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Four years ago last month, I wrote an article titled “Why I Don’t Eat Sushi Or Sashimi” after ten patrons of a restaurant in Kisai, Japan were diagnosed with cholera contracted as a result of having eaten contaminated sashimi.

I was taken to task by a reader who pointed out that FDA and the European Union require that fish used for sushi and sashimi be frozen before consumption in order to kill parasites. “So while there might be issues in Japan and other places,” my reader opined, “the EU and USA are relatively safe places to eat sashimi and sushi.”

In response to this comment, I explained that freezing the fish does not provide any protection against food poisoning bacteria such as Salmonella, unsanitary handling practices, cross-contamination or poor temperature control.

I suggest that the 258 victims of this year’s Salmonella Bareilly/Salmonella Nchanga outbreak would agree that eating raw sushi may be a risky business – especially when the sushi contains Nakaochi Scrape.

Today’s update from CDC revealed that the Salmonella outbreak now covers 24 states, including California, where the importer of the contaminated tuna is located. Thirty-two out of 258 outbreak victims have been hospitalized.

Sushi Case Count Map As of May 2, 2012 (source CDC)

Victims of this outbreak range in age from 4 to 86 years (median age of 30). More than half (57%) of the confirmed case patients are female. Illness onset dates range between January 28th and April 20th.

The Epi curve (a bar chart showing illness onset dates) clearly indicates that additional cases are likely to be reported. The shaded area in this chart indicates the time frame within which additional cases may have developed, but have not yet been confirmed or reported to CDC.

Confirmed infections by date of illness onset as of May 2, 2012 (source CDC)

While this outbreak plays out, CDC continues to offer the following advice:

CDC’s Advice to Consumers

  • Do not eat the recalled frozen raw yellowfin tuna product, known as Nakaochi Scrape, from Moon Marine USA Corporation. This product is tuna backmeat that is scraped from the bones of tuna and may be used to make sushi, particularly “spicy tuna” sushi.
  • If you purchase “spicy tuna” or other sushi, sashimi, ceviche, or similar dishes that might contain Nakaochi Scrape tuna product from a restaurant or grocery store, check with the establishment to make sure that it does not contain raw recalled product from Moon Marine USA Corporation. When in doubt, don’t eat it.
  • Persons who think they might have become ill from eating possibly contaminated raw Nakaochi Scrape tuna product should consult their healthcare providers.
  • Infants, older adults, pregnant women, and persons with impaired immune systems are more likely than others to develop severe illness and should not eat raw or partially cooked fish or shellfish. If you are unsure of your risk, ask your healthcare provider.

CDC’s Advice to Retailers and Establishments

  • Do not serve raw recalled frozen raw yellowfin tuna product, known as Nakaochi Scrape, from Moon Marine USA Corporation. If you do not know the source of your raw scraped yellowfin tuna product, check with your supplier.

CDC and FDA have been close-mouthed, as usual, regarding the retail distribution of the Nakaochi Scrape tuna product that is behind this Salmonella outbreak. California, though, has published a list of restaurants and sushi bars that are known to have been supplied with the implicated tuna.

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