Salmonella tomatoes have sickened 757 people, making it the largest in US history to be linked to tomatoes. Unfortunately, that number probably doesn’t come close to measuring the true size of this outbreak. Last week, the Centers for Disease Control (CDC) estimated that as many as 8500 people might eventually become sick from the Salmonella tomatoes.

No one will ever know the true number of illnesses caused by Salmonella tainted tomatoes, because health officials are never notified of most illnesses. Many people with a mild case of Salmonella poisoning won’t seek medical attention, and among many of those that do, testing of stool samples – the only way to confirm Salmonella – is never done. Generally, this strain of Salmonella- St. Paul – sickens only about 400 people a year.

According to the CDC, the states affected by this outbreak include: Arkansas (10 persons), Arizona (38), California (10), Colorado (6), Connecticut (4), Florida (1), Georgia (15), Idaho (3), Illinois (66), Indiana (11), Kansas (11), Kentucky (1), Maryland (25), Massachusetts (17), Michigan (4), Missouri (12), New Hampshire (3), Nevada (4), New Jersey (4), New Mexico (80), New York (18), North Carolina (5), Ohio (3), Oklahoma (17), Oregon (7), Pennsylvania (6), Rhode Island (3), Tennessee (6), Texas (330), Utah (2), Virginia (22), Vermont (1), Washington (4), Wisconsin (6), and the District of Columbia (1).

The bulk of the illnesses were reported between April 10 and June 13. The CDC says most of the increase does not represent new infections, but rather results from a backlog of lab tests that were recently finished.

At least 95 persons were hospitalized. No deaths have been officially attributed to this outbreak. However, a man in his sixties who died in Texas from cancer was infected with Salmonella St. Paul at the time of his death. The CDC says the infection may have contributed to his death.

Unfortunately, the Food & Drug Administration (FDA) still has not been able to identify the source of the Salmonella tomatoes. Investigators from the agency have spent the past week inspecting farms in parts of Florida and Mexico and the warehouses and other stops those farms’ tomatoes made on the way to market.

It is important however, that anyone who is exhibiting symptoms of Salmonella seek medical attention, because the disease can become serious. Salmonella symptoms include fever, abdominal pain, nausea, gas and bloody diarrhea. Symptoms appear within 36 hours of exposure, and usually last four to seven days. In very severe cases, Salmonella can lead to kidney failure and other complications. Salmonella can be particularly dangerous for children, the elderly and people with weakened immune systems. Some victims of Salmonella will develop a disease called Reiter’s Syndrome, a difficult- to- treat condition that causes severe joint pain, irritation of the eyes, and painful urination. Reiter’s Syndrome can plague its victims for months or years, and can lead to chronic arthritis.

To avoid illness, the FDA is advising consumers to limit their tomato consumption to those that are not the likely source of this outbreak. These include cherry tomatoes; grape tomatoes; tomatoes sold with the vine still attached; tomatoes grown at home; and red plum, red Roma, and round red tomatoes from specific sources listed on the agency’s website.