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Investigation Details
Posted June 12, 2024
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are collecting different types of data to investigate a multistate outbreak of Salmonella Africana infections. Epidemiologic data show that cucumbers may be contaminated with Salmonella and may be making people sick.
CDC and FDA are also investigating an outbreak of Salmonella Braenderup infections, with 185 illnesses in 24 states. The two outbreaks share several similarities, including where and when illnesses occurred and the demographics of ill people. Investigators are working to determine whether the two outbreaks could be linked to the same food. Information will be provided on the source of the Salmonella Braenderup outbreak as it becomes available.
Epidemiologic Data
As of June 12, a total of 196 people infected with the outbreak strain of Salmonella Africana have been reported from 28 states and the District of Columbia (see map). Illnesses started on dates ranging from March 11, 2024, to May 23, 2024 (see timeline). Of 164 people with information available, 68 have been hospitalized and no deaths have been reported.
The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.
Public health officials collect many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provides clues to help investigators identify the source of the outbreak.
The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).
| Demographics | Information |
|---|---|
| Age (n=195) |
Range from <1 to 94 years Median age of 41 |
| Sex (n=194) |
62% female 38% male |
| Race (n=158) |
84% White 12% African American/Black 1% Native American or Alaska Native 3% Asian 0% Native Hawaiian or other Pacific Islander 0% reported more than one race |
| Ethnicity (n=153) |
88% non-Hispanic 12% Hispanic |
State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 85 people interviewed, 63 (74%) reported eating cucumbers. This percentage was significantly higher than the 50% of respondents who reported eating cucumbers in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. This difference suggests that people in this outbreak got sick from eating cucumbers.
Laboratory Data
WGS analysis of bacteria from 196 people’s samples predicted resistance to fosfomycin. Among these, bacteria from 6 people’s samples also predicted resistance to one or more of the following antibiotics: amoxicillin-clavulanic acid, ampicillin, azithromycin, cefoxitin, ceftiofur, ceftriaxone, ciprofloxacin, and tetracycline. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site. Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed, some illnesses in this outbreak may be difficult to treat with some commonly recommended antibiotics and may require a different antibiotic choice.
As part of the Salmonella Africana investigation, officials in the Pennsylvania Department of Agriculture collected samples of cucumbers from several retail locations in the state. Testing identified Salmonella Bareilly, a different strain of Salmonella than the one making people sick in this outbreak. CDC is not currently investigating an outbreak of illnesses with this strain.
Public Health Actions
CDC advises people not to eat, sell, or serve recalled cucumbers while the investigation is ongoing.
The Florida grower that supplied the recalled cucumbers to Fresh Start is no longer growing and harvesting cucumbers for the season.
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are collecting different types of data to investigate a multistate outbreak of Salmonella Africana infections. Epidemiologic data show that cucumbers may be contaminated with Salmonella and may be making people sick.
CDC and FDA are also investigating an outbreak of Salmonella Braenderup infections, with 158 illnesses in 23 states. The two outbreaks share several similarities, including where and when illnesses occurred and the demographics of ill people. Investigators are working to determine whether the two outbreaks could be linked to the same food. Information will be provided on the source of the Salmonella Braenderup outbreak as it becomes available.
Epidemiologic Data
As of June 4, a total of 162 people infected with the outbreak strain of Salmonella Africana have been reported from 25 states and the District of Columbia (see map). Illnesses started on dates ranging from March 11, 2024, to May 16, 2024 (see timeline). Of 127 people with information available, 54 have been hospitalized and 0 deaths have been reported.
The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.
Public health officials collect many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provides clues to help investigators identify the source of the outbreak.
The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).
| Demographics | Information |
|---|---|
| Age (n=161) |
Range from <1 to 92 years Median age of 40 |
| Sex (n=159) |
64% female 36% male |
| Race (n=120) |
83% White 13% African American/Black 1% Native American or Alaska Native 3% Asian 0% Native Hawaiian or other Pacific Islander 0% reported more than one race |
| Ethnicity (n=115) |
89% non-Hispanic 11% Hispanic |
State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 65 people interviewed, 47 (72%) reported eating cucumbers. This percentage was significantly higher than the 50% of respondents who reported eating cucumbers in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. This difference suggests that people in this outbreak got sick from eating cucumbers.
Laboratory Data
Public health investigators used the PulseNet system to identify illnesses that may have been part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).
WGS showed that bacteria from sick people’s samples are closely related genetically. This means that people in this outbreak likely got sick from the same type of food.
WGS analysis of bacteria from 162 people’s samples predicted resistance to fosfomycin. Among these, bacteria from 5 people’s samples also predicted resistance to one or more of the following antibiotics: amoxicillin-clavulanic acid, ampicillin, azithromycin, cefoxitin, ceftiofur, ceftriaxone, ciprofloxacin, and tetracycline. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site. Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed, some illnesses in this outbreak may be difficult to treat with some commonly recommended antibiotics and may require a different antibiotic choice.
As part of this investigation, officials in the Pennsylvania Department of Agriculture collected samples of cucumbers from several retail locations in the state. Testing identified Salmonella in one sample of these cucumbers. Further testing is underway to determine if the strain of Salmonella from the cucumber sample is the same strain that is making people sick.
Public Health Actions
CDC advises people not to eat, sell, or serve recalled cucumbers while the investigation is ongoing.
Cucumbers distributed by Fresh Start Produce Sales, Inc. are from a variety of growers. The grower that likely supplied potentially contaminated cucumbers is no longer growing and harvesting cucumbers for the season.
