Several other states have been excluded but, beyond that, Acheson said, "anywhere else is essentially open for question in terms of whether that is the source."
The number of people affected by the outbreak remains essentially flat, with 167 people from 17 states infected and 23 people hospitalized. The death of a man in Texas who died is still being investigated, Dr. Ian Williams, chief of the OutbreakNet Team at the U.S. Centers for Disease Control and Prevention, said during the teleconference. The man had cancer and consumed pico de gallo, which is made with tomatoes.
The actual number of people infected is likely to be many more, Williams said. "Many people with salmonella infection don't have stool specimen tests," he said.
On Tuesday, the warning about salmonella-contaminated tomatoes was expanded to include the entire country.
The outbreak was first identified in May with a cluster of approximately 20 people in New Mexico infected with salmonella which had the same genetic footprint. Another cluster was then identified in Texas.
Officials were then able to trace the outbreak to contaminated tomatoes.
The particular type of salmonella involved, Salmonella Saintpaul, is virulent and relatively rare, accounting for only about 400 reported cases annually in the United States, Williams said.
Acheson reiterated that the outbreak of salmonella contamination seems to be linked with certain types of raw, red tomatoes and products containing these tomatoes. In particular, the agency said, raw, red plum tomatoes, raw, red Roma tomatoes and raw, round red tomatoes should be avoided at this time.
Cherry tomatoes, grape tomatoes, homegrown tomatoes and tomatoes sold with the vine still attached appear to be safe. But all tomatoes should be washed before eating, officials advised.
And, until a source for the outbreak is identified, consumers need to employ a little de
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