List of foodborne illness outbreaks in the United States
In 1999, an estimated 5,000 deaths, 325,000 hospitalizations and 76 million illnesses were caused by foodborne illnesses within the US. The Centers for Disease Control and Prevention began tracking outbreaks starting in the 1970s. By 2012 the figures were roughly 130,000 hospitalizations and 3,000 deaths.
- The Swill milk scandal leads to the deaths of 8,000 babies in one year alone.
- 1971 Bon Vivant botulism outbreak in vichyssoise manufactured by Bon Vivant Soup Company of Newark, New Jersey.
- Botulism in peppers served at the Trini and Carmen restaurant in Pontiac, Michigan, caused the largest outbreak of botulism poisonings in the United States up to that time. The peppers were canned at home by a former employee. Fifty-nine people were sickened.
- Botulism in Clovis, New Mexico. 34 people who ate at a restaurant, Colonial Park Country Club, developed clinical botulism in the second-largest outbreak in United States history. The outbreak was traced to either potato salad or a commercially prepared three-bean salad served to a group attending a banquet. Despite a thorough search of the local landfill, the discarded three-bean salad containers were never located, making it impossible to test them to confirm the source of contamination. All patients were hospitalized and 33 received trivalent botulinal antitoxin. There were two deaths.
- Botulism (Type A Clostridium botulinum) in Peoria, Illinois. 28 persons were hospitalized, and 20 patients were treated with an antitoxin. 12 patients required ventilatory support and 1 death resulted. The source was sauteed onions made from fresh raw onions served on a patty melt sandwich. The sandwiches were served at the Skewer Inn Restaurant located inside Northwoods Mall.
- 1985 California listeriosis outbreak in Queso blanco in Southern California. The largest number of food poisoning deaths recorded in U.S. history since the CDC began keeping records in 1970 is traced to Mexican-style soft cheese. There were 52 deaths, including 19 stillbirths and 10 infant deaths. Jalisco Cheese produced the contaminated cheese.
- 1985 United States salmonellosis outbreak in milk from the Hillfarm Dairy in Melrose Park, Illinois caused 16,284 confirmed, and possibly as many as 200,000 cases of food poisoning in six Midwest states. The tainted milk was responsible for two deaths and may have been related to the death of 4 or 5 others with some counts being as high as 12. It is considered the largest outbreak of Salmonella food poisoning recorded in U.S. history since the CDC began keeping records in 1970.
- Botulism in whitefish in New Jersey. Four members of a Fort Lee family were stricken with botulism after eating fish bought in Jersey City.
- E. coli O157:H7 outbreak caused by undercooked hamburgers from Jack in the Box. Four children died and nearly 700 others became sick in the Seattle area and other parts of the Pacific Northwest. The outrage resulting from the deaths placed strong political pressure on Washington and resulted in new regulations from the USDA to reform century-old practices in the meat industry. The new regulations, titled Pathogen Reduction and Hazard Analysis and Critical Control Point Systems Final Rule, required a mandatory HACCP inspection system and microbial testing in meat processing plants.
- Salmonella in ice cream from Schwan's Sales Enterprises of Marshall, Minnesota. The outbreak was confirmed to have sickened 740 people in 30 states and is suspected to have sickened over 3,000 additional people in as many as 41 states. The contamination occurred when raw, unpasteurized eggs were hauled in a tanker truck that later carried pasteurized ice cream to the Schwan's plant. The ice cream premix wasn't pasteurized again after delivery to the plant.
- E. coli O157:H7 in unpasteurized apple juice from Odwalla. The company was using blemished fruit and ignored warnings from in-house safety experts and specialized in selling unpasteurized juices for their supposed health benefits. 70 people in several U.S. states were stricken, mostly in the West, and in Canada. The outbreak caused one death, a 16-month-old girl from Colorado.
- E. coli O157:H7 in lettuce sickened at least 61 people in Illinois, Connecticut and New York in May and June 1996.
- Hepatitis A on frozen strawberries from Andrew & Williamson Sales Co. of San Diego, California. The strawberries were grown in Baja California, Mexico and processed by A&W. Thousands of students from Arizona, California, Georgia, Iowa, Michigan, and Tennessee may have been exposed to the virus from eating strawberries in school lunches. Over 2.6 million pounds of strawberries were recalled.
