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The U.S. Centers for Disease Control and Prevention and the Food and Drug Administration continue to investigate two salmonella outbreaks likely connected to cucumbers as the total of those sickened has grown to more than 380 people in at least 28 states.

The number of people taken ill in both outbreaks has risen, the FDA reported Wednesday. Cases in the first reported outbreak have risen to 196 in 28 states and Washington, D.C. – up from 162 people in 25 states. The CDC said that 68 of those sickened with the strain Salmonella Africana have been hospitalized. No deaths have been reported.

Those cases were reported between March 30 and May 23, the CDC says. Nearly three-fourths of the 85 patients interviewed (74%) said they ate cucumbers.

Cases of people infected with the strain Salmonella Braenderup in the second outbreak have risen to 185 cases in 24 states, up from 158 in 23 states, the FDA says.

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States where people have gotten sick from salmonella linked to cucumbers

Back on May 31, Fresh Start Produce Sales Inc. of Delray, Florida, recalled cucumbers grown in Florida and shipped to 14 states between May 17 and 21. That recall came after some cucumbers tested positive for salmonella, the FDA said on June 1.

The salmonella strain those cucumbers tested were found to have a third strain, Salmonella Bareilly, which doesn't match any of the currently reported outbreaks, the FDA said.

While epidemiologic data show that cucumbers may be contaminated with Salmonella Africana and may be making people sick, the FDA and CDC have not confirmed that cucumbers are the source of illness in any ongoing outbreaks.  The agencies are continuing to investigate both outbreaks to determine the specific sources and products involved.

However, with so many people who developed salmonella infections having reported eating cucumbers, it's likely those cucumbers are involved, Bill Marler, a food safety lawyer, told USA TODAY.

The epidemiological investigation after the Fresh Start cucumbers were recalled led "to cucumbers in that company," he said.

"Just because the leftover cucumbers (those tested), which are clearly the ones people didn't eat, have a different strain, doesn't mean the CDC and FDA are wrong" about having Fresh Start issue the recall, he said. "Most of the time there's never food to test because people eat the evidence," Marler said.

Here's the states reporting Salmonella Africana infections:

• Alabama
• Arkansas
• Connecticut
• District of Columbia
• Delaware
• Florida
• Georgia
• Illinois
• Iowa
• Indiana
• Kentucky
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Missouri
• North Carolina
• New Jersey
• New York
• Ohio
• Pennsylvania
• Rhode Island
• South Carolina
• Tennessee
• Texas
• Vermont
• Virginia
• Washington

Symptoms of salmonella infection

The bacteria Salmonella can enter the food production chain when the process isn't sanitary and when workers handling food do not wash their hands, according to the FDA. Salmonella is usually spread via contaminated water such as that used to irrigate crops, the CDC says, and undercooked and raw foods, like cucumbers.

Salmonella infection symptoms usually occur between six hours and six days after exposure and may include diarrhea, fever and stomach cramps, the CDC says. Severe infections may include aches, headaches, elevated fever, lethargy, rashes, blood in the urine or stool. Some salmonella infections may become fatal.

Salmonella causes about 1.35 million illnesses, 26,500 hospitalizations, and 420 deaths in the U.S. annually, according to the CDC. Other recent salmonella outbreaks have been linked to pet bearded dragons, backyard poultry and basil, the agency says.

Salmonella and cucumbers: What consumers should know

Consumers should be concerned about food safety during this situation because we don't know the specific sources of salmonella contamination in the outbreaks, said Barbara Kowalcyk, director of the Institute for Food Safety and Nutrition Security at George Washington University's Milken Institute School of Public Health in Washington, D.C.

Even though the initial shipments of cucumbers potentially linked to the Salmonella Africana outbreak were recalled – and likely wouldn't be edible by now – eating cucumbers could still be risky, she said.

"I hate to tell someone not to eat fresh produce, but if I were someone over the age of 65, with a compromised immune system, maybe I was dealing with cancer … I probably wouldn't eat cucumbers now."

Those more likely to develop a serious illness from salmonella infection, according to The CDC, includes people with immune systems weakened from a medical condition – such as diabetes, liver or kidney disease, and cancer or cancer treatment – as well as children younger than 5, and older adults.

"If you were to eat cucumbers, I would wash it thoroughly and I would be very careful about cross-contamination," Kowalcyk said. "And I probably wouldn't eat (cucumbers) every meal, every day."

While the number of salmonella cases are at more than 380 now, those infected likely number 30 times more, she said. So it's good to be cautious, she said, until "there's a little more clarity."

Follow Mike Snider on X and Threads: @mikesnider & mikegsnider.

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