From the Board of Health

Peanut Butter Alert

On February 14, 2007 the FDA issued a warning to consumers not to eat Peter Pan and Great Value peanut butter with a product code located on the lid of the jar that begins with the number "2111" due to the risk of contamination with Salmonella Tennessee. The FDA is telling consumers that if they have any of this brand peanut butter in their home that has been purchased since May 2006, they should discard it. At least 288 people in 39 states have been identified with this strain of Salmonella Tennessee which has been epidemiologically linked to the consumption of these particular brands of peanut butter. Five of these cases are Massachusetts residents with onsets of illness from early November 2006 to late January 2007.

MDPH is recommending that people who have consumed the implicated peanut butter and are well should immediately discard the product. People who have recently consumed the product and are ill with gastrointestinal symptoms should notify their health care provider and be tested. Ill individuals should record all information from the product lid and label before discarding. Local health departments will be asked to obtain complete food histories, including peanut butter consumption from all confirmed cases of Salmonella Tennessee.

At this time MDPH will not be collecting or testing any peanut butter product from either ill or well individuals. Consumers who have questions can contact ConAgra at 866-344-6970, the FDA at 888-INFO-FDA, or the Massachusetts Department of Public Health at 617-983-6800. Consumers can also obtain a refund by sending the product lid and their names and addresses to ConAgra Foods, P.O. Box 57078, Irvine, CA 92619-7078.

Multistate Outbreak of Salmonella Tennessee Infections, August 2006 - January 2007

Public health officials in multiple states, with the assistance of the Centers for Disease Control and Prevention, are investigating a large outbreak of Salmonella Tennessee infections. As of February 14, 2007, 6PM EST, 288 persons with illness have been reported to CDC from 39 states; Alaska ,Alabama, Arkansas, Arizona, California, Colorado, Connecticut, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, Mississippi, Montana, Nebraska, New Jersey, North Carolina, New Mexico, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Virginia, Vermont, Washington Wisconsin, and West Virginia.

State public health officials continue to investigate cases of illness. Among 120 patients for whom clinical information is available, 31 (26%) were hospitalized. There have been no reports of deaths attributed to this infection. Onset dates, which are known for 140 patients, ranged from August 1, 2006 to January 21, 2007. The outbreak has been prolonged and of low intensity, with 0-2 new cases reported daily in January nationwide. Two closely related DNA fingerprint patterns of Salmonella Tennessee isolates have been associated with this outbreak. DNA fingerprinting is routinely done at public health laboratories in all states as part of PulseNet (the network of public health laboratories that sub-type bacteria).

CDC is working with state and local health officials, the Food and Drug Administration (FDA), and the Department of Agriculture (USDA) to determine the food responsible for this outbreak. Public health investigators have identified peanut butter as being consumed more often by ill persons than well persons and as statistically linked with illness. Evaluation of additional information about the brand of peanut butter, the consumption habits of cases, and the patterns of distribution of cases is ongoing. Health officials and the peanut butter industry representatives are working collaboratively to learn more about production of peanut butter to determine how it may have become contaminated.

Persons who think they may have become ill from eating peanut butter are advised to visit their health care provider and call their local health departments.

Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment. However, in some persons the diarrhea may be so severe that the patient needs to be hospitalized. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness.

For more information on Salmonella infection and this outbreak, please refer to the following website: http://www.cdc.gov/ncidod/diseases/submenus/sub_salmonella.htm