Investigation Details
Posted January 19, 2024
This outbreak is over. Learn what you can do to protect yourself from getting sick from Salmonella.
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Salmonella (Sundsvall and Oranienburg) infections.
Epidemiologic, laboratory, and traceback data showed that cantaloupes were contaminated with Salmonella made people sick.
As of January 19, 2024, this outbreak is over.
Epidemiologic Data
A total of 407 people infected with one of the outbreak strains of Salmonella were reported from 44 states (see map). Illnesses started on dates ranging from October 15, 2023, to December 25, 2023 (see timeline). Of 362 people with information available, 158 (44%) were hospitalized. Six deaths were reported, including four from Minnesota, one from Indiana, and one from Oregon.
The true number of sick people in this outbreak was likely much higher than the number reported, and the outbreak may not have been limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella.
Public health officials collected 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 provided 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=404) |
Range from <1 to 100 years Median age of 60 years 26% are 5 years or younger 47% are 65 years or older |
| Sex (n=406) |
45% male 55% female |
| Race (n=321) |
84% White 10% African American/Black 4% Asian 1% Native American or Alaska Native <1% reported more than one race |
| Ethnicity (n=328) |
85% non-Hispanic 15% Hispanic |
State and local public health officials interviewed people about the foods they ate in the week before they got sick. Of the 197 people interviewed, 135 (69%) reported eating cantaloupe. This percentage was significantly higher than the 19.6% of respondents who reported eating cantaloupe in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. Of the 134 people who reported eating cantaloupe, 67 people specifically reported eating pre-cut cantaloupe and 40 reported eating whole cantaloupe. Fifty-two people resided at long-term care facilities when they got sick. Among 24 of these people interviewed, 12 reported eating cantaloupe. Forty-four children attended childcare centers when they got sick. Of 34 children with information available, 19 ate cantaloupe.
Laboratory Data
WGS analysis of bacteria from 405 people’s samples did not predict resistance to any antibiotics. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.
Canada also investigated this Salmonella outbreak and linked the illnesses to cantaloupes. The strain that caused illnesses in Canada was the same strain as the U.S. illnesses.
Public Health Action
Several recalls of cantaloupe products were issued as a result of this investigation:
- 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.
- 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.
- On November 22, 2023, 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.
- On November 27, 2023, Kwik Trip recalled pre-cut cantaloupe and fruit mixes.
- On November 28, Bix Produce recalled pre-cut fruit cups.
- On November 29, GHGA recalled pre-cut cantaloupe products sold at Kroger, Sprouts Farmers Market, and Trader Joe’s.
- On November 30, Cut Fruit Express recalled pre-cut cantaloupe products with use-by dates from November 4 through November 6.
- On December 5, TGD Cuts recalled pre-cut cantaloupe products with use-by dates from November 2 through November 24.
- Stop & Shop recalled cantaloupes purchased from October 23 through November 11.
Epidemiologic Data
Since the last update on December 7, 72 more illnesses have been reported. As of December 14, 302 people infected with one of the outbreak strains of Salmonella have been reported from 42 states (see map). Illnesses started on dates ranging from October 16, 2023, to November 28, 2023 (see timeline). Of 263 people with information available, 129 (49%) have been hospitalized. Four deaths have been reported, three from Minnesota and one from Oregon.
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=299) |
Range from <1 to 100 years Median age of 61 years 26% are 5 years or younger 48% are 65 years or older |
| Sex (n=300) |
48% Male 52% Female |
| Race (n=240) |
84% White 11% African American/Black 4% Asian <1% Native American or Alaska Native 1% reported more than one race |
| Ethnicity (n=239) |
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 145 people interviewed, 107 (74%) reported eating cantaloupe. This percentage was significantly higher than the 19.6% of respondents who reported eating cantaloupe in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. Of the 107 people who reported eating cantaloupe, 56 people specifically reported eating pre-cut cantaloupe and 29 reported eating whole cantaloupe.
Forty people resided at long-term care facilities when they got sick. Of 17 interviewed, 11 reported eating cantaloupe.
Thirty children attended childcare centers when they got sick. Of 26 children with information available, 17 ate cantaloupe.
Laboratory Data
WGS analysis of bacteria from 300 people’s samples did not predict resistance to any antibiotics. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.
Public Health Action
Since the last update, one additional recall for cantaloupes has been issued. Stop & Shop recalled cantaloupes purchased from October 23 through November 11.
Epidemiologic Data
Since the last update on November 30, 113 more illnesses have been reported. As of December 6, 230 people infected with one of the outbreak strains of Salmonella have been reported from 38 states (see map). Illnesses started on dates ranging from October 16, 2023, to November 20, 2023 (see timeline). Of 185 people with information available, 96 (52%) have been hospitalized. Three deaths have been reported, two from Minnesota and one from Oregon.
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=227) |
Range from <1 to 100 years Median age of 59 years 27% are 5 years or younger 47% are 65 years or older |
| Sex (n=229) |
54% Male 46% Female |
| Race (n=171) |
85% White 10% African American/Black 3% Asian 1% Native American or Alaska Native 1% reported more than one race |
| Ethnicity (n=170) |
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 105 people interviewed, 78 (74%) reported eating cantaloupe. This percentage was significantly higher than the 19.6% of respondents who reported eating cantaloupe in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. Of the 78 people who reported eating cantaloupe, 42 people specifically reported eating pre-cut cantaloupe and 18 reported eating whole cantaloupe.
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.
Laboratory Data
WGS analysis of bacteria from 228 people’s samples did not predict resistance to any antibiotics. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.
Public Health Action
Since the last update, two additional recalls for pre-cut cantaloupes have been issued.