- 1997 E. coli O157:H7 in ground beef from Hudson Foods Company of Rogers, Arkansas. Burger King was the largest client. The plant was in Columbus, Nebraska. The company recalled over 25 million pounds of ground beef it had manufactured, in the second largest recall in history.
- 1998 United States listeriosis outbreak was the third-deadliest outbreak of foodborne illness. There were 14 deaths and 4 miscarriages or stillbirths in a Listeria outbreak in hot dogs and cold cuts. Some sources put the death toll as high as 21.
- 1999 Sun Orchard salmonellosis outbreak in unpasteurized orange juice. The juice was imported from Mexico in a tanker cooled with contaminated ice.
- E. coli O157:H7 was found in the drinking water at the Washington County Fair in Easton, New York. Over 700 people were affected and 2 people died.
- Salmonella in bean sprouts from Pacific Coast Sprout Farms. They bought dry seeds in China and Australia and when germinated, the sprouts caused an outbreak from Oregon to Massachusetts. At least 67 people became ill, and 17 were hospitalized.
- A young girl died and 65 other people were sickened in an E. coli O157:H7 outbreak in Milwaukee, Wisconsin. The source of the outbreak was two Sizzler restaurants that apparently allowed raw meat to come into contact with other food items. The infected meat was traced to the Excel meat packing plant in Colorado.
- There were 19 confirmed cases, 19 likely cases, and 49 suspected cases of E. coli O157:H7 in Oregon in August. The cases were linked to a Wendy's restaurant, and although beef was the suspected vector of transmission, such a link was not conclusively shown.
- E. coli O157:H7 in ground beef from ConAgra. 19 people became ill in California, Colorado, Michigan, South Dakota, Washington and Wyoming as a result of eating tainted hamburger from a ConAgra plant in Greeley, Colorado. The company recalled over 19 million pounds of ground beef it had manufactured, in the third largest recall in history.
- Listeria in processed chicken from Pilgrim's Pride. The company recalled over 27 million pounds of poultry products it had manufactured, in the largest recall in history. The outbreak killed 7 people, sickened 46, and caused 3 miscarriages.
- Botulism sickened 8 people in Western Alaska as a result of eating a beached beluga whale.
- Fifty-seven people in 7 states became ill in August and September after consuming meat contaminated with E. coli O157:H7. The tainted meat originated at the meat packing plant Emmpak Foods. Emmpak recalled 2.8 million pounds of ground beef in the aftermath of the outbreak.
- The 2003 United States hepatitis A outbreak was the worst hepatitis A outbreak in U.S. history, with more than 660 people infected, including four fatalities. The infection was from green onions served at Chi-Chi's restaurants in Pennsylvania and West Virginia.
- E. coli O157:H7 from Taco Bell in South Plainfield, New Jersey and Long Island. 39 people in central New Jersey and on Long Island were sickened and suffered from hemolytic uremic syndrome. Centers for Disease Control and Prevention at first believed the E. coli O157:H7 to be in the green onions. The FDA on December 13, 2006 said it could not confirm that scallions were the cause of the problem, as previously suspected, and that it was not ruling out any food as a possible culprit. It was later suspected that infected lettuce was the cause.
- 2006 North American E. coli outbreak. E. coli O157:H7 in bagged spinach packaged by Natural Selection Foods and most likely supplied by Earthbound Farm in San Juan Bautista. 3 dead, and 198 people reported sickened by the outbreak across 25 US states, and 1 person reported sickened by the outbreak in Ontario.
- On December 27, the Massachusetts Department of Public Health warned not to drink milk or milk related products from Whittier Farms in Shrewsbury, MA due to a listeria bacteria contamination that resulted in two deaths.
- On October 11, food manufacturer ConAgra asked stores to pull its Banquet and generic brand chicken and turkey pot pies due to 152 cases of salmonella poisoning in 31 states being linked to the consumption of ConAgra pot pies, with 20 people hospitalized. By October 12, a full recall was announced, affecting all varieties of frozen pot pies sold under the brands Banquet, Albertson's, Food Lion, Great Value, Hill Country Fare, Kirkwood, Kroger, Meijer, and Western Family. The recalled pot pies included all varieties in 7-oz. single-serving packages bearing the number P-9 or "Est. 1059" printed on the side of the package.
