San Diego sees surge in sal­monella cases this year

The Tribune (SLO) - - State - BY PAUL SISSON

Through mid-De­cem­ber, San Diego County recorded 730 sal­monella cases, the high­est to­tal ob­served in at least 25 years.

That num­ber comes amid a large num­ber of sal­monella-re­lated re­calls this year that have ranged from Cap’n Crunch ce­real and Dun­can Hines cake mix to gold­fish crack­ers and ham­burger meat.

Ac­cord­ing to county re­ports, sal­monella rates in San Diego County have run higher than they are in the state or the na­tion in re­cent years. While more fre­quent out­breaks have con­trib­uted to the in­crease, bet­ter test­ing has con­trib­uted to the over­all rise na­tion­wide, said Dr. Eric McDon­ald, med­i­cal di­rec­tor of the county’s epi­demi­ol­ogy and im­mu­niza­tion ser­vices branch.

Ac­cord­ing to es­ti­mates from the U.S. Cen­ters for Dis­ease Con­trol and Pre­ven­tion, only about one in 20 sal­monella cases ever gets di­ag­nosed. The se­vere gas­troin­testi­nal dis­tress caused by the bac­te­ria usu­ally passes with­out hos­pi­tal­iza­tion, so a for­mal di­ag­no­sis usu­ally isn’t made. How­ever, re­cent ad­vances in test­ing make it eas­ier and quicker to prove that sal­monella is present.

“Peo­ple who wouldn’t have even got­ten tested 10 years ago are get­ting tested more of­ten to­day, and that clearly has some­thing to do with the in- crease,” McDon­ald said.

As to why ex­actly San Diego’s num­bers are higher than they are in other parts of the state and na­tion, that’s a bit of a mys­tery.

This year, though, there have been food-re­lated cases re­lated to na­tion­wide out­breaks along­side a lo­cal sal­monella clus­ter that has been linked to un­pas­teur­ized queso fresco cheeses pur­chased in Ti­juana, McDon­ald said.

“We have three con­firmed sal­monella cases and an­other dozen that are prob­a­ble and await­ing con­fir­ma­tion. Seven of them re­ported con­sum­ing Mex­i­can cheeses pur­chased in Ti­juana,” McDon­ald said last week.

The rest, he said, have sec­ondary links to some­one who con­sumed queso fresco, an iconic style of cheese made from fresh milk and usu­ally con­sumed shortly after it’s made. When this cheese is made from un­pas­teur­ized milk, the odds are greater that it may carry the bac­te­ria that cause lis­te­ria, bru­cella and tu­ber­cu­lo­sis.

Health con­se­quences for the re­cent queso fresco clus­ter were of­ten rel­a­tively se­vere, McDon­ald added.

“In the cheese-re­lated out­break, two of the three con­firmed cases, plus five of the 12 un­con­firmed cases, were sick enough that they had to be hos­pi­tal­ized,” McDon­ald said.

Though it is tech­ni­cally il­le­gal for a com­pany to make and sell cheese from un­pas­teur­ized milk and sell it to the pub­lic un­less it has been aged for at least 60 days, queso fresco is of­ten made in small batches at the house­hold level in Mex­ico. And those who cross into San Diego from Ti­juana are al­lowed to bring some cheese along for per­sonal use.

“We’ve seen peo­ple bring tens of pounds back, suit­cases full,” said Dr. Steve Water­man of the CDC. “There is no doubt that some of it gets sold or shared once it ar­rives in the United States.”

These days, Water­man is chief of the CDC’s Dengue Branch in San Juan, but be­fore mov­ing to that post, he was sta­tioned in San Diego and was a cen­tral fig­ure in the cross­bor­der ed­u­ca­tion ef­forts around queso fresco.

He was co-au­thor of a 2009 study that sur­veyed bor­der crossers about their knowl­edge of the dan­gers of un­pas­teur­ized queso fresco. Re­sults showed that 58 per­cent were aware that the cheese could make them sick and 56 per­cent said they thought that the cheese could be un­safe for preg­nant women. How­ever, nearly 20 per­cent of re­spon­dents said they had eaten the cheese while preg­nant.

Those re­sults, Water­man said, gal­va­nized a pub­lic health cam­paign that con­tin­ues to­day fo­cused on those at high­est risk of get­ting sick.

“You know, this is cul­tur­ally sort of a loved food in Mex­ico, and I don’t think we’re go­ing to stop Mex­i­can Amer­i­cans or im­mi­grants from eat­ing this cheese, but we’re try­ing to ed­u­cate the pub- lic that preg­nant women, peo­ple with com­pro­mised im­mune sys­tems like those with can­cer, older peo­ple and in­fants should not be con­sum­ing it,” Water­man said.

There are many queso fresco va­ri­eties avail­able that are made from pas­teur­ized milk, but those made with raw milk con­tinue to have an ap­peal for many, es­pe­cially those born and raised south of the bor­der.

Such is def­i­nitely the case for chef Claudette Zepeda-Wilkins, owner of El JardÍn in Lib­erty Sta­tion. Some of her ear­li­est mem­o­ries, she said, are of queso fresco made with fresh milk on her aunt’s ranch in El Salto out­side Guadala­jara. That fresh taste, with its grassy notes, she said, is sim­ply lost through the heat­ing process of pas­teur­iza­tion. For her, she said, it’s the pas­teur­ized stuff that her body just can’t take. But she’s spent a life­time eat­ing un­pas­teur­ized queso fresco with­out a prob­lem.

“I eat what you can get in the United States, and it just makes me a lit­tle sad,” she said.

She stresses, though, that any food needs to be pre­pared in a san­i­tary man­ner.

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