There are another 84 people sick, 26 more in hospitals, and one more state involved in an outbreak of Salmonella Oranienburg infections associated with fresh onions from Mexico.

In its first updat since Oct. 29, the CDC reports there are at least 892 people sick across 38 states and Puerto Rico. The most recent person to become ill had symptoms begin on Oct. 25. Texas has been hardest hit with 207 illnesses reported.

Click on map to enlarge.

The Centers for Disease Control and Prevention expects the patient count to increase because of the time it takes to confirm illnesses and report them to the government, which can take a month or more.

Two companies imported the onions from Mexico that have been implicated in the outbreak. They have recalled red, white, yellow, and sweet onions nationwide, according to the Food and Drug Administration. The importers are ProSource Produce LLC (also known as ProSource Inc.) of Hailey, ID, and Keeler Family Farms of Deming, NM.

The companies distributed the onions to wholesalers and distributors who may have repackaged the onions under various brands, including retail brands such as the Green Giant brand, which has been recalled by Potandon Produce, and foodservice brands such as Sysco. 

Many companies have recalled onions that were sold to retail grocers and foodservice operations including restaurants and at least one meal delivery business. The FDA has a partial list of retailers posted on its website. It includes Walmart and Save-A-Lot locations. Some of the other retailers can be found by clicking here. Other retailers that received the onions can be found by clicking here.

The FDA found the outbreak strain in a partially eaten cup of a multi-ingredient, salsa-type topping from an unnamed restaurant.

ProSource Produce LLC and Keeler Family Farms and imported from the State of Chihuahua, Mexico, between July 1, and Aug. 31. However, the FDA reports that onions can remain edible for three months or more depending on storage conditions. Officials have not reported how many tons of the onions were imported.

Although the CDC posted its updat today, it says the information is up to date as of Nov. 12. Sick people range in age from less than 1 year to 101 years old, with a median age of 37. Fifty-eight of the patients are female. Of 571 people with information available, 183 — one-third — have been hospitalized. That is an unusually high percentage of hospitalizations for Salmonella outbreaks, suggesting that the outbreak strain is particularly dangerous.

Consumers are being urged to throw away any onions that are either from one of the recalls or are clearly marked as a product of Chihuahua, Mexico. If it is unclear whether onions are related to the outbreak they should be thrown away. Some of the implicated onions were sold in unmarked bins in grocery stores.

In addition to the onions themselves, the CDC warns of cross-contamination dangers.

“Check to see if you have any recalled onions. If you have any recalled onions or if you can’t tell wher your onions are from, don’t eat them. Throw them away,” the CDC says. “Wash surfaces and containers (including refrigerators)  these onions may have touched using hot soapy water or a dishwasher.”

Consumers can find more information at:

• Cleaning Your Refrigerator Because of a Food Recall
• How to Report a Foodborne Illness

about Salmonella infections
Food that is contaminated with Salmonella bacteria usually does not look, smell or taste spoiled. Anyone can become sick with a Salmonella infection, but 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.

It is possible for some people to be infected with the bacteria and to not get sick or show any symptoms, but to still be able to spread the infection to others.

Anyone who has eaten any of the suspect 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 need to be hospitalized. 

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.