In its 11th update since the nationwide Salmonella outbreak went public on Jan. 22, the federal Centers for Disease Control and Prevention (CDC) in Atlanta Tuesday added five cases to its count, bringing the total infected to 230.

That was up from 225 reported Feb. 11, but with the five new cases the outbreak did not spread beyond the 44 states and the District of Columbia.  The outbreak is associated with recalls of ready-to-eat meats from Rhode Island-based Daniele Inc., especially its Italian-style salami.

Black pepper, possibility originating halfway around the world in Vietnam, used to coat some of the salami products is suspected to be contaminated.   Daniele received its pepper from Brooklyn-based Wholesome Spice and NJ-based Mincing Overseas Spice.

According to CDC, the number of ill persons identified in each state with this strain is as follows: AK (1), AL (2), AZ (7), CA (30), CO (5), CT (5), DC (1), DE (3), FL (3), GA (3), IA (1), ID (2), IL (15), IN (3), KS (4), LA (1), MA (13), MD (1), ME (1), MI (4), MN (5), MO (2), MS (1), NC (10), ND (1), NE (1), NH (2), NJ (8), NM (2), NY (18), OH (9), OK (1), OR (9), PA (7), RI (2), SC (1), SD (3), TN (5), TX (7), UT (9), VA (1), WA (17), WI (1