Update: Onions linked to Salmonella outbreak
A fast-growing Salmonella Oranienburg outbreak has sickened 419 people in 35 states. Health officials are still working to determine the source of the outbreak, but some evidence suggests that cilantro, peppers and onions are possible suspects.
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On September 24, 2021, the Centers for Disease Control and Prevention (CDC) reported that it had collected and tested a condiment cup from a takeout meal eaten by one of the outbreak patients. Originally, the cup contained onions, cilantro, and lime, but at the time it was tested no onions were left in the cup. The sample tested positive for the outbreak strain Salmonella Oranienburg. Because foods contaminated with bacteria can cross-contaminate foods they touch, any of these three ingredients could be the source of the outbreak.
In Texas, the state hardest hit by this outbreak, a health official told a local news station that a mixture of cilantro, lime, and jalapeno peppers was commonly cited by outbreak patients as part of a meal they ate before they became ill.
Salmonella can survive on the surface of lime or lemon wedges and be transferred to beverages or foods, according to a 2019 study in the Journal of Food Protection called “Survival of Salmonella on Lemon and Lime Slices and Subsequent Transfer to Beverages.” But citrus juice inhibits bacterial growth and there has never been a Salmonella outbreak linked to limes. There have been, however, plenty of Salmonella outbreaks linked to onions, peppers, and cilantro.
Salmonella from Restaurant Food
Another aspect of this outbreak is that several clusters of illness have been linked to food served at restaurants. The majority of onion and cilantro Salmonella outbreaks occur in restaurant settings.
While the CDC and the U.S. Food and Drug Administration (FDA) work to identify which ingredient is the source of this outbreak, here’s a look at Salmonella outbreaks linked to onions, cilantro, and two foods containing them that are common sources of restaurant outbreaks -salsa and guacamole.
Salmonella and Salsa Ingredients
Between 1990 and 2006, at least 70 food poisoning outbreaks were linked to salsa, according to 2010 study published in the Journal of Food Protection. It’s a trend that continued to the late 2000s and beyond. In 2008, an outbreak linked to jalapeno and serrano peppers sickened 1,442 people in 43 states. At least 286 people were hospitalized and two of them died.
Researchers in the 2010 study, called “Survival of Salmonella and Staphylococcus aureus in Mexican red Salsa in a Food Service Setting,” said restaurants prepare large batches of salsa and store it in the refrigerator but serve it at room temperature. So, they inoculated batches of salsa containing tomatoes, cilantro, and onions with Salmonella Enteritidis and stored some of the batches at room temperature (20˚C/ 68˚F) and others at refrigeration temperature (4˚C/39˚F). Salmonella survived at both temperatures.
A 2019 study, also published in the Journal of Food Protection, called “Room Temperature Growth of Salmonella enterica Serovar Saintpaul in Fresh Mexican Salsa,” measured the growth of Salmonella in freshly made salsa and individual ingredients.
Researchers inoculated chopped tomatoes, jalapeño peppers, cilantro, and onions, and freshly made salsa containing different amounts of each with five different strains of Salmonella: Saintpaul, Typhimurium, Montevideo, Newport, or Enteritidis. The samples were stored at room temperature (23°C/ 73˚F) and tested between the 12-hour and 72-hour marks.
The Salmonella grew to dangerous levels most quickly (two days) in the tomato, jalapeño pepper, and cilantro samples. The Salmonella in the onions grew more slowly, reaching a dangerous level by the 72-hour mark.
Salmonella grew in all of the salsa samples whether or not they contained lime juice. But the growth rate varied by strain. For example, Salmonella levels moderately increased in salsa samples inoculated with Salmonella Typhimurium, Salmonella Montevideo, Salmonella Newport, and Salmonella Enteritidis. But Salmonella Saintpaul grew at twice the rate of the other four. It was even able to grow in salsas that contained 10 percent lime juice.
Salsa and Guacamole are Common Sources of Restaurant Outbreaks
The CDC didn’t start tracking food poisoning outbreaks until 1973 and it would another 11 years before an outbreak linked to salsa or guacamole made a debut. Most salsa or guacamole outbreaks that occurred between 1984 and 2008, 84 percent, occurred in restaurant or deli settings.
Between 1984 and 1997, salsa or guacamole outbreaks accounted for 1.5 percent of all outbreaks at food establishments. That percentage doubled to 3.9 percent during the next 10-year period. Between 1998 to 2008, about 1 out of every 25 restaurant-associated food poisoning outbreaks was associated with salsa or guacamole. The causes most frequently cited in these outbreaks were inappropriate storage times or temperatures (30 percent) and food worker hygiene (20 percent).
Salsa, Guacamole, Onion, and Cilantro Salmonella Outbreaks
Between 2009 and 2018, there have been at least four guacamole Salmonella outbreaks, six salsa Salmonella outbreaks, three cilantro Salmonella outbreaks, and nine onion Salmonella outbreaks, according to CDC data. These outbreaks resulted in hundreds of illnesses and dozens of hospitalizations.
Cilantro Salmonella outbreaks
The three cilantro Salmonella outbreaks were single-state outbreaks including a 2016 outbreak at a private residence in California, and a 2013 outbreak in Nebraska, and a 2014 outbreak in Florida that occurred at restaurants.
Onion Salmonella outbreaks
Four of the nine onion Salmonella outbreaks were multistate. Of the eight outbreaks where a setting was listed, six occurred at restaurants, one occurred at a long-term care facility and one occurred at a private residence.
In 2020, a Salmonella outbreak linked to onions produced by Thompson International of Bakersfield, CA, and sold under a variety of brand names sickened 1,127 hospitalizing 167, according to the Centers for Disease Control and Prevention (CDC). The outbreak included illnesses in 48 states and 515 illnesses in a separate outbreak in Canada.
Experienced Salmonella Lawyers
If you developed a Salmonella infection and would like a free consultation with an experienced Salmonella lawyer, please contact us. The Pritzker Hageman Salmonella Legal Team has represented clients in every major Salmonella outbreak in the U.S. You can reach us by calling 1-888-377-8900, sending a text to 612-261-0856, or by completing the form below. There is no obligation and we don’t get paid unless we win.
This post was originally published On September 27, 2021.
This post was updated on October 1, 2021, to include updated outbreak information.