From the MMWR Today – Since February 1, a total of 228 cases have been reported from 13 states: Nebraska (110 cases), Iowa (35), South Dakota (35), Michigan (18), Kansas (eight), Pennsylvania (seven), Minnesota (five), Ohio (three), Illinois (two), West Virginia (two), Florida (one), North Carolina (one), and Utah (one) (Figure 2). Patients range in age from <1 year to 85 years (median: 29 years); 69% are female. Among patients with available information, 4% reported being hospitalized. No deaths have been reported.

On February 24, 2009, the Nebraska Department of Health and Human Services identified six isolates of Salmonella serotype Saintpaul with collection dates from February 7–14. Salmonella Saintpaul is not a commonly detected serotype; during 2008, only three Salmonella Saintpaul isolates were identified in Nebraska. This report summarizes the preliminary results of the investigation of this outbreak, which has identified 228 cases in 13 states and implicated the source as alfalfa sprouts produced at multiple facilities using seeds that likely originated from a common grower. On April 26, the Food and Drug Administration (FDA) and CDC recommended that consumers not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts, until further notice. On May 1, FDA alerted sprout growers and retailers that a seed supplier was withdrawing voluntarily from the market all lots of alfalfa seeds with a specific three-digit prefix.

For this investigation, a case was defined as illness in a person whose stool culture on or after February 1, 2009, yielded Salmonella Saintpaul with the outbreak strain pulsed-field gel electrophoresis (PFGE) patterns (XbaI JN6X01.0072, JN6X01.0252, JN6X01.0340, JN6X01.0709, JN6X01.0712, JN6X01.0718, or JN6X01.0719). During January 1, 2008 to January 31, 2009, only four cases of the outbreak strain of Salmonella Saintpaul were identified by PulseNet.

By March 19, a total of 186 cases had been identified in Illinois, Iowa, Kansas, Minnesota, Nebraska, and South Dakota. Of the 156 patients with completed interviews, 114 (73%) reported alfalfa sprout consumption.

In mid-April, 42 additional case-patients with onset of illness beginning after March 15 were identified from Florida, Iowa, North Carolina, Michigan, Minnesota, Nebraska, Ohio, Pennsylvania, Utah, and West Virginia. At least 20 of these case-patients reported recently eating sprouts. Alfalfa sprouts eaten by these case-patients were traced back to growing facilities in Michigan, Minnesota, and Pennsylvania that received seed lots identified with prefix 032 from Caudill Seed Company. Alfalfa sprout irrigation water collected on March 10 from a growing facility in Wisconsin grew Salmonella Saintpaul indistinguishable from the outbreak strain. These sprouts also were grown from a seed lot identified with prefix 032 received from Caudill Seed Company. No human illnesses have been linked to the Wisconsin facility. Preliminary findings indicate that the implicated seed lots were sold in many states and might account for a large proportion of the alfalfa seeds that were being used by sprout growers during this outbreak.

We presently have nearly a dozen clients from several states.  Four Lawsuits have been filed.