The US Salmonella outbreak tied to contaminated jalapenos has grown by 86 cases, 21 hospitalizations, and five states, for a total of 431 infections and 57 hospitalizations in 32 states, the Centers for Disease Control and Prevention (CDC) announced yesterday.

The true number of infections is likely much higher than that reported and 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,” the CDC said. “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.”

The contaminated peppers were grown in Sinaloa, Mexico, and distributed by Coast Citrus Distributors. On August 8, the producer, NatureBest Precut & Produce, voluntarily recalled NatureBest and HEB products containing the tainted jalapenos, including soup mix, pico de gallo, stuffed mushrooms, and diced jalapenos. 

The products were distributed to retail outlets in Texas and Louisiana from July 3 to August 5, with symptom onsets of June 19 to August 2. People sickened in the outbreak are 1 to 85 years old.

Of the 224 people interviewed, 91% reported eating at a Mexican-style restaurant before their illness, namely Chipotle Mexican Grill and Qdoba, with meal dates of June 14 to July 16. The CDC has identified 28 illness clusters at restaurants in eight states. 

In otherwise healthy people, Salmonella can cause fever, diarrhea, nausea and vomiting, and abdominal pain. But young children, frail or older adults, and those with weakened immune systems can experience serious or fatal illness. Rarely, the bacterium gets into the bloodstream, leading to severe illnesses such as arterial infections, endocarditis, and arthritis.