A month after Thomson International Inc. initiated a recall of onions linked to a Salmonella outbreak, federal officials are reporting the patient tally has topped 1,000 in the United States. Canadian officials say hundreds are sick in that country.

As of this week, 1,012 people across 47 states have been confirmed as being infected, according to the U.S. Centers for Disease Control and Prevention. Of those interviewed so far, 90 percent report they specifically remember eating onions or foods containing onions during the days before they developed symptoms of Salmonella infection.

Of those patients with complete information available, 136 have been so sick they had to be admitted to hospitals. No deaths have been reported. Because of the delay between when a person becomes ill and when confirmed lab tests results are reported, there will likely be more patients identified in this outbreak.

Initially it was thought only red onions were involved, but because of the way onions are grown, harvested and prepared for sale other varieties including yellow, white and sweet onions are under recall. Cross contamination of varieties is suspected.

“Of the 154 people who were asked what types of onions they ate, 103 (67 percent) ate red onions, 96 (62 percent) ate white onions, and 86 (56 percent) ate yellow onions. Most ill people reported eating more than one type of onion,” according to the CDC update.

See the full list of recalled onions and foods for U.S. consumers.

In Canada, there are now 457 confirmed patients. One person has died, but it is not known if Salmonella contributed to the cause of death, according to the Public Health Agency of Canada.

“. . . based on the investigation findings to date, exposure to red onions imported from the USA has been identified as a likely source of the outbreak. Many of the ill individuals under investigation reported having eaten red onions before getting sick,” according to the Canadian federal officials. 

“Through a collaborative investigation between public health and food safety partners in Canada and the U.S., traceback information has identified that the contaminated red onions are coming from Thomson International Inc. of Bakersfield, CA.”

The Canadian Food Inspection Agency has issued food recall warnings for implicated products that were sent to Canada. Some of the products were possibly distributed nationally, according to the CFIA recall notices.

Outbreak patients in Canada became sick between mid-June and early August. Of them, at least 66 have been hospitalized. Patients are between 1 and 100 years of age. Ill people reported eating red onions at home, in menu items ordered at restaurants and in residential care settings before becoming sick.

Public health officials in both countries are urging consumers and business to discard any onions of unknown origin in addition to discarding all onions specifically under recall.

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 onions 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.