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Kratom Multistate Salmonella Outbreak

The CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella I 4,[5],12:b:- infections.

As of February 16, 2018, 28 people infected with the outbreak strain of Salmonella I 4,[5],12:b:- have been reported from 20 states. A list of the states and the number of cases in each can be found on the CaseCount Map page. WGS performed on isolates from ill people were closely relatedly genetically. This means that people in this outbreak are more likely to share a common source of infection.

Illnesses started on dates ranging from October 13, 2017 to January 30, 2018. Ill people range in age from 6 to 67 years, with a median age of 41. Sixteen people are male. Eleven hospitalizations have been reported. No deaths have been reported.

This outbreak can be illustrated with a chart showing the number of people who became ill each day. This chart is called an epidemic curve, or epi curve. Illnesses that occurred after January 23, 2018, might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks.

Epidemiologic evidence indicates that kratom is a likely source of this multistate outbreak. Kratom is a plant consumed for its stimulant effects and as an opioid substitute. Kratom is also known as Thang, Kakuam, Thom, Ketom, and Biak.

In interviews, ill people answered questions about the foods they ate and other exposures in the months before they became ill. Eight (73%) of 11 people interviewed reported consuming kratom in pills, powder, or tea. No common brands or suppliers of kratom have been identified at this time.

At this time, CDC recommends that people not consume kratom in any form. The investigation indicates that kratom products could be contaminated with Salmonella and could make people sick.

Salmonella symptoms include:

  • Diarrhea
  • Abdominal cramps
  • Fever of 100-102 F
  • Bloody diarrhea
  • Vomiting
  • Headache
  • Body aches

Symptoms typically appear 6-72 hours after eating contaminated food and last for 3-7 days without treatment. If you or a family member experienced symptoms, contact your local health department.

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