North Carolina’s Buncombe County reported Monday that the number of Salmonella Paratyphi B cases in an outbreak linked to unpasteurized tempeh has risen from 46 to 60. 

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As Food Safety News reported last week, the rare type of Salmonella was traced to tempeh, a fermented soy bean product made by a small local producer, Smiling Hara in Asheville.

Test results from the North Carolina Department of Public Health laboratory confirmed that the bacteria found in the tempeh matched the outbreak strain of Salmonella Paratyphyi B.

The strain associated with the outbreak causes a non-typhoidal Salmonella, which can cause severe symptoms, but not as severe as the strain lab tests first indicated, according to the Buncombe County Department of Health. As of May 4, seven of the outbreak cases had been hospitalized.

Smiling Hara temporarily halted production and recalled all its tempeh made between January 11 and April 11 with best-by dates of July 11 through October 25. Owners of the firm believe the pre-packaged culture they used to make tempeh likely was contaminated with Salmonella.

Although many of those sickened either ate the implicated tempeh or possibly ate other foods cross-contaminated by the tempeh, the Buncombe County Department of Health has said the outbreak is continuing through person-to-person contact. 

The health department has urged the public to prevent the spread of disease by washing hands and properly preparing food. In addition, the department suggests those with symptoms of Salmonella should seek medical care so that a health professional can evaluate the need for antibiotics or other treatment. People should report cases of Salmonella to the Buncombe County Department of Health Disease Control or their local health department if they do not reside in Buncombe County, to aid in continued monitoring of this outbreak.