There are now 35 confirmed cases of salmonella Saintpaul in Texas, including four cases in Dallas County and one in Tarrant County.
A total of 11 states, which now include Wisconsin and Virginia, have confirmed 112 cases of the Saintpaul strain. Of those cases, 83 were reported in Texas and New Mexico.
The U.S. Food and Drug Administration said preliminary investigations suggest that raw red plum, red Roma or round red tomatoes are to blame.
The agency advised residents of Texas and New Mexico to only eat tomatoes that haven't been connected to the outbreak, including homegrown, cherry and grape tomatoes as well as those sold attached to the vine.
They also reminded consumers that fresh salsa, guacamole, pico de gallo and other products may contain raw tomatoes.
The reports have prompted local restaurants and supermarkets to limit their offerings of tomatoes as health officials work to determine the specific type and source of the tomatoes causing the outbreak.
Local restaurants such as Matt's Rancho Martinez Mexican restaurant in Lakewood has pulled all raw tomatoes from its menu. "We feel it's our responsibility to be safety-minded," said general manager Patrick Johnson.
Some restaurant chains have followed suit. Subway has asked its Texas and New Mexico stores not to serve tomatoes. Sonic has made the same request for all its stores nationwide.
Jerry Johnston, a Chick-fil-A spokesman, said its stores have pulled all Roma and red round tomatoes from its menu in the two states. They have not removed other tomatoes, such as the grape, used in their wraps.
Pappasito's Cantina has substituted Roma and red round with cherry, grape and vine-cluster tomatoes, the company said.
Albertsons and Kroger have pulled red round and Roma tomatoes from their shelves in Texas and New Mexico, the companies said. The stores are offering refunds to customers and continue to sell other varieties of tomatoes, including grape and cherry tomatoes and those sold on the vine.
In New Mexico, investigators are working to confirm the source of the outbreak by testing a variety of tomatoes from stores statewide, according to the New Mexico Department of Health. Emily Palmer of the Texas Department of State Health Services said officials are monitoring the outbreak and may consider testing as the investigation continues.
Symptoms of salmonella, including abdominal pain, nausea, diarrhea and vomiting, generally develop within 12 to 72 hours. The illness usually last for four to seven days and most people do not need treatment. Those with salmonella are advised to drink water, rest and visit their doctor.