- E. coli O157:H7 in ground beef from the Topps Meat Company in Elizabeth, New Jersey. As of 2007[update], it is the second-largest beef recall in United States history.
- Salmonella in Metz Fresh, California spinach. Recalled 8,000 cartons of fresh spinach. No reports of any illness.
- Botulism from cans of Castleberry's, Austex and Kroger brands of chili sauce. In total, over 25 different brands of a variety of products were recalled by Castleberry's Food Company. The best by dates for the affected products range from April 30, 2009, through May 22, 2009. The contamination by the toxin is extremely rare for commercially canned products. Centers for Disease Control and Prevention medical epidemiologist Dr. Michael Lynch said the last such U.S. case dates to the 1970s. The roughly 25 cases reported each year were mainly from home canned foods.
- Salmonella from Peter Pan and Great Value Peanut Butter (both manufactured by ConAgra) in 44 states. By March 7, 2007, the outbreak had grown to 425 cases in 44 states since its start in August 2006. The CDC said it is believed to be the first salmonella outbreak associated with peanut butter in United States history.
- In April and May, 14 people in 11 states were sickened after eating E. coli O157:H7-tainted beef packed by United Food Group. The meat packing company ultimately recalled 5.7 million pounds of potentially contaminated meat.
- 2008 United States salmonellosis outbreak. As of August 28, 2008, from April 10, 2008, the rare Saintpaul serotype of Salmonella enterica caused at least 1442 cases of salmonellosis food poisoning in 43 states throughout the United States, the District of Columbia, and Canada. As of July 2008, the U.S. Food and Drug Administration suspects that the contaminated food product is a common ingredient in fresh salsa, such as raw tomato, fresh jalapeño pepper, fresh serrano pepper, and fresh cilantro. It is the largest reported salmonellosis outbreak in the United States since 1985. During a House subcommittee hearing into food supply safety and the recent salmonella contamination, a top federal official told panel members that agencies have found the source of the contamination after it showed up in yet another batch of Mexican-grown peppers. Adam Acheson, Food and Drug Administration associate commissioner for foods, said the FDA tracked the salmonella positive test to serrano peppers and irrigation water at a packing facility in Nuevo León, Mexico, and a grower in Tamaulipas. New Mexico and Texas were proportionally the hardest hit by far, with 49.7 and 16.1 reported cases per million, respectively. The greatest number of reported cases have occurred in Texas (384 reported cases), New Mexico (98), Illinois (100), and Arizona (49). There have been at least 203 reported hospitalizations linked to the outbreak, it has caused at least one death, and it may have been a contributing factor in at least one additional death. The Centers for Disease Control and Prevention (CDC) maintains that "it is likely many more illnesses have occurred than those reported." If applying a previous CDC estimated ratio of non-reported salmonellosis cases to reported cases (38.6:1), one would arrive at an estimated 40,273 illnesses from this outbreak.
- An aggressive strain of Salmonella, the Newport serotype, was found in beef products made by a Fresno, California-based unit of Cargill (Beef Packers Inc.) in August 2009, resulting in a large recall.
- Salmonellosis in peanut butter from Peanut Corporation of America in Blakely, Georgia has become "one of the nation’s worst known outbreaks of food-borne disease" in recent years. Nine are believed to have died and an estimated 22,500 were sickened. Criminal negligence has been alleged after product tested positive then re-tested "negative" by a second testing agency, and shipped on several occasions. The product was in turn used by dozens of other manufacturers in hundreds of other products which have had to be recalled. The CEO of Peanut Corporation of America was sentenced to 28 years in prison for his role in the outbreak.
- E. coli O157:H7 was believed to have contaminated Nestle Toll House refrigerated cookie dough. Nestlé recalled its products after the FDA reported there was a possibility that the E. coli O157:H7 outbreak, which sickened at least 66 people in 28 states, might be a result of raw cookie dough consumption. According to Marler Clark, the number of illnesses reached 70 in 30 states by June 23, 2009, with 35 hospitalizations required, and seven cases of hemolytic-uremic syndrome. The products which were originally believed to have been tainted came from a Danville, Virginia plant. However, no E. coli O157:H7 has been found in the plant, according to the FDA. Many media sources have failed to report that E. coli contamination has not been confirmed in Nestlé products. The CDC has reported that ground beef is a likely source of the contamination.
