Food-borne illnesses sickened thousands of people in the US last year, with pathogens including salmonella and E. coli lurking in cantaloupe, alfalfa sprouts, ground beef, and more.
Every year, food pathogens send 128,000 Americans to the hospital, and 3,000 die. The Food and Drug Administration has oversight over the food industry and steps in to recall contaminated items such as bagged salads when reports of poisonings begin cropping up across the country.
The tallies for illnesses and deaths due to food-borned pathogens is almost certainly an undercount because many people affected end up recovering on their own without reporting their illness to a government agency.
Included on the list of the worst outbreaks and/or recalls were some unsurprising offenders, including raw cookie dough and leafy greens, which have been responsible for many illnesses and subject of many recalls in recent years. There were also items that might not typically be associated with illness, such as flour.
Cantalope
Six Americans and nine Canadians died from whole and precut cantaloupe that was found to contain salmonella
The FDA recalled contaminated whole and precut cantaloupe in November 2023 when 407 Americans and 190 Canadians got sick from the fruit sold at grocery giants including Aldi, Kroger, Stop & Shop, and Trader Joes.
The brand’s producer, Sofia Produce recalled all sizes of its fresh cantaloupes sold with the ‘Malichita’ label due to salmonella, which sent 158 Americans and 68 Canadians to the hospital.
Six Americans and nine Canadians died.
The melons were distributed across a wide swathe of the country – Arizona, California, Maryland, New Jersey, Tennessee, Illinois, Michigan, Wisconsin, Texas and Florida between Oct. 16-23, 2023.
Salmonella is a type of bacteria that causes salmonellosis, which causes nausea, vomiting, diarrhea, abdominal cramping, and sometimes bloody stool.
Many people with salmonellosis also develop a fever, which can become severe and require hospitalization. And the severe GI upset can lead to dehydration.
Illness usually occurs within 12 to 72 hours after eating contaminated food and usually lasts four to seven days.
Adults 65 and older, children under 5 years, and people with weakened immune systems are likelier to get sick from Salmonella. Fifty-two people who got sick lived in long-term care facilities, while 44 children attended childcare centers when they got sick.
Fresh diced onions
The FDA found salmonella in the water and surrounding environment of the farm that supplied produce to Gills Onions based in California. In all, 80 people got sick, 18 were hospitalized, and one died
In October 2023, Gills Onions in California recalled several lots of chopped onions distributed across Arizona, California, Idaho, Montana, Oregon and Washington after dozens of people were poisoned by salmonella.
Products included some lots of diced yellow onions (3-pound bags and 8-ounce cups), diced celery and onions (8-ounce cups), diced mirepoix (10-ounce cups) and diced red onions (8-ounce cups), and had use-by dates between August 8 and August 28.
Ultimately, 80 people got sick, 18 of whom were hospitalized, and one died.
The FDA found salmonella in the water and surrounding environment of the farm that supplied produce to Gills Onions.
To avoid salmonella from diced onions, cooking them is the best bet. Food safety experts also recommend discarding the top layer of the cup and using more of the inner core, according to Consumer Reports.
Alfalfa sprouts
A key issue lies in the warm, moist environments where sprouts are cultivated—conditions perfect for pathogens. In total, 63 people got sick and 10 were hospitalized after eating alfalfa sprouts due to salmonella contamination.
Sun Sprouts, a Nebraska company, recalled its raw alfalfa sprouts after more than a dozen people got sick in December 2022.
The company had to recall 808 pounds’ worth of sprouts sent to five food service companies and grocery stores in Nebraska, Iowa and Kansas in November and December over salmonella concerns.
An FDA investigation of the facilities found that the company did not test irrigation water for salmonella and E. coli, nor did it clean and sanitize food contact surfaces that come into contact with sprouts or the seeds or beans used to grow them.
The agency also said that none of the company’s supervisors or managers had passed a food safety training course.
In total, 63 people got sick and 10 of them were hospitalized.
The best way to avoid salmonella from alfalfa sprouts is to avoid them altogether, especially if the person is pregnant, elderly, or has a weakened immune system.
Raw cookie dough
Not only does raw cookie dough contain raw eggs, a common vehicle for salmonella, but also flour, which can carry salmonella
This one can be particularly hard to swallow, but cookie dough contains raw egg which can cause salmonella.
Last year, the FDA recalled cookie dough from the pizza franchise Papa Murphy’s. The culprits behind 26 illnesses and four hospitalizations were the chain’s chocolate chip cookie dough and S’mores bars dough.
The company Papa Murphy’s owns over 1,100 stores across the US. The states in which people go sick included Washington, Oregon, California, Utah, Idaho, and Missouri.
The standard advice is to forego licking the spoon and wait until the cookies are fully baked.
Leafy greens
The source of listeria on leafy greens is typically contaminated water used to irrigate the fields that grow the greens. And recalls of leafy greens are not unusual. Last year, greens sicked 19 people
Leafy greens are one of the risky foods out there due to E. coli and listeria outbreaks. Romaine lettuce and bagged salads are responsible for the most deaths, according to a Consumer Reports analysis of food recalls over the past six years.
