FDA: Frequently Asked Questions on tomatoes and salmonella

Posted to the FDA Web site yesterday:

Consumer and Industry Advice and General Information
What kind of illness does Salmonella cause?
People who eat food contaminated with Salmonella often have fever, diarrhea (which may be bloody), nausea, vomiting, and abdominal pain. The bacterium can enter the bloodstream and causes more severe illness, although this rarely happens. Infection with Salmonella also may be more serious or fatal in young children, frail or elderly people, and people with weakened immune systems.
How many people have become ill in this outbreak?
To date, 145 cases have been linked to the outbreak. Twenty-three people have been hospitalized.
In what states have confirmed illnesses been reported?
Confirmed cases have been reported in the following states: Arizona, California, Colorado, Connecticut, Idaho, Illinois, Indiana, Kansas, New Mexico, Oklahoma, Oregon, Texas, Utah, Virginia, Washington, and Wisconsin.
What is the source of the contaminated tomatoes?
FDA has not yet identified the source of the contaminated tomatoes. FDA recognizes that the source of the contaminated tomatoes may be limited to a single grower or packer in a specific geographic area and is working diligently with the states, the Centers for Disease Control and Prevention (CDC), and the Indian Health Service, and various food-industry trade associations to quickly determine the source of the tomatoes associated with the outbreak.
What states or countries have been ruled out as the source of this outbreak?
The U.S. states in which people have become ill from tomatoes do not necessarily represent the areas where the tomatoes were grown. The tomatoes might have been shipped to these states from elsewhere.
U.S. states and territories and countries other than the U.S. that had not gone into tomato production at the time of the outbreak or have been otherwise ruled out as the source of the contamination, include the following.
U.S. States
Alabama
Arkansas
California
Georgia
Hawaii
Louisiana
Maine
Maryland
Minnesota
Mississippi
Nebraska
New York
North Carolina
Ohio
Pennsylvania
South Carolina
Tennessee
Texas
Virginia
U.S. Territories
Puerto Rico
Countries Other than the U.S.
Belgium
Canada
Dominican Republic
Guatemala
Israel
Netherlands
As the investigation continues, more states, territories, and countries may be added to this list.
What steps are being taken to prevent future illness from this outbreak?
The FDA, the CDC, the Indian Health Service, and state health department officials are collaborating closely to ensure that the outbreak is contained and that consumers and retailers are made aware of the contamination. The food industry is cooperating in the investigation and is assisting government officials in their efforts to find the source of the contamination and ensure that additional tainted tomatoes do not reach consumers.
What is Salmonella?
Salmonella is a type of bacterium. Fruits and vegetables that come into contact with Salmonella may become contaminated with it, causing illness if eaten. Salmonella lives in some animals, and can live in soil and water for months. Salmonella can be spread from surface to surface. For example, a tomato containing Salmonella can spread the bacterium to the cutting board on which the tomato is sliced.
What is the FDA's current advice about eating tomatoes?
At this time, consumers should avoid eating or handling raw red plum, raw red Roma, and raw round red tomatoes unless they are from the sources listed above. If consumers have tomatoes in their homes and are unsure of where they were grown or harvested, they are encouraged to contact the store where they bought the tomatoes. Currently, consumers may continue to buy cherry tomatoes, grape tomatoes, tomatoes with the vine still attached, and tomatoes grown at home — all of which do not appear to be involved in the outbreak.
Safety tips include avoiding tomatoes that look damaged; for example, if the skin of a tomato is broken or the tomato is spoiled, the tomato should be thrown out.
However, contaminated tomatoes may look healthy, so safe handling is important for every tomato, as it is for all other types of fresh produce. Consumers are advised as follows:
Wash hands with soap and warm water before handling tomatoes.
Wash each tomato thoroughly under running water. Don't wash tomatoes in a tub or sink filled with water.
When finished washing a tomato, cut out the scar where the stem was, and throw it away.
Never cut a fresh tomato until it has been thoroughly washed.
Cut the tomato on a clean cutting board, using clean utensils. Don't let the tomato come in contact with other raw foods or the surfaces they have touched. Wash cutting boards and utensils in between each different type of food that is cut.
Refrigerate fresh, cut tomatoes (or products made from them, such as salsa) at 41° F or less if they're not eaten within two hours.
Wash hands with soap and warm water after preparing the tomatoes.
Note: The FDA doesn't recommend using any kinds of detergents to wash fresh produce, because it is not yet known if their residues are harmful to humans.
Can cooking tomatoes eliminate Salmonella?
At this time, the FDA does not recommend cooking tomatoes to prevent illness from this outbreak. The types of tomatoes implicated in this outbreak should not be eaten.
What is FDA's advice to retailers and food service providers about tomatoes?
The safe-handling recommendations listed above also apply to retailers and food-service providers. Refrigeration will not kill Salmonella in fresh, cut tomatoes, but it will help prevent the bacterium from growing. Additional recommendations for retailers and food-service providers include the following:
Fresh, cut tomatoes should be refrigerated at 41° F or less.
If fresh, cut tomatoes are added to another food, such as salsa, the food should be refrigerated at 41° F or less.
If fresh, cut tomatoes are placed on a salad, it should be refrigerated at 41° F or less.
Fresh, cut tomatoes on sandwiches must be refrigerated at 41° F or less.