- More than 500 million eggs were recalled after dangerous levels of Salmonella were detected in the eggs of two Iowa producers, Wright County Egg and Hillandale Farm, that distribute eggs in fourteen U.S. states. Nearly 2,000 illnesses were reported between May and July, approximately 1,300 more than usual for this strain of the bacteria. Jack DeCoster and Peter DeCoster "have pleaded guilty to the "distribution of adulterated eggs in interstate commerce," and Quality Egg "admitted to falsifying expiration dates on egg cartons" as well as to two attempts to bribe a USDA inspector In August 2010, the company recalled 380 million eggs in connection with a salmonella outbreak, and a related company, Hillandale Farms, recalled 170 million eggs.
- In 2011, the United States saw an outbreak of listeriosis from cantaloupes from Colorado that lasted from July to September. 30 people died, making it the second-deadliest recorded U.S. outbreak since the Centers for Disease Control and Prevention began tracking outbreaks in the 1970s.
- In June 2011, twenty people fell ill from eating cantaloupe from Del Monte Fresh Produce infected with Salmonella Panama from Guatemala. The Centers for Disease Control and Prevention had found that eight of the people sickened had eaten cantaloupes purchased from Costco, and they used the purchase records to figure out that the food in common was cantaloupes, and they had come from the same Guatemalan farm. Del Monte went to court to lift the import ban by the Food and Drug Administration. An investigation found that a pipe carrying raw sewage emptied into an open ditch about 110 yards from the farm's packing house.
- Andrew Williamson Fresh Produce voluntarily recalls one lot of organic grape tomatoes sold under the Limited Edition and Fresh & Easy labels due to a possible health risk from Salmonella.
- Emporia, Kansas-based Tyson Fresh Meats (Tyson Foods) announces it is recalling 131,300 pounds of ground beef products due to possible E. coli O157:H7 contamination.
- Publix Super Markets issues a voluntary recall for spinach dip because it may be adulterated with Listeria monocytogenes.
- Roundy's Super Markets Inc., a Milwaukee, Wisconsin-based company with an establishment in Kenosha, Wisconsin, is recalling 360 pounds of breaded chicken breast products, that should have been fully cooked, because they may have been undercooked.
- E. coli in strawberries from Newberg, Oregon killed one person on August 8, 2011. The Oregon Health Authority announced that they had linked at least 10 E. coli infections to a strawberry farm in Newberg, Oregon. Four patients had been hospitalized and an elderly woman died from kidney failure associated with her E. coli illness. The strawberries were sold to buyers who resold them at roadside stands and farmer's markets.
- One dead in California from Salmonella and 76 more people sickened in 26 states. On August 3, 2011, Cargill recalled 36,000,000 pounds of fresh and frozen ground turkey products produced at the company's Springdale, Arkansas, facility from February 20, 2011, through August 2, 2011, due to possible contamination from Salmonella Heidelberg.
- In March and April 2011, Jennie-O recalled almost 55,000 pounds of turkey burgers because drug-resistant salmonella was found in its products.
- In June 2011, nearly 3,000 cases of Dole Food Company salad bags were recalled after a random test found the bacteria Listeria monocytogenes in a bag of the salad.
- Contaminated papaya appears to be the cause of an outbreak of Salmonella food poisoning (salmonellosis) in 23 states, the Food and Drug Administration (FDA) is warning consumers. The FDA says papayas imported from Mexico and distributed by Agromod Produce Inc. of McAllen, Texas, is likely the source of 97 cases of Salmonella Agona. To date, 10 people have been hospitalized but there have been no reported deaths. As a result, all papayas sold before Saturday, July 23, 2011, have been voluntarily recalled by Agromod. The cases were reported between January 1 and July 18 in Arkansas, Arizona, California, Colorado, Georgia, Illinois, Louisiana, Massachusetts, Minnesota, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, Ohio. Oklahoma, Pennsylvania, Tennessee, Texas, Virginia, Washington and Wisconsin. While ages ranged from 1 year to 91 years old, the average age of those stricken is 20. More than half of the cases are women. Texas had the most cases with 25 people falling ill.
- The 2012 salmonella outbreak has caused sickness in hundreds of people in the Netherlands and the United States via Salmonella-tainted salmon.