In 2023, 19 people became sick with listeria while 18 of them were hospitalized.
While the CDC was able to determine what strain of the bacteria was responsible for the outbreak, there was not enough information to identify a responsible brand and trigger a recall.
The source is typically contaminated water used to irrigate the fields that grow the greens. And recalls of leafy greens are not unusual.
Listeriosis is caused by infection by the germ Listeria monocytogenes found in dirty water, irrigation water, soil and fertilizer.
The pathogen is unique among others that cause food-borne illnesses in that it thrives in low temperatures, such as inside a refrigerator. It can multiply to dangerous levels during storage.
Listeria starts with flu-like symptoms such as fever, chills, muscle aches, nausea and sometimes diarrhea.
The time from consuming the bacterium to showing the signs of illness can often be between 8 to 90 days, and some people end up in the hospital with dehydration.
To avoid illness, it’s recommended that people cook their greens. Rather than buy bagged salads, people should also opt for whole heads of lettuce and remove the outer leaves to avoid any bacteria lurking there.
Ground beef
Eighteen people became ill from from April to July, 2023 due to salmonella. Seven of them were so sick they needed to be hospitalized. There were no deaths though the CDC said cases are likely an undercount
A multistate salmonella outbreak last year was linked to ground beef sold at ShopRite stores in Connecticut, New Jersey, and New York.
Eighteen people became ill from April 27, 2023, to July 6, 2023. Seven of them were so sick they needed to be hospitalized.
There were no deaths, but the Centers for Disease Control and Prevention warned at the time that the true number of sick people was likely higher than those reported.
There was no recall, but the CDC advised special caution when preparing meat, cooking it to 160° F which will kill salmonella and other common pathogens like listeria and E. coli. Whole cuts require only 145° F.
All leftovers should be refrigerated within two hours of cooking to avoid bacteria growth. Chefs should also use separate cutting boards for meat and other foods, and clean up any splattered juices using a paper towel or a wipe.
Deli meat and cheese
It can be difficult to ensure your deli meats and cheeses are free of pathogens, because they are typically not cooked before you eat them. The 2023 listeria outbreak sickened 16 people and sent 13 to the hospital
Deli meat is a relatively common source of listeria outbreaks because of contamination in the facilities where they’re processed.
Eating them typically does not involve cooking, another potential source of contamination.
The 2023 outbreak sickened 16 people and sent 13 to the hospital. One person became ill during pregnancy and lost their baby. The outbreak was traced first to a deli in Brooklyn, New York, where five patients bought sliced deli meat and cheese.
The CDC later determined the source was a deli meat or cheese product that had been distributed among several states, including California, Illinois, Maryland, Massachusetts, New Jersey, and New York.
Genome sequencing from patient samples showed that their genetic makeups were similar, indicating that people became sick from the same food source. But no single food source was identified.
Flour
Flour, when eaten before being cooked, can carry salmonella. The 2023 outbreak linked to Gold Medal flour sicked 14 illnesses, including three hospitalizations.
General Mills announced a recall last April of 2-, 5- and 10-pound bags of its Gold Medal Bleached and Unbleached All Purpose Flour after a routine inspection at the Kansas City, Missouri plant found salmonella.
Subsequent genomic testing of the flour tied the strain to 14 illnesses including three hospitalizations. Of eight people interviewed by health officials at the CDC, seven reported eating raw dough or batter.
Flour may not be the first foodstuff that comes to mind when discussing foodborne illnesses. But most flour is raw and not treated for germs.
A study in 2019 found that most Americans are not aware that uncooked flour can be dangerous, with roughly a third of respondents saying they had consumed uncooked flour in the previous year.
Peaches, nectarines, and plums
Listeria in stone fruits sickened 11 people last year. Of those, 10 were hospitalized and one died
Eleven people were sickened by listeria from contaminated peaches, nectarines and plums produced by HMC Farms in Kingsberg, California last year.
Ten people were hospitalized and one died across California, Colorado, Kansas, Illinois, Michigan, Ohio, and Florida.
According to the CDC: ‘The true number of sick people in this outbreak was likely higher than the number reported, and the outbreak may not have been limited to the states with known illnesses.’
The farm issued a recall in November for packages sold to a wide array of stores including Cub, Hyvee, Meijer, Sam’s Club, Sprouts, Walmart, and other grocery, produce, and more.
Enoki mushrooms
Five people got sick and went to the hospital due to listeria in enoki mushrooms
The Maryland Department of Health found listeria in samples of enoki mushrooms produced by Shandong Youhe Biotechnology Co. based in China in January 2023.
Missouri officials had found listeria contamination in mushrooms from the same company a month prior. And both cases were linked to another outbreak in 2022.
In 2022, no other food was recalled as often as enoki mushrooms. The repeat instances of infections prompted the FDA and state health boards to increase mushroom testing.
In all, five people got sick and were hospitalized.
The CDC recommends that no one eat them raw and that no one in high-risk groups eat them at all. High-risk groups include children, pregnant women, older adults and people with compromised immune systems.