Salmonella infects more than 60 in New England

By Stephen Smith, Globe Staff

More than 60 adults and children across New England have fallen ill with the bacterial disease salmonella since September, part of a mysterious national outbreak that has stricken hundreds of people.

In Massachusetts alone, 39 people ranging in age from infancy to their 90s have developed the telltale symptoms of the infection, including diarrhea, fever, and abdominal cramps. Connecticut, Maine, New Hampshire, Rhode Island, and Vermont are all reporting cases, too, according to representatives of health agencies in those states. All of the patients have survived.

Like nearly 400 people across the nation, all of the New England patients carry a distinctive strain of the germ, suggesting they were exposed by the same source. Disease sleuths have yet to figure out where the bacteria originated, although a spokeswoman for the US Centers for Disease Control and Prevention said investigators assume the cause is tainted food.

Nothing obvious links the cases, reported in 42 states. In Massachusetts, the patients hail from all corners of the state, and there's no evidence that a group of them, for example, worked in the same place or dined at the same restaurant or attended the same event -- the sort of classic associations disease detectives hunt for in disease outbreaks.

"Those are the clues we look for, at first," said Dr. Alfred DeMaria, state epidemiologist in Massachusetts. "It's more difficult to find a source when it's this diffuse. It may be some low-grade exposure that millions and millions of people are getting exposed to but only a relative few get sick."

Specialists said the illnesses in New England and across the country almost certainly reflect the increasing globalization of food supplies, with produce -- and the germs that can hitch a ride -- traveling from one continent to another in a matter of days.

Earlier this year, more than 1,400 people in 43 states -- including all six New England states -- became sick in a salmonella outbreak blamed largely on tainted jalapeno and serrano peppers. It was the latest in a succession of disease outbreaks sparked by sullied produce.

"Just a small contamination along the supply chain can cause infections across the country," said Dr. Dora A. Mills, director of the Maine Center for Disease Control and Prevention. "One-hundred years ago, if there was an outbreak, it was quite locally controlled."

The most recent confirmed case in Massachusetts involved someone whose symptoms began in mid-December, which disease specialists said strongly suggests the germ is still circulating. It can take two to three weeks before a case is reported and health authorities confirm that it's part of the outbreak.

"Obviously," DeMaria said, "there's going to be a lot of effort to find the source of it so that we can eliminate the source and prevent further cases."

New Hampshire has reported 10 salmonella cases, while Connecticut has reported six. Rhode Island and Vermont each have had three, and Maine has had two.