Officials say a significant salmonella outbreak linked to cantaloupe sold across Canada this fall has killed five people and sickened dozens more, with many patients being children in daycare or seniors in long-term care.
The Public Health Agency of Canada (PHAC) said the death toll had risen to five as of Thursday, but provided no further detail.
An update said the outbreak, linked to contaminated Malichita or Rudy brand cantaloupe, has made 129 people sick across six provinces — nearly double the number of cases reported on Dec. 1, when there was just a single death.
“Many of those individuals have reported living in long-term care facilities, retirement homes and attending daycare. Quite unfortunately, people in those age groups are often at highest risk for severe illness and that is what we are seeing in this outbreak investigation,” April Hexemer, director of the outbreak management division at PHAC, said of the current cases.
“This is more [cases] than what we would normally see in a salmonella outbreak investigation.”
Salmonella is a bacteria commonly associated with raw or undercooked chicken, but can also be found in raw fruits and vegetables. Most people who get sick recover on their own in a few days, but the illness can be severe.
The current outbreak, which is also affecting hundreds of people across dozens of U.S. states, has been linked to contaminated Malichita or Rudy brand cantaloupe sold in October and November.
Dr. Isaac Bogoch, an infectious disease specialist, urged people who have recalled cantaloupes in their home to discard them and get checked if they have symptoms.
Cases have spiked in Quebec, with 91 confirmed infections as of Thursday compared to 35 last week.
The agency said there are also 17 cases in Ontario and 15 in British Columbia, as well as two each in New Brunswick, Prince Edward Island and Newfoundland and Labrador.
Nearly half of the people who have become infected are people over 65, while another third are children under five. There have been cases in babies less than a year old and at least one adult as old as 100, the update said.
‘A major outbreak’
“Obviously, this is a major outbreak,” said Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital.
“The number of cases that are diagnosed is really the tip of the iceberg. There are probably many, many, many more cases of milder illness that don’t make it to clinical attention.”
The recalled Malichita cantaloupe was sold in Canada between Oct. 11 and Nov. 14, while the Rudy brand fruit was sold from Oct. 10 to Nov. 24.
Hexemer said officials are still investigating how and where the outbreak started.
“We are working very closely with our colleagues at [the Canada Food Inspection Agency] and U.S. Federal and Drug Administration to determine what was the root cause of this very large outbreak,” she said.
PHAC said people became sick between mid-October and mid-November, with 44 ending up in hospital. Investigators are still looking into additional infections to see whether those illnesses are connected to the cantaloupe.
“People who are infected with salmonella bacteria can spread salmonella to other people several days to several weeks after they have become infected, even if they don’t have symptoms,” PHAC said.
Consumers should not buy, eat or sell cantaloupe distributed by Malichita or Rudy. The agency has issued separate recalls for other types of fruit, like honeydew, pineapple, watermelon and assorted fruit trays.
“We’re asking people to check their refrigerators and their freezers for any of the recalled items, including the cantaloupes. If you find them, please throw them out,” Hexemer said.
Contamination likely started at farm: experts
Experts suspect contamination started at farms, either in the soil or through irrigation.
“The very likely source here is likely at the site of origin: at the farm,” said Bogoch. “It’s common, unfortunately, for these to be contaminated with the feces of animals [carrying salmonella bacteria].”
Keith Warrier, a professor in food safety at the University of Guelph, said salmonella is especially problematic in fruits like melons because they’re rarely cooked before people eat them.
“The trouble with cantaloupe is that it’s a long shelf life and obviously it’s liked and consumed by high-risk populations,” he said. “The other problem is your washing [with plain water] doesn’t do anything — spreads it if anything else — and then when people cut into it and the outside of it gets into the flesh … it grows very well.”
Officials in the United States are also investigating an salmonella outbreak that has killed three people and infected 230 illnesses across 38 states.
PHAC said cases in both countries are being caused by the same genetic strain of salmonella bacteria.
Salmonella symptoms include fever, chills, nausea, vomiting, diarrhea and headaches. The illness is more likely to cause severe symptoms in young children, seniors and people with compromised immune systems.
People who think they are sick should contact their health-care provider.
“It is not hard to diagnose salmonella, it is not hard to treat salmonella, but you have to know what you’re treating and people need to come to medical care early,” sad Bogoch.