"We will take care of people who got sick," vowed Steve Sheetz, chairman of the Altoona-based convenience store chain linked to the outbreak. The company will compensate those customers, but officials have not decided how, he said.
State and federal investigators still are looking at lettuce or Roma tomatoes as the likely carriers of the salmonella bacteria, but were surprised Monday when salmonella found on tomatoes at a Franklin County Sheetz store turned out to be a different strain than the Javiana one that sickened people in 24 Pennsylvania counties, Ohio, West Virginia and possibly in Maryland and Virginia.
"It's possible that there's more than one type of salmonella going on here," said Ellen Morrison, director of the U.S. Food and Drug Administration's Office of Crisis Management.
The strain identified on the tomatoes, E1, has not been linked to any illnesses, but public health officials are reviewing salmonellosis cases they previously concluded were not linked to the Sheetz outbreak to see whether they might be. Salmonella has more than 2,000 strains, said Dr. Patricia Griffin, team leader for the U.S. Centers for Disease Control and Prevention's Foodborne Diseases Epidemiology.
A state investigator said 141 people who ate at Sheetz stores in Pennsylvania have been infected with the Javiana strain. Thirty-one people in Ohio and West Virginia also have been infected. In addition, 24 people in Pennsylvania who didn't eat at Sheetz stores have been confirmed with the Javiana strain, suggesting another food establishment could be linked to the outbreak.
State Department of Agriculture officials asked four convenience stores in Allegheny County on Thursday to pull Roma tomatoes from their shelves as a precautionary measure, said John Stella, the department's food safety regional supervisor.
All the salmonellosis victims linked to the Sheetz outbreak ate at the company's stores between July 2 and July 10. Generally, those infected get sick with diarrhea, abdominal cramps and fever within 12 to 72 hours and can be sick for up to 10 days. Most people recover without treatment.
Each year, about 40,000 cases of salmonellosis are confirmed nationally, including 2,000 statewide and 113 in Allegheny County. Nationwide, 600 people die each year from the disease. Cases are more common in the summer.
For every confirmed case of salmonellosis, the CDC estimates that 30 times as many go unreported.
Stacy Miller, 34, believes she is one of those. She became "violently sick" with salmonellosis-like symptoms after sharing a salad from the Ligonier Sheetz on July 9 with her mother. Her mother, who is recovering from shoulder surgery, had a few pieces of lettuce and the ham and turkey and was mildly ill for two days, but Miller said she ate all the Roma tomatoes and most of the lettuce and was sick for nine days.
A state agriculture investigator picked up a second, uneaten salad bought at the same time for testing. It is the only one of 237 samples the state Agriculture Department took for testing that still is awaiting results. One tested for the E1 strain, and the 235 others came back negative, said Bobby McLean, director of the Bureau for Food Safety. Officials will meet today to determine what to sample next, he said.
The FDA is reviewing Sheetz records to try to determine relevant shipping dates and to trace suspect products to packers and growers, Morrison said.
In the past, trace-back investigations of tomatoes and other produce were stymied because multiple growers take their products to cooperatives where they are mixed for packing, sometimes making it impossible to trace further, Morrison said. "I've seen as many as 40 farms go into one place," she said.
The FDA's trace-back investigation of Sheetz produce has not progressed far enough to determine whether that will be a problem, she said.