Illinois has joined Maine and Minnesota in naming themselves as locations of ill persons linked to Salmonella Agona tainted Unsweetened Puffed Rice and Puffed Wheat cereal. The U.S. Food and Drug Administration said Saturday that diagnoses of salmonellosis linked with the consumption of Malt-O-Meal cereals have been reported in 14 states. Three people have been treated in hospital.

Three states down, eight to go. What continues to go unreported is what the same plant that produced the same PFGE (genetic fingerprint) Salmonella Agona in 1998 has been doing since 1998? Also, have there been Salmonella Agona illnesses linked to cereal consumption over the last ten years?

Craig Hedberg, PhD, a foodborne disease expert and associate professor of environmental health sciences at the University of Minnesota School of Public Health in Minneapolis, told CIDRAP News that there may an environmental source of S Agona at the plant, despite the steps that Malt-O-Meal reportedly took in response to the previous outbreak in 1998.

"My guess is that the bug may have been in the plant the whole time, but that to have enough contamination to cause an outbreak also required an amplifying event," he said.

Hedberg said that if this is, in fact, the same strain that caused the previous outbreak, it would be interesting to review PulseNet data see if health officials have missed other cases involving the outbreak strain over the past 10 years.