CDC is collaborating with public health officials in multiple states and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of Salmonella Virchow infections. Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet, the national subtyping network of public health and food regulatory agency laboratories, is coordinated by CDC. DNA fingerprinting is performed on Salmonella bacteria isolated from ill people by using a technique calledpulsed-field gel electrophoresis, or PFGE. PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. One DNA fingerprint (outbreak strain) is included in this outbreak investigation. The outbreak strain is new to the PulseNet database.

A total of 11 people infected with the outbreak strain of Salmonella Virchow have been reported from nine states. The number of ill people identified in each state is as follows: Minnesota (2), New Jersey (2), New Mexico (1), Ohio (1), Oklahoma (1), Oregon (1), Tennessee (1), Utah (1), and Wisconsin (1).

Illnesses started on dates ranging from December 5, 2015, to January 21, 2016. Ill people range in age from 8 years to 76, with a median age of 35. Fifty-five percent of ill people are male. Among 10 ill people with available information, one reported being hospitalized, and 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 8, 2016, 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. Please see the Timeline for Reporting Cases of Salmonella Infection for more details. The recalled products have a long shelf life and may still be in people's homes, and illnesses may continue to be reported.

Investigation of the Outbreak

The epidemiologic and laboratory evidence available at this time suggest that RAW Meal Organic Shake & Meal products made by Garden of Life, LLC are a likely source of this outbreak. This investigation is ongoing.

In interviews, ill people answered questions about foods eaten and other exposures in the week before they became ill. Of the 10 ill people who were interviewed, 10 (100%) reported consuming powdered supplements or meal replacements powders in the week before illness onset; all 10 (100%) specifically reported consuming RAW Meal products made by Garden of Life, LLC.

On January 29, 2016, Garden of Life, LLC voluntarily recalled a limited quantity of its RAW Meal Organic Shake & Meal products available in chocolate, original, vanilla, and vanilla chai because they have the potential to be contaminated with Salmonella Virchow. The recalled products were available for purchase nationwide in many retail stores and online.

On January 31, 2016, the Utah Public Health Laboratory reported it isolated Salmonellafrom an open container of Garden of Life RAW Meal collected from an ill person's home. On February 1, 2016, Oregon health officials also reported Salmonella was isolated from an open container of Garden of Life RAW Meal collected from an ill person's home. DNA "fingerprinting" is being conducted for both samples to determine the PFGE pattern of theSalmonella isolated from this product.