Again, washing hands with soap and warm water before and after handling tomatoes, and cleaning cutting surfaces and utensils before and after use, are crucial.
Are tomatoes from farmers' markets included in this outbreak?
Some farmers' markets get their tomatoes from sources other than local farms. These other sources may include the same ones that provided the tomatoes implicated in the Salmonella outbreak. At this time, buying the types of tomatoes that are linked to this outbreak at a farmer's market instead of a grocery store, for example, is not a guarantee that the tomatoes are safe. Consumers should ask retailers at farmers' markets what the sources of their tomatoes are.
During this outbreak, is it safer to eat locally grown tomatoes?
Tomatoes not implicated in the outbreak are the best choice at this time. These include cherry tomatoes, grape tomatoes, tomatoes with the vine still attached, and home-grown tomatoes. Consumers should confirm with their retailers the sources of tomatoes advertised as "locally grown."
Where can consumers find out more about how to keep from becoming sick from tomatoes?
More information about safe handling of fresh produce is available on the FDA website.
About the Outbreak
What is an outbreak?
An outbreak is defined by the CDC as two or more cases of the same disease that share a common exposure.
When did the illnesses associated with the current outbreak start?
The illnesses began between April 23 and May 27, 2008.
How is the cause or source of a Salmonella outbreak determined?
Once an outbreak is detected and the states and the CDC have determined that two or more cases of the same disease share a common exposure, the FDA conducts a "traceback" investigation to determine the source of the contamination. The product is tracked from the point of purchase or service, through each point in the distribution, to find the source of the contamination. At each point in the distribution chain, an environmental investigation is performed to determine whether the contamination may have occurred at that point and, if so, how it occurred. When outbreak illnesses occur across multiple states, the contamination often occurred at, or near, the original source of the product. In addition to helping contain current outbreaks, information gained from traceback and other investigations can help scientists develop measures to prevent future occurrences.
From farm to table, where in the process are tomatoes most likely to become contaminated? What are the most likely sources of contamination?
Fresh produce, including tomatoes, can become contaminated at any point along the supply chain, from the field or greenhouse where it is grown to distribution points to food preparation in restaurants and homes.
FDA's 1998 Guide to Minimize Microbial Contamination of Fresh Fruits and Vegetables (also referred to as the Good Agricultural Practices (GAPs) guide) describes potential sources of microbial contamination in the field and packing house environments and makes recommendations for how to reduce or minimize opportunities for contamination.
According to the GAPs guide, areas that should be considered to minimize the potential for the microbial contamination of produce include: agricultural water (e.g., for irrigation or crop protection sprays); wild and domestic animals; worker health and hygiene; the production environment (use of manure, previous land use, and use of adjacent land); post harvest water quality (water used to wash or cool produce) and sanitation of facilities and equipment.
Have there been other outbreaks from contaminated tomatoes, before this one?
Since 1990, at least 12 large, multi-state foodborne outbreaks and some small local outbreaks have been associated with different varieties of tomatoes. From 1998 - 2006, outbreaks reported to FDA associated with tomatoes made up 17 percent of the produce-related outbreaks. Salmonella has been the pathogen of concern most often associated with outbreaks from tomatoes.
Government Activities Related to Produce Safety
Is the government conducting investigations and tests?
Yes, the federal (principally CDC and the FDA) and state governments are working together to analyze samples from ill persons and product samples of tomatoes in an attempt to quickly identify the source(s) of the outbreak.
The outbreak strain of Salmonella from ill persons is being "fingerprinted" at public health laboratories around the country, as part of PulseNet (the network of public health laboratories that sub-type bacteria). All Salmonella strains associated with this outbreak have the same genetic "fingerprint" (DNA pattern).
What steps has FDA taken to reduce the potential for Salmonella outbreaks from tomatoes?
On June 12, 2007, FDA announced a Tomato Safety Initiative, a multi-year effort focusing on the East Coast. The Initiative is a collaborative effort between FDA and the State health and agriculture departments in Virginia and Florida, in cooperation with several universities and the produce industry. This initiative is part of an ongoing, risk-based strategy to reduce foodborne illness by focusing food safety efforts on specific products, practices, and growing areas that have been found to be problematic in the past.
This project includes identifying practices or conditions that potentially lead to product contamination, which will allow FDA to continue to improve its guidance and policy on tomato safety. The Initiative also is evaluating the need for additional produce safety research, education, and outreach. The Initiative supports an important goal in the 2004 FDA Produce Safety Action Plan: minimizing the incidence of foodborne illness associated with the consumption of fresh produce.
Does FDA issue assignments to sample and test domestic and foreign tomatoes?
The FDA routinely collects random samples of tomatoes of all varieties, domestic and imported, from various growers, packers and shippers. The samples are sent to a FDA laboratory, to be analyzed for a variety of bacteria, including Salmonella.
Has FDA conducted outreach/education activities regarding tomato safety?
The FDA has issued a press release to notify the public of the current Salmonella outbreak in tomatoes; the press release will be updated as information continues to be obtained and evaluated. In addition, FDA has posted consumer and industry (retailer) warnings and advice related to the current Salmonella outbreak on its website.
The FDA web site also includes a consumers' page about safe handling of fresh produce, including tomatoes. In 2006, the FDA issued a publication called Program Information Manual: Retail Food Protection — Storage and Handling of Tomatoes for members of the food industry. Safe-handling guidelines for the tomato-supply industry are nearing completion.