FDA warns against sprouts tied to the outbreak; other outbreak investigations ongoing

During this first week of 2023, the Food and Drug Administration continues to investigate three outbreaks of foodborne illnesses initially reported in 2022.

The most recent outbreak has sickened people in three states and has been traced to fresh, raw alfalfa sprouts, according to the FDA and the Centers for Disease Control and Prevention. The FDA traced the Salmonella outbreak to sprouts from SunSprout Enterprises in Nebraska.

There is concern that some consumers may still have unused portions of the implicated sprouts in their homes because they have best-by dates through Jan. 7.

SunSprout Enterprises recalled four lots — 4211, 5211, 3212, and 4212 — of raw alfalfa sprouts in 4-ounce clamshells and 2.5-pound packages, with best-by dates between Dec. 10, 2022, and Jan. 7, 2023. An investigation is underway to determine how this alfalfa product was handled and stored after it left its Nebraska production facility, according to the FDA.

As of the most recent patient count update, which was posted on Dec. 30, 15 people from three states have been infected. The states and the number of sick people are Nebraska with 8, South Dakota with 6, and Oklahoma with 1. Two patients have been hospitalized. No deaths have been reported.

Of 12 patients who have been interviewed so far by public health officials, all reported eating sprouts in the days before becoming sick. 

The patients range in age from 19 to 78 years old with a median age of 39. Sixty-seven percent of the patients are female.

Investigators from state health agencies and the FDA are working on traceback of the sprouts as well as on-site inspections and sample collection and analysis.

Whole genome sequencing has already shown that bacteria from sick people’s samples are closely related genetically. This suggests that people in this outbreak got sick from the same food.

Additional patients will likely be identified.

“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,” according to the CDC.

Anyone who has eaten sprouts and developed symptoms of Salmonella is urged to seek medical attention. 

Food contaminated with Salmonella bacteria does not usually look, smell, or taste spoiled. Anyone can become sick with a Salmonella infection. Infants, children, seniors, and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC.

Anyone who has developed symptoms of Salmonella infection should seek medical attention. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis.

Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Otherwise, healthy adults are usually sick for four to seven days. In some cases, however, diarrhea may be so severe that patients require hospitalization.

Older adults, children, pregnant women, and people with weakened immune systems, such as cancer patients, are more likely to develop severe illnesses and serious, sometimes life-threatening conditions.

Some people get infected without getting sick or showing any symptoms. However, they may still spread the infections to others.

Other ongoing outbreak investigations
The FDA is continuing to investigate an outbreak of Salmonella Typhimurium infections of unknown origin that has sickened 274 people. The outbreak has been declared over, but investigators continue their work. They have initiated traceback efforts as well as sample testing, but the agency has not reported what food is being traced and tested. The FDA has not reported where the outbreak victims live.

A third outbreak investigation remains open at this time. It is regarding infections from Listeria monocytogenes and enoki mushrooms. Two people, one each in Nevada and Michigan, are sick and both have been hospitalized. The FDA and CDC are trying to determine what brand of enoki mushrooms are involved. There have been numerous recalls of enoki mushrooms this year because of Listeria contamination.

Additional outbreak information
Click here to go to the FDA page with links to specific outbreak details. The investigations are in a variety of stages. Some outbreaks have limited information with active investigations ongoing, others may be near completion.

A public health advisory will be issued for investigations that have resulted in specific, actionable steps for consumers to take to protect themselves, according to the FDA. Please direct your attention to those pages for the most up-to-date information on the investigation and for consumer protection information.

Outbreak and adverse event investigations that do not result in specific, actionable steps for consumers may or may not conclusively identify a source or reveal any contributing factors. Adverse event investigations rely on self-reported data. Although these reports may name a particular product, FDA will only indicate a product category in the table and will not publicly name a specific product until there is sufficient evidence to implicate that product as a cause of illnesses or adverse events. If a cause and/or contributing factors are identified that could inform future prevention, FDA commits to providing a summary of those findings.