Multistate Outbreak of Salmonella Infections Linked to Pistachio Nuts (FINAL UPDATE)

Posted April 14, 2009

Outbreak Summary

On March 26, 2009 the US Food and Drug Administration (FDA) informed CDC that multiple samples of pistachio nuts and pistachio-containing products collected over several months from a single company were contaminated with several serotypes of Salmonella, including Montevideo, Newport, and Senftenberg. Since that time, CDC has been actively investigating whether this contamination is linked to human illness.

FDA has provided PulseNet, the CDC database of bacterial DNA fingerprints, with the DNA fingerprints of the Salmonella strains found in association with the company’s products. Some of the DNA fingerprints of the Salmonella strains from the pistachio products match the DNA fingerprints of Salmonella strains from recently ill persons already in the PulseNet database. The number of recent human infections with these strains is not currently above the expected baseline in the United States. In addition to the pistachios, some of these DNA fingerprints have been associated with other foods, and a fingerprint match does not mean that the illnesses are necessarily linked to pistachios. CDC is collaborating with state and local public health agencies to interview persons with Salmonella strains having DNA fingerprints that match those from the pistachio products to determine whether they had eaten pistachio nuts or pistachio-containing products before their illnesses. To date, one patient in Connecticut infected with a Salmonella strain with a matching DNA fingerprint has reported consuming a pistachio-containing product.

Salmonella that contaminates food, including nuts, can cause human illness and is a public health concern. CDC estimates that the Salmonella illnesses reported to the public health system represent approximately 3% of the illnesses that actually occur, because many ill persons do not seek medical care or have a specimen cultured. Even if no reported illnesses are related to a contaminated product, it is possible that some illnesses occurred.

All of the contaminated pistachios came from a single company, Setton Pistachio of Terra Bella Inc., California. Setton Pistachio has stopped distribution of roasted shelled, roasted in-shell, and raw shelled pistachios from their 2008 crop and has issued a voluntary recall of those products. Companies that receive pistachios from Setton Pistachio continue to recall their products. The contaminated pistachios may have been used in a wide range of foods, including cakes, cookies, puddings, trail mix, snack bars, and ice cream.

Information on Salmonella and Salmonellosis

What is salmonellosis?

• Salmonellosis is an infection with the bacteria Salmonella. The bacteria are carried in the intestines of animals.
• Most people get sick from eating food contaminated with the bacteria.
• You can also get salmonellosis by touching an infected pet or other animal. Reptiles and young birds are especially likely to carry the bacteria.

What are the symptoms of salmonellosis?

• Most people who get salmonellosis have diarrhea, fever, and abdominal cramps.
• Most people get sick 12 hours to 3 days after they are exposed to the bacteria.
• The illness usually lasts 4 to 7 days.

What is the treatment for salmonellosis?

• Most people with salmonellosis get better without medical treatment.
• People with diarrhea should drink lots of fluids.
• Serious cases can lead to hospitalization or death.
• Serious illness is most likely to occur in infants, the elderly, and people with impaired immune systems.

What should you do if you have symptoms of salmonellosis?

• If you have a diarrheal illness lasting more than 3 days, accompanied by a fever over 101.5ºF or the diarrhea is bloody, consult a healthcare provider.

Information on Salmonella and Salmonellosis

• Consumers should avoid eating recalled products.
• In addition, follow these rules to avoid illness:
  • Wash hands, kitchen surfaces, and cooking utensils with soap and water right after touching raw meat or poultry (like chicken and turkey).
  • Cook poultry and ground beef all the way through, until there is no pink in the middle. Cook eggs until they are not runny.
  • If a restaurant serves you undercooked food, send it back to the kitchen for further cooking.
  • Wash fresh produce carefully before eating.
  • Do not eat or drink foods made with raw eggs or raw (unpasteurized) milk.
  • Be especially careful when making foods for infants, the elderly, or people with impaired immune systems.
  • Wash hands with soap and water after handling pets, especially reptiles and birds.