The only good thing that can be said about the multi-state Salmonella Newport outbreak is that so far, no one has died.

The federal Centers for Disease Control and Prevention Thursday reported 126 additional ill people from 13 states have been added to the outbreak associated with the JBS meat plant in Tolleson, AZ, since the last updat on Oct. 23. For the latest update, 246 people in 25 states are associated with the outbreak that has sent 59 people to hospitals for care. Since the last update, the outbreak has expanded to include Connecticut, Massachusets, and Missouri.

“Do not eat, serve, or sell recalled beef products, including ground beef, that were recalled by JBS Tolleson Inc. of Tolleson, AZ, because they may be contaminated with Salmonella,” the CDC updat warns.

“(The) recalled beef products were produced and packaged from July 26, 2018, to September 7, 2018, and were shipped to retailers nationwide under many brand names. Check your freezer for recalled beef. Look for beef labeled with the establishment number “EST. 267.” This is usually found inside the USDA mark of inspection, but can be elsewher on the package. … Return recalled beef to the store or throw it away.”

More than 100 retailers, including chains and local stores, sold the recalled beef. Stores are listed by state, in alphabetical order, on the USDA’s Food Safety and Inspection Service website. The FSIS has also posted a list of the brand names the recalled beef was packaged under.

Public and regulatory officials in several states are investigating the multistate Salmonella outbreak in addition to CDC and the U.S.Department of Agriculture’s FSIS. JBS at Tolleson, AZ, recalled 6.9 million pounds of beef products on Oct. 4 in one of the largest beef recalls in years. The beef is linked to the Salmonella Newport outbreak.

Illnesses associated with the outbreak so far had symptom onset dates from Aug.5 to Oct. 16. Ill people in the outbreak range from less than 1 year old to 88, with the median age of 38. Fifty-six were male. For the 168 people for whom there is information, 59, or 35 percent, have been hospitalized.

It is still possible, because of the time it takes between when a person becomes ill and when the illness is reported, that there are additional victims. It generally takes two to four weeks for a specific case to be included as a confirmed outbreak case.

According to CDC, whole genome sequencing analysis did not identify predicted antibiotic resistance in 180 Salmonella bacteria isolates from 176 ill people and four food samples. Testing of seven outbreak isolates using standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory confirmed these results.

State and local health departments continue to ask ill people questions about the food they ate and other exposures in the week before they became ill. CDC says 137 people have responded and 123, or 90 percent, reported eating ground beef at home. By comparison, a control group who did not get sick reported 40 percent ate ground beef the week before they were interviewed.

An unopened package ground beef from the home of an Arizona resident tested positive for the outbreak strain of Salmonella outbreak. Whole genome sequencing found Salmonella Newport was closely related genetically to Salmonella in samples from ill people.

In the Nov. 15 update, CDC continues to provide information on food safety and ground beef along with symptoms of Salmonella infections. It is provided below.

Ground beef food safety
Consumers and restaurants should always handle and cook ground beef safely to avoid foodborne illness. It is important to handle and prepare all ground beef products carefully.

Don’t eat raw or undercooked ground beef.

Cook ground beef hamburgers and mixtures such as meatloaf to 160 degrees F internal temperature. Use a food thermometer to make sure the meat has reached a safe internal temperature. You can’t tell whether meat is safely cooked by looking at it.

Ask that ground beef hamburgers and mixtures be cooked to 160 degrees F internal temperature when ordering at a restaurant.

 Wash hands and items that came into contact with raw ground beef—including countertops, utensils, dishes, and cutting boards—with soap and water.

Salmonella symptoms

Most people infected with Salmonella develop diarrhea, fever, and stomach cramps 12 to 72 hours after being exposed to the bacteria.

The illness usually lasts 4 to 7 days, and most people recover without treatment.

In some people, diarrhea may be so severe that the patient needs to be hospitalized. Salmonella infection may spread from the intestines to the bloodstream and then to other places in the body.

Children younger than 5 years, adults older than 65 years, and people with weakened immune systems are more likely to have a severe illness.