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Texas leads onion outbreak case map; more than 800 infected

salmonella case map

Since the last update on October 18, 2021, 156 more sick people were added to this outbreak. As of October 28, 2021, 808 people infected with the outbreak strain of Salmonella Oranienburg have been reported from 37 states and Puerto Rico (see map). Illnesses started on dates ranging from May 31, 2021, to October 13, 2021 (see timeline).

Sick people range in age from less than 1 year to 101 years, with a median age of 37, and 57% are female. Of 505 people with information available, 157 (31%) have been hospitalized.

The true number of sick people in an 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.

Laboratory Data

Whole genome sequencing of bacteria from 709 people’s samples did not predict any antibiotic resistance. Five people’s samples were predicted to be resistant to one or more of the following antibiotics: amoxicillin-clavulanic acid, ampicillin, cefoxitin, and ceftriaxone, gentamicin, streptomycin, sulfamethoxazole, and tetracycline. Standard antibiotic susceptibility testing of three people’s samples by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory also found no resistance. Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed, this resistance is unlikely to affect the choice of antibiotic used to treat most people because it is rare.

Previous outbreak investigation information: 

The FDA, along with CDC and state and local partners, continue to investigate a multistate outbreak of Salmonella Oranienburg infections linked to whole, fresh onions. FDA’s traceback investigation is ongoing but has identified ProSource Produce, LLC (also known as ProSource Inc.) of Hailey, Idaho, and Keeler Family Farms of Deming, New Mexico, as suppliers of potentially contaminated whole, fresh onions imported from the State of Chihuahua, Mexico.

On October 20, 2021, ProSource Produce LLC issued a company announcement. On October 22, 2021, Keeler Family Farms issued a company announcement.

More information including advice for consumers, restaurants, and retailers is available at Outbreak Investigation of Salmonella Oranienburg: Whole, Fresh Onions (October 2021).

The table below lists recalls conducted by companies that further processed the onions by using them as ingredients in new products or by repackaging them.

2021 Recalls of Food Products Associated with Onions from ProSource Produce LLC and Keeler Family Farms due to the Potential Risk of Salmonella | FDA