San Diego County and its Salmonella problem

In a year that has seen a large number of Salmonella-related recalls – including shell eggs, ground beef, dry cereal, and cake mix, to name just a few – San Diego County has recorded its highest total of Salmonella cases in at least 25 years: 730 through mid-December.

One would have to go back to 1996 to find the last time more than even 600 cases were recorded in a year.

The rate of cases in San Diego County is not only the highest in the state of California, but it is also the highest in the country in recent years, according to county reports.

Why are the numbers so high? Local officials are searching for answers.

San Diego County: better testing

Not only has the rise in more frequent Salmonella-related recalls contributed to the increase, but “better testing has contributed to the overall rise nationwide,” Dr. Eric McDonald, the medical director of San Diego County’s epidemiology and immunization services branch, told the San Diego Union-Tribune. Recent advances in testing make it easier to determine if a person is sick with Salmonella.

According to the Centers for Disease Control and Prevention (CDC), there are about 1.2 million foodborne illnesses in the United States annually. That total, however, doesn’t include many cases of salmonellosis – only about 5 percent (1 in 20) are diagnosed.

Why? The severe gastrointestinal distress caused by the bacteria usually passes without hospitalization, so a medical diagnosis usually isn’t made.

“People who wouldn’t have even gotten tested 10 years ago are getting tested more often today, and that clearly has something to do with the increase,” McDonald said.

San Diego County: queso fresco

The county has experienced numerous Salmonella cases related to nationwide outbreaks, along with a local outbreak linked to unpasteurized queso fresco cheeses purchased in Tijuana, according to McDonald.

“We have three confirmed Salmonella cases and another dozen that are probable and awaiting confirmation,” he said. “Seven of them reported consuming Mexican cheeses purchased in Tijuana.”

The unconfirmed cases have secondary links to someone who consumed queso fresco, a style of cheese made from unpasteurized milk. Odds are higher that the cheese might carry bacteria that cause Listeria, Brucella, and tuberculosis, due to the use of unpasteurized milk.

“In the cheese-related outbreak, two of the three confirmed cases, plus five of the 12 unconfirmed cases, were sick enough that they had to be hospitalized,” McDonald said.

San Diego County: salmonellosis

Salmonellosis affects the intestinal tract and is one of the most common types of food poisoning yearly. The disease can develop anywhere from 12 hours to three days after consumption of food contaminated with Salmonella.

As with most types of foodborne illnesses, symptoms can include:

• diarrhea
• abdominal pain
• vomiting
• fever
• chills.

Symptoms can last up to a week, and most people recover without treatment. In some cases, however, diarrhea becomes so severe that dehydration occurs, and then hospitalization is required.

The CDC estimates 23,000 Salmonella victims will need to be hospitalized, and approximately 450 of them will die.

San Diego County: complications

People most at risk for developing complications are children under the age of 5, pregnant women, the elderly, and anyone with a compromised immune system.

Complications, which can occur when Salmonella bacteria enter the bloodstream, can result in:

• meningitis: inflammation of the membranes surrounding the brain and spinal cord
• endocarditis: infection of the heart’s inner lining, usually involving the heart valves
• osteomyelitis: bone inflammation that generally targets the legs, arms, or spine
• reactive arthritis (or Reiter’s syndrome): a form of inflammatory arthritis that develops in response to a Salmonella infection in another part of the body

Pregnant women are at a higher risk for contracting salmonellosis – and developing complications – because their immune systems are suppressed by hormonal changes. A pregnant woman who becomes ill from Salmonella can sustain a miscarriage, go into premature labor, or experience stillbirth.

San Diego County: 2018 outbreaks

Many different types of food can carry Salmonella bacteria, including dairy, meat, fish, raw fruits and vegetables, spices, and nuts. In 2018, the CDC reported outbreaks in the United States due to these contaminated foods:

• shell eggs Gravel Ridge Farms and Rose Acre Farms
• ground beef JBS Tolleson
• dry cereal Kellogg’s Honey Smacks and Quaker Oats Captain Crunch
• cake mix Duncan Hines
• tahini Achdut
• pre-cut melon Caito Foods
• frozen shredded coconut Coconut Tree Brand
• dried coconut Go Smiles
• pasta salad Hy-Vee grocery stores
• chicken salad Triple T Specialty Meats
• raw chicken and turkey
• alfalfa sprouts
• kratom

San Diego County in California has recorded its highest total of Salmonella cases in at least 25 years, 730 through mid-December. This graphic shows the correct minimum internal temperature to which you should cook food. (Source: FoodSafety.gov)

San Diego County: home tips

You have no control over food you eat at a restaurant, but you do have control over food you prepare at home. To prevent Salmonella contamination:

• Wash your hands before cooking and after being around animals.
• Keep food-preparation surfaces clean.
• Always wash raw fruits and vegetables before eating.
• Keep raw vegetables away from eggs, and raw meat and poultry.
• Always cook meat and poultry to the proper internal temperature.
• Drink only pasteurized milk and juices.