research Service:

Salmonella contamination occurs in a wide range of animal and plant products. Poultry products and eggs are frequently contaminated with S. Enteritidis, while beef products are commonly contaminated with S.Typhimurium. Other food sources of Salmonella may include raw milk or other dairy products and pork.

In the past two decades, consumption of produce, especially sprouts, tomatoes, fruits, leafy greens, nuts, and nut butters, has been associated with Salmonella illnesses.[4] The surface of fruits and vegetables may be contaminated by human or animal feces. Changes in food consumption and production, as well as the rapid growth of international trade in agricultural products, have facilitated the transmission of Salmonella associated with fresh fruits and vegetables. 

In the United States, Salmonella is the second most commonly isolated bacterial pathogen when laboratory diagnosis of diarrhea is sought.[5] However, passive laboratory surveillance, which uses voluntary reporting by health care providers and facilities, captures only a fraction of illnesses that actually occur. Furthermore, only a small proportion of illnesses are confirmed by laboratory testing and reported to public health agencies. Thus, researchers rely on quantitative statistical modeling to estimate the incidence of foodborne illness. These estimates are used to direct policy and interventions.

What are the Symptoms of Salmonellosis?

Salmonella infections can produce a broad range of disease, from no symptoms to severe illness. The most common clinical presentation is acute gastroenteritis. Symptoms commonly include diarrhea and abdominal cramps, often accompanied by fever of 100°F to 102°F (38°C to 39°C). More serious infections may also involve bloody diarrhea, vomiting, headache, and body aches.[6]

The incubation period, or the time from ingestion of the bacteria until the symptoms start, is generally 6 to 72 hours; however, there is evidence that in some situations the incubation can be longer than 10 days. People with salmonellosis usually recover without treatment within three to seven days. Nonetheless, Salmonella bacteria can persist in the intestinal tract and stool for many weeks after the resolution of symptoms—on average, one month in adults and longer in children.[7]

Treatment of Salmonellosis

S. Typhi and S. Paratyphi are capable of causing systemic illness if they invade the bloodstream (termed “bacteremia”). “Septicemia” or “sepsis” (bloodstream infection or “blood poisoning”) occurs if the bacteria multiply in the blood and cause the immune system to respond by activating inflammatory mechanisms. This may result in the development of “systemic inflammatory response syndrome,” or “SIRS.” By definition, SIRS includes tachycardia, tachypnea, fever, and abnormal white blood cell count. When the bacteria involved are S. Typhi or S. Paratyphi, this serious illness is called enteric typhoid, or paratyphoid fever. Symptoms may start gradually and include fever, headache, malaise, lethargy, and abdominal pain. In children, it can present seemingly innocuously as a non-specific fever. The incubation period for S. Typhi is usually 8 to 14 days, but it can range from three to 60 days. For S. Paratyphi infections, the incubation period is similar to that of nontyphoidal Salmonella—one to 10 days.[8]

Medical treatment is acutely important, though, if the patient becomes severely dehydrated or if the infection spreads from the intestines. Persons with severe diarrhea often require re-hydration, usually with intravenous (IV) fluids. But antibiotics are not necessary or indicated unless the infection spreads from the intestines, at which time the infection can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin. Unfortunately, though, some Salmonella bacteria have become resistant to antibiotics, largely as a result of the use of antibiotics to promote the growth of feed animals.[9]

[1]           Chiu, C.-H. (2019). Salmonella, Non-Typhoidal Species (S. Choleraesuis, S. Enteritidis, S. Hadar, S. Typhimurium). http://www.antimicrobe.org/b258.asp. 

[2]           Ohad eGal-Mor, Erin C Boyle, & Guntram A. Grassl. (2014). Same species, different diseases: how and why typhoidal and non-typhoidal Salmonella enterica serovars differ. Frontiers in Microbiology, 5. https://doi.org/10.3389/fmicb.2014.00391

[3]           Id.

[4]           National Typhoid and Paratyphoid Fever Surveillance Annual Summary, 2015.” Centers for Disease Control and Prevention, 6 Nov. 2018. Available at: https://www.cdc.gov/typhoid-fever/reports/annual-report-2015.html. 

[5]           “National Enteric Disease Surveillance: Salmonella Annual Report, 2016.” Centers for Disease Control and Prevention, 28 Feb. 2018. Available at: https://www.cdc.gov/nationalsurveillance/pdfs/2016-Salmonella-report-508.pdf. 

[6]           “Salmonella.” Centers for Disease Control and Prevention, 24 Jun. 2020. Available at: https://www.cdc.gov/salmonella/. 

[7]           Id.

[8]           Miller, S. and Pegues, D. “Salmonella Species, Including Salmonella Typhi” in Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, Sixth Edition, Chap. 220, pp. 2636-50 (2005).

[9]           Medalla, F., Gu, W., Mahon, B. E., Judd, M., Folster, J., Griffin, P. M., & Hoekstra, R. M. (2016). Estimated Incidence of Antimicrobial Drug-Resistant Nontyphoidal Salmonella Infections, United States, 2004-2012. Emerging infectious diseases, 23(1), 29–37. https://doi.org/10.3201/eid2301.160771