The FDA’s outbreak table now lists 212 people sickened in an outbreak of Salmonella Javiana, up from 106 the week before. The agency says it has conducted traceback and initiated sampling. It has not said what food it traced, what it is sampling, where the sick live, or how old they are. The outbreak went on the table on July 23 with no product attached, and it is still there with no product attached — twice as large.
Doubling in a week is usually the sound of a laboratory catching up rather than a hundred new people getting sick in seven days. Whole genome sequencing matches isolates retrospectively, and the cases that appear in a lump were mostly infected weeks ago. Which means the exposure that made these people sick may well have ended before the rest of us learned it existed.
What FDA will not say, the last twenty-five years mostly will. Javiana is a produce serotype and an environmental one. It is not a meat-and-poultry bug — USDA’s own review of roughly 500,000 HACCP samples between 1998 and 2009 turned up 30 Javiana-positive samples and no meaningful correlation between the products FSIS regulates and human Javiana illness. Where it does show up, over and over, is on things people eat raw.
Tomatoes lead the list. In 1990, 176 people across Illinois, Michigan, Minnesota and Wisconsin were infected by tomatoes from a single South Carolina packer, contaminated when field-grown fruit was dumped into a shared water bath. In 2002, 141 people in 32 states fell ill after the U.S. Transplant Games in Orlando, including dozens of organ transplant recipients — people on immunosuppressive drugs, the last people on earth who should be handed a plate of contaminated pre-diced tomatoes. In 2004, 429 laboratory-confirmed cases turned up in nine states and one Canadian province, 383 of them Javiana, traced to Roma tomatoes. Looking across CDC’s outbreak surveillance for 1998 through 2008, Javiana accounted for 11 percent of tomato-associated Salmonella outbreaks and 20 percent of leafy vegetable outbreaks.
Melons and cut fruit are next. A 1991 Michigan school outbreak came from watermelon. And in the winter of 2019, 165 people in 14 states were infected — 73 of them hospitalized — by a cut fruit mix of cantaloupe, honeydew, pineapple and grapes distributed by Tailor Cut Produce of New Jersey. That fruit went to long-term care facilities, hospitals, hotels, schools and universities. Nursing homes. Hospitals. The traceback eventually pointed at a midwestern melon operation, and no public recall of that farm’s product was ever issued, because the growing season had ended before anyone confirmed the source. The melons were gone. The people were still sick.
Beyond produce the record thins out but does not vanish: cheese from a single Minnesota plant in 1989, paprika-spiced potato chips that sickened roughly a thousand people in Germany in 1993, a Michigan potato salad in 2010 where the contaminated ingredient turned out to be yellow onion, a children’s hospital salad bar in St. Louis in 2003 where an ill food handler was the likely link. Away from food entirely, the published risk factors are well water, swallowing water while swimming, and contact with frogs, toads, turtles and snakes — which is why this serotype clusters in the Southeast and peaks from July through October. Every one of those alternative exposures will be waved around by a defendant later. None of them explains a multistate cluster of 212.
We have been doing this since 1993, and the pattern in front of us is familiar enough to be boring. A national cluster grows. The agency confirms it is tracing something and testing something. The public is told to watch for symptoms. Nobody is told what not to eat. By the time a name is attached, the food has been eaten, the lot is gone, the season is over, and the only people still living with the outbreak are the ones who were hospitalized by it.
Two hundred and twelve people are now on the wrong side of that sentence, and the number is still moving. Somebody at FDA knows what is being sampled. There is no good reason the 213th person should not know it too.