- The 2012 peanut butter recall – Peanut butter and other products manufactured by Sunland Inc. caused sickness of 41 people in 20 states in the U.S. via Salmonella-tainted products.
- July – August. The E. coli O157:H7 outbreak at Federico's Mexican Restaurant in Litchfield Park, Arizona, (a suburb of Phoenix) has now grown to include 79 people. At least 23 people have been hospitalized in this outbreak. This is now the largest E. coli outbreak in the United States in years. At least two people have developed hemolytic uremic syndrome (HUS), a severe complication of an E. coli O157:H7 infection that can destroy the kidneys. Symptoms of an E. coli infection include severe stomach cramps, diarrhea that may be bloody and/or watery, fever, nausea, and vomiting. Symptoms of HUS are the same as E. coli symptoms but include pale skin tone, small, unexplained bruises, bleeding from the nose and mouth, decreased urination, blood in the urine, and swelling. Victims have filed three civil suits against Federico's parent company, Femex LLC, in Maricopa County Superior Court.
- October – November. A company that makes prepared chicken salad has recalled more than 180,000 pounds of its products after some were linked to a few cases of Escherichia coli (E. coli) infection. CA-based Glass Onion Catering has recalled products distributed to AZ, CA, NV, NM, OR, TX, UT, and WA, the U.S. Department of Agriculture (USDA) says. So far, 26 people in 3 states have been diagnosed with the same E. coli 0157:H7 infection, the USDA says (15 of them say they ate products traced to Glass Onion Catering, which supplies midsized grocery store chains such as Trader Joe's with "gourmet grab and go" products, many featuring grilled chicken (chicken is rarely contaminated with E. coli). Most E. coli strains are harmless and even beneficial, but the aforementioned strain can cause abdominal cramps, diarrhea (which may be or become bloody), and dehydration. In most, that is the extent of any illness, but in some young, old, or immunocompromised patients, it can lead to widespread infection (sepsis) and/or a severe disease of the kidneys called hemolytic-uremic syndrome (HUS; which can lead to kidney failure), which may be deadly.
- One person died and three newborns became ill in an outbreak of listeria (listeriosis) linked to Hispanic-style cheese. The Centers for Disease Control and Prevention (CDC) said on Friday, February 21, 2014, that the death occurred in California. Seven additional illnesses were reported in Maryland. All of the Maryland victims reported eating soft or semi-soft Hispanic-style cheese that they purchased at different locations of the same grocery store chain. Listeria was later detected in a sample of Caujada en Terron, or fresh cheese curd, purchased at that chain. The CDC says three of the victims are newborns. Two of those ill are mothers of two of the ill newborns. The agency says the cheese was probably produced by Roos Foods of Kenton, Delaware.
- As of May 16, 2014, 11 cases of E. coli O157:H7 in 4 states (Massachusetts, Michigan, Missouri, and Ohio) from tainted ground beef from Wolverine Packing Company of Detroit, Michigan.
- In August through September 2015, over 300 people were infected with Salmonella. The bulk of the cases were in California and Arizona with the states of California and Texas having one fatality each. It was traced to cucumbers from Mexico distributed by Andrew & Williamson Fresh Produce who, on September 4, 2015, voluntarily issued a recall.
- In October through November 2015, 45 people contracted E. coli from Chipotle Mexican Grill restaurants. The cases were in Washington State, California, Minnesota, New York, Ohio, and Oregon. At least 16 were hospitalized. The outbreak warranted the closing and sanitization of over 40 Chipotle restaurants across Washington and Oregon. The restaurants have since reopened after discarding all supplies and ordering fresh ingredients.
- In November 2015, before Thanksgiving Day, about 200 patients were admitted to hospitals of New York with intoxication. It was caused by products of "Koch's Turkey Farm".
- List of foodborne illness outbreaks by death toll
- List of foodborne illness outbreaks (countries other than the United States)
- "Emerging Infectious Diseases journal". cdc.gov.
- William Neuman (September 27, 2011). "Deaths From Cantaloupe Listeria Rise". New York Times. Retrieved 2011-09-29.
