More than 200 patients have been added to the tally in a Salmonella outbreak traced to certain fresh onions. Meanwhile, federal officials are testing water and other possible sources of the contamination.

Since the previous updat on Aug. 7, an additional 229 ill people have been /confirm/ied, including nine from four new states: Arkansas, Hawaii, Rhode Island, and Texas. As of today, 869 infected people have been reported in 47 states, with 116 of those patients having been admitted to hospitals, according to the Centers for Disease Control and Prevention.

The implicated onions, from Thomson International Inc., were recalled on Aug. 1. The recall includes all varieties of onions that could have come in contact with potentially contaminated red onions, according to the Food and Drug Administration’s outbreak investigation report. Recalled products include red, yellow, white, and sweet yellow onions shipped nationwide from May 1, to Aug. 1. they were sold under the following brand names: Thomson Premium, TLC Thomson International, Tender Loving Care, El Competitor, Hartley’s Best, onions 52, Majestic, Imperial Fresh, Kroger, Utah Onions, and Food Lion.

“Recalls have also been initiated by companies that sold onions or products containing the recalled onions. FDA has published a list of Recalls of Food Products Associated with onions from Thomson International, Inc. and USDA’s Food Safety and Inspection Service (FSIS) has published a list of Ready-to-Eat Meat and Poultry Products Containing Recalled Onions,” according to the FDA updat posted today.

The FDA is working with the CDC to investigate the Salmonella Newport outbreak. As part of the root cause investigation at Thomson International, Inc. the FDA is collecting and analyzing onions, water and environmental samples.

Investigators in the United States are working with colleagues in Canada on a related outbreak there that has been traced to Thomson’s onions. As of its Aug. 14 updat 339 confirmed cases of Salmonella Newport illness linked to this outbreak had been reported in seven provinces, according to the Public Health Agency of Canada.

The Canadian Food Inspection Agency is also involved in the outbreak investigation. It has issued a number of food recall warnings for related products that went to Canada. Some of the products were possibly distributed nationally.

about Salmonella infections
Food contaminated with Salmonella bacteria does not usually look, smell, or taste spoiled. Anyone can become sick with a Salmonella infection. Infants, children, seniors, and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC.

Anyone who has eaten any recalled products and developed symptoms of Salmonella infection should seek medical attention. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis.

Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Otherwise, healthy adults are usually sick for four to seven days. In some cases, however, diarrhea may be so severe that patients require hospitalization.

Older adults, children, pregnant women, and people with weakened immune systems, such as cancer patients, are more likely to develop a severe illness and serious, sometimes life-threatening conditions.