North and South Carolina, Tennessee and New York impacted.

Salmonella paratyphi B.pngThe Buncombe County Department of Health North Carolina reports that 5 more cases of Salmonella Paratyphi B were identified over the weekend, bringing the total to 34, as of Monday, April 30, 2012. The local health department is working with NC Department of Public Health, Center for Disease Control, US Department of Agriculture and others to continue intensive testing, interviewing, and epidemiological investigation of the outbreak in order to squelch the spread of the disease. Cases still appear to have been associated with residence or travel to Buncombe County since February 28, 2012. A single source of infection has not been confirmed.

According to the Health Department:

As much as the public wants to know which foods or restaurants should be avoided, state and local health officials do not have final laboratory test results that would allow conclusive identification of a specific source of salmonella contamination.

According to the CDC, humans are one of the only known reservoir sources of Salmonella paratyphi B. Salmonella paratyphi B is most often acquired through consumption of water or food that has been contaminated by feces of an infected person or a chronic, asymptomatic carrier.

Worldwide some six million cases of Salmonella paratyphi are estimated to occur annually. However, only approximately 150 cases of Salmonella paratyphi are reported each year in the United States, most of which are in recent travelers.

The incubation period of Salmonella paratyphoid B is longer that other Salmonella with onset of infections ranging from 6–30 days. The onset of illness is increasing fatigue and a fever that increases daily from low-grade to as high by the third to fourth day of illness. A rash of rose-colored spots can occasionally be seen on the trunk. Untreated, the disease can last for a month. The serious complications of Salmonella paratyphoid B generally occur after 2–3 weeks of illness and may include intestinal hemorrhage or perforation, which can be life threatening.