About the peanut butter:
- Many patients that have become ill report eating peanut butter in the preceding days.
- The peanut butter may have been distributed by Peanut Corporation of America (PCA), a company that supplies large buckets of peanut butter to institutional settings such as nursing homes, hospitals, schools, hospitals and bakeries. As Kellogg made some items with this source of peanut butter, it has voluntarily recalled some products.
- To date, name brand peanut butters sold in grocery stores haven't been linked to the outbreak. (Phew. Thank goodness. Just bought a jar recently.)
- Gastroenteritis secondary to nontyphoidal Salmonella is clinically indistinguishable from gastro caused by other pathogens.
- Symptoms start 8 - 72 hours after ingesting contaminated food or water.
- Treatment is usually supportive. Consider empiric antibiotic treatment (fluroquinolone, trimethoprim-sulfamethoxazole, amoxicillin, or 3rd generation cephalosporin) in immunocompromised patients, those at extremes of age and severely ill immunocompetent individuals age 2-50.
- DO NOT give antibiotics empirically if there is any concern for Enterohemorrhagic E. coli which is often manifest by bloody diarrhea, abdominal pain and tenderness but NO fever. This may result in increased Shiga toxin production. Epidemilogic clues to Enterohemorrhagic E. coli include fecally contaminated beef or produce ingestion or recent visit to a petting zoo.
Source
"Salmonella Typhimurium Outbreak." US Food and Drug Administration. http://www.fda.gov/oc/opacom/hottopics/salmonellatyph.html#salmonella 17 Jan 2009.
Hohmann, E. MD. "Approach to the patient with nontyphoidal Salmonella in a stool culture." Up to Date. Oct 2008.