The Illinois Department of Public Health announced yesterday that 97 cases of Salmonella serotype Hvittingfoss had been confirmed among Subway restaurant customers in 28 counties in the state.

At least 25 people were hospitalized due to the severity of their illnesses.  Subway customers who reported becoming ill with Salmonella infection ate at the restaurants between May 5 and June 4.

One of those hospitalized after the outbreak filed a lawsuit against Subway this week.

According to the lawsuit, which was filed in Will County Circuit Court, a Bollingbrook, Will County, Illinois woman became ill with a Salmonella infection after consuming a sandwich purchased from an Aurora, Illinois Subway restaurant on May 12.  She is represented by Seattle-based food safety law firm Marler Clark.

The woman fell ill later that evening, complaining of severe gastrointestinal symptoms including abdominal cramps, diarrhea, and body aches.  She drove herself to the emergency room and was given fluids for re-hydration and medication for her pain.

The Health Department announced Friday that food handlers at several Subway locations in Illinois had tested positive for Salmonella serotype Hvittingfoss.  All employees who tested positive for Salmonella are required to have two consecutive tests that are negative for Salmonella serotype Hvittingfoss before they will be allowed to return to work.

“The Illinois Department of Public Health is working closely with local health departments to help protect the people of Illinois from becoming sick from Salmonella,” state public health director Dr. Damon T. Arnold said. “In an effort to prevent a secondary outbreak, the Department is taking precautions by requiring food handlers at certain Subway restaurants in Illinois to be tested and cleared before being allowed to handle food.”

After the Salmonella outbreak was announced, Subway discarded several fresh produce items from the implicated restaurants and replaced them.  A specific food source has not been determined to be the source of the outbreak.  The Illinois Department of Public Health, Centers for Disease Control and Prevention, U.S. Food and Drug Administration, Subway, and local Illinois health departments are working together to determine the source of Salmonella contamination at Subway restaurants.

Cases have reported eating at Subway restaurants located in 28 counties–Bureau, Cass, Champaign, Christian, Coles, Dekalb, DeWitt, Ford, Fulton, Henry, Knox, LaSalle, Livingston, Macon, Marshall, McLean, Moultrie, Ogle, Peoria, Rock Island, Sangamon, Schuyler, Shelby, Tazewell, Vermilion, Warren, Will and Winnebago.

According to About-Salmonella.com, Symptoms of Salmonella gastroenteritis include diarrhea, abdominal cramps, fever, nausea, and/or vomiting. In mild cases diarrhea may be non-bloody, occur several times per day, and not be very voluminous; in severe cases it may be frequent, bloody and/or mucoid, and of high volume.

Fever generally occurs in the 100°F to 102°F (38°C to 39°C) range. Vomiting is less common than diarrhea. Headaches, myalgias (muscle pain), and arthralgias (joint pain) are often reported as well. Whereas the diarrhea typically lasts 24 to 72 hours, patients often report fatigue and other nonspecific symptoms lasting 7 days or longer.

Reactive arthritis may develop after a person eats food contaminated with pathogenic bacteria such as Salmonella.  Reactive arthritis typically involves inflammation of one joint (monoarthritis) or several joints (oligoarthritis), preferentially affecting those of the lower extremities.  The most common joints affected are the knees and ankles.