The number of illnesses tied to a Salmonella outbreak in western North Carolina has risen from 29 to 37, health authorities reported Monday. Meanwhile, a Buncombe County tempeh maker recalled its products, apparently because it is one of several companies under investigation as a possible link to the outbreak.

The recall was initiated by Smiling Hara, which supplies frozen tempeh to local restaurants and stores, according to a news release from Blue Ridge Food Ventures, a shared-use commercial kitchen used by Smiling Hara. Tempeh is made from cooked and fermented soybeans.

“Immediately upon learning  of the investigation, Blue Ridge Food Ventures temporarily halted our normal production schedule and began extensive environmental testing as a proactive, voluntary and precautionary measure,” the news release stated.

Blue Ridge Food Ventures said its facility is used by about 20 small, local food companies that rent time and industrial kitchen space to make their products. Each business has its own food production and safety plans, according to the Blue Ridge Food Ventures statement.

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The bacteria – Salmonella Paratyphi B – seems to have infected those who live in or have recently visited Buncombe County, a region close to the Tennessee border that includes the city of Asheville. The local health department is collaborating with the North Carolina Department of Public Health, the federal Centers for Disease Control and Prevention and the U.S. Department of Agriculture to determine the source of the outbreak.

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

However, officials have issued control measures for food establishments based on initial lab results. A routine sample of Smiling Hara unpasteurized soybean tempeh tested positive for Salmonella, according to the North Carolina Department of Agriculture and Consumer Services. That prompted the recall of 12-oz. packages of tempeh with best-by dates 7/11/12 through 10/25/12.

Asheville Independent Restaurant Association (AIR) is also working to educate food workers on how to prevent the spread of disease. 

Final characterization of the outbreak strain of bacteria is expected by the end of the week, according to Gibbie Harris, Health Director of Buncombe County. 

Humans carry Salmonella Paratyphi B bacteria in the intestine. The bacteria can spread from one person to another via food or water contaminated with the feces of an infected individual, or via direct contact with a person who has the infection.

Symptoms of a Salmonella Paratyphi B infection usually appear 6 days after exposure but may take up to 30 days to develop.  Signs of illness may include diarrhea (sometimes bloody), high fever, headache and abdominal pain. These usually last between 4 and 7 days. The elderly, infants and those with compromised immune systems are at risk for more serious illnesses and may need to be hospitalized.  

This strain of bacteria can be treated with antibiotics.

A hotline with information about the outbreak has been set up and is available at 828-250-5300.

Healthcare providors or ill individuals can report symptoms and speak with a communicable disease nurse by calling 828-250-5109.

The Buncombe County Health Department recommends that anyone displaying symptoms of a Salmonella Paratyphi B infection take the following steps:

See a doctor immediately

Do not prepare food or drinks  for others until a doctor tells you it is safe for you to do so

Do not go to work or school until you no longer have diarrhea

If you are a food worker, health care worker or child care worker, do not return to work until released by the Buncombe County Health Director.

Drink plenty of water and juice

Call your doctor or go to the emergency room if you are unable to keep down liquids or have signs of dehydration (dark urine, small amount of urine or a rapid heart rate)

Call the Buncombe County Department of Health Disease Control Division at 250-5109 to report possible Salmonella Paratyphi B infection