- On November 30, Cut Fruit Express recalled pre-cut cantaloupe products with use-by dates from November 4 through November 6.
- On December 5, TGD Cuts recalled pre-cut cantaloupe products with use-by dates from November 2 through November 24.
All cantaloupe recalls are listed on FDA’s cantaloupe recall website.
Epidemiologic and laboratory data show that cantaloupes are contaminated with Salmonella and are making people in this outbreak sick.
Canada is also investigating this outbreak and has linked illnesses in Canada to Malichita brand cantaloupes.
Since the last update on November 24, CDC has added a second strain of Salmonella (Oranienburg) to this outbreak investigation after the Canadian Food Inspection Agency found this strain in a sample of Malichita brand cantaloupes. Two people in the United States are infected with the outbreak strain of Salmonella Oranienburg.
Epidemiologic Data
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 (see map). Illnesses started on dates ranging from October 17, 2023, to November 14, 2023 (see timeline). Of 103 people with information available, 61 (59%) have been hospitalized. Two deaths have been reported from Minnesota.
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=115) |
Range from <1 to 100 years Median age of 64 years 29% are 5 years or younger 50% are 65 years or older |
| Sex (n=116) |
59% Male 41% Female |
| Race (n=100) |
85% White 11% African American/Black 3% Asian 1% reported more than one race |
| Ethnicity (n=99) |
87% non-Hispanic 13% Hispanic |
State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 52 people interviewed, 40 (77%) reported eating cantaloupe. This percentage was significantly higher than the 19.6% of respondents who reported eating cantaloupe in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. Of the 40 people who reported eating cantaloupe, 19 people specifically reported eating pre-cut cantaloupe and 11 reported eating whole cantaloupe.
Fourteen people in this outbreak resided at long-term care facilities when they got sick. Of six interviewed, four reported eating cantaloupe.
Seven children in this outbreak attended childcare centers when they got sick. Of six children with information available, all six ate or maybe ate cantaloupe.
Laboratory Data
WGS analysis of bacteria from 117 people’s samples did not predict resistance to any antibiotics. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.
Public Health Actions
Three more recalls have been issued since the last update.
- On November 27, 2023, Kwik Trip recalled pre-cut cantaloupe and fruit mixes.
- On November 28, Bix Produce recalled pre-cut fruit cups.
- On November 29, GHGA recalled pre-cut cantaloupe products sold at Kroger, Sprouts Farmers Market, and Trader Joe’s.
CDC is advising you to not eat recalled fruits and to not eat pre-cut cantaloupes if you don’t know whether Malichita or Rudy brand cantaloupes were used. CDC also advises long-term care facilities, childcare centers, hospitals, and other facilities that care for people at higher risk for severe Salmonella illness to not serve recalled fruits and to not serve cantaloupe that was supplied pre-cut if they don’t know whether Malichita or Rudy brand cantaloupes were used.
Epidemiologic and laboratory data show that cantaloupes are contaminated with Salmonella and are making people in this outbreak sick.
Canada is also investigating this outbreak and has linked illness in Canada with the same Salmonella strain to cantaloupes.
Epidemiologic Data
Since the last update on November 17, 2023, 56 more illnesses have been reported. As of November 24, 99 people infected with the outbreak strain of Salmonella have been reported from 32 states (see map). Illnesses started on dates ranging from October 17, 2023, to November 10, 2023 (see timeline). Of 77 people with information available, 45 have been hospitalized. Two deaths have been reported from Minnesota.
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=97) |
Range from <1 to 100 years Median age of 62 years |
| Sex (n=98) |
60% Male 40% Female |
| Race (n=75) |
88% White 9% African American/Black 1% Asian 1% reported more than one race |
| Ethnicity (n=73) |
86% non-Hispanic 14% Hispanic |
State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 33 people interviewed, 29 (88%) reported eating cantaloupe. This percentage was significantly higher than the 19.6% of respondents who reported eating cantaloupe in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness.
Laboratory Data
WGS analysis of bacteria from 89 people’s samples did not predict resistance to any antibiotics. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.
Public Health Actions
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.
CDC is advising people not to eat, sell, or serve recalled fruit.
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 Sundsvall infections.
Epidemiologic and laboratory data show that cantaloupes are making people in this outbreak sick.
Epidemiologic Data
As of November 17, 43 people infected with the outbreak strain of Salmonella have been reported from 15 states (see map). Illnesses started on dates ranging from October 17, 2023, to November 6, 2023 (see timeline). Of 30 people with information available, 17 have been hospitalized. 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=43) |
Range from 1 to 100 years Median age of 62 years |
| Sex (n=43) |
58% Female 42% Male |
| Race (n=33) |
94% White 3% Asian 3% reported more than one race |
| Ethnicity (n=32) |
81% non-Hispanic 19% Hispanic |
State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 29 people interviewed, 15 (52%) reported eating cantaloupe. This percentage was significantly higher than the 19.6% of respondents who reported eating cantaloupe in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness.
Laboratory Data
Public health investigators are using the PulseNet system to identify illnesses that may be 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 suggests that people in this outbreak got sick from the same food.
Canada is also investigating a Salmonella outbreak linked to cantaloupes. The strain causing the outbreak in Canada is the same as the US outbreak strain. The Canadian Food Inspection Agency found Salmonella in a sample of Malichita brand cantaloupe, and WGS showed that the Salmonella on the cantaloupe is closely related genetically to the bacteria from sick people in Canada. This suggests that people in the Canadian and US outbreaks likely got sick from eating cantaloupe.
WGS analysis of bacteria from 41 people’s samples did not predict resistance to any antibiotics. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.
Public Health Actions
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.