At least 13 people in eight states have died after eating cantaloupe contaminated with listeria, in the deadliest outbreak of food-borne illness in the United States in more than a decade, public health officials said on Tuesday. ... The outbreak appeared to be the third worst in the United States attributed to any form of food-borne illness, in terms of the number of deaths, since the C.D.C. began regularly tracking such outbreaks in the early 1970s. The deadliest outbreak in the United States since then occurred in 1985, when a wave of listeria illness, linked to Mexican-style fresh cheese, swept through California. A federal database says 52 deaths were attributed to the outbreak, but news reports at the time put the number as high as 84. The second deadliest outbreak was in 1998 and 1999, when there were at least 14 deaths and four miscarriages or stillbirths in a listeria outbreak linked to hot dogs and delicatessen meats. Some sources put the death toll in that outbreak as high as 21. ...
- Stephanie Strom (January 4, 2013). "F.D.A. Offers Sweeping Rules to Fight Food Contamination". New York Times. Retrieved 2013-01-05.
One in six Americans becomes ill from eating contaminated food each year, the government estimates; of those, roughly 130,000 are hospitalized and 3,000 die.
- Patrick Lyons (October 5, 2007). "In a Beef Packager's Demise, a Whiff of Vichyssoise.". New York Times. Retrieved 2007-10-09.
On an early July day in 1971 when it was too hot to cook, a couple in Westchester County, New York, sat down to a meal of Bon Vivant vichyssoise, a soup often served chilled (and in this case, straight from the can). The soup tasted funny, so they didn't finish it; within hours he was dead and she was paralyzed from botulism poisoning. F.D.A. investigators found five other cans of vichyssoise from the same batch of 6,444 that were also tainted with botulism, and spot checks of other products raised questions about the company's processing practices, so the agency shut down the plant and told the company to recall all its soups.
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The manufacturer, Schwan's Sales Enterprises in Marshall, Minn., recalled its ice cream last week after the first reports of food poisoning. Investigators have found salmonella bacteria in samples of Schwan's ice cream eaten by people who became ill. ...
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The New York Times reported in January that in the weeks before the outbreak, Odwalla began relaxing its standards on accepting blemished fruit and began to rein in the authority of its own safety officials, according to company documents and interviews with former Odwalla managers. By these accounts, on the day the contaminated juice was pressed, production managers brushed aside warnings from a company inspector that a batch of apples was too rotten to use without taking special precautions against contaminants. ...
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Interviews with former Odwalla managers and company documents show that in the weeks before the outbreak, Odwalla began relaxing its standards on accepting blemished fruit and reining in the authority of its own safety officials, culminating in tense, dramatic moments on the morning of Oct. 7, 1996, the day the contaminated juice was pressed. ...
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The Department of Public Health (DPH) has issued a warning to consumers not to drink any milk products from Whittier Farms in Shrewsbury because of listeria bacteria contamination, which has contributed to the death of two people
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Topps Meat Co. of Elizabeth, which is involved in the second-largest beef recall in U.S. history, said today it is going out of business after more than six decades
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Federal investigators later discovered that the dilapidated plant was ravaged by salmonella and had been shipping tainted peanuts and paste for at least nine months. But they were too late to prevent what has become one of the nation’s worst known outbreaks of food-borne disease in recent years, in which nine are believed to have died and an estimated 22,500 were sickened.
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Product samples from Peanut Corp. of America in Lynchburg, Va., were tested positive in Minnesota and Connecticut for the bacteria that have sickened at least 474 people in 43 states and may have contributed to six deaths, said officials from the U.S. Food and Drug Administration (FDA) and federal Centers for Disease Control and Prevention.
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In March, the federal Centers for Disease Control and Prevention and the FDA found that cantaloupes from a Guatemala farm were connected to 12 cases of salmonella poisoning. The FDA later concluded that the cantaloupes were imported into the U.S. by Del Monte. As of June, 20 people had fallen ill from the outbreak of Salmonella Panama, including two people in California, according to the CDC. ... The melon recall was relatively small compared with some of the other food contaminations that have occurred in recent months, including strawberries with E. coli that killed one person in Oregon and salmonella-tainted ground turkey products that killed one person in California and made more than 100 people ill nationwide.
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The company, which is one of the country’s largest produce marketers, says the restrictions could damage its reputation, and it has sued the Food and Drug Administration to lift them. ...
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Federal officials said on Tuesday that they were investigating an apparent link between ground turkey meat and a nationwide outbreak of salmonella illness that has so far killed one person in California and sickened at least 76 more people in 26 states.
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