The FDA has alerted people in New Mexico and Texas that a salmonellosis outbreak appears to be linked to consumption of certain types of raw red tomatoes, and products containing raw red tomatoes. The bacteria causing the illnesses are Salmonella serotype Saintpaul, an uncommon type of Salmonella. Salmonella is one of the most common enteric (intestinal) infections in the United States with an estimated 1.4 million cases of salmonellosis occuring each year in the US: 95 per cent of those cases are foodborne-related. Salmonella infection occurs when the bacteria are ingested, typically from food derived from infected food-animals, but it can also occur by ingesting the feces of an infected animal or person. "An epidemiologic investigation conducted by the New Mexico and Texas Departments of Health and the Indian Health Service using interviews comparing foods eaten by ill and well persons has identified consumption of raw tomatoes as the likely source of the illnesses in New Mexico and Texas," confirmed the US Centers for Disease Control and Prevention (CDC) this week. While the specific type and source of tomatoes is under investigation, the centre comments that "preliminary data suggest that large tomatoes, including Roma and red round are the source." At this time, the FDA is advising that consumers in New Mexico and Texas should limit their tomato consumption to cherry tomatoes, grape tomatoes, tomatoes sold with the vine still attached, and tomatoes grown at home. Since late April, 57 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in Texas (24 persons) and New Mexico (33 persons). Patients range in age from 3 to 82 years, and at least 17 persons were hospitalized. No deaths have been reported, said the US CDC. In addition, 29 persons with the outbreak strain of Salmonella Saintpaul have been reported since mid-April in residents of Arizona (6 persons), Colorado (1), Idaho (2), Illinois (12), Indiana (1), Kansas (3), Utah (1), Virginia (1), and Wisconsin (2). In a statement this week the FDA said that it recognizes that the source of the contaminated tomatoes "may be limited to a single grower or packer or tomatoes from a specific geographic area." The FDA "also recognizes that there are many tomato crops across the country and in foreign countries that are just becoming ready for harvest or will become ready in the coming months." During the past decade, the consumption of fresh and fresh-cut tomatoes has been linked to 12 different outbreaks of foodborne illness in the United States. Those outbreaks include 1,840 confirmed cases of illness. In response to these outbreaks, last year the FDA began a multi-year Tomato Safety Initiative to reduce the incidence of tomato-related foodborne illness. The Initiative is a collaborative effort between FDA and the state health and agriculture departments in Virginia and Florida, in cooperation with several universities and members of the produce industry. And in a further extension of these food safety initiatives, in fall last year the FDA and the California Department of Public Health announced that safety efforts would have a broader focus on leafy greens, including spinach. Beginning in October 2007, governmental and state investigators will visit farms in California to assess risk factors for contamination of leafy greens with E Coli., a potentially fatal foodborne bacterium. The agency also aims to assess the extent to which Good Agricultural Practices (GAPs) and other preventive controls are being implemented, and to identify areas where risk factors are present. The move formed the next step in a multi-year initiative by FDA and the State of California's Departments of Public Health and Food and Agriculture to reduce public health risks by focusing on preventive food safety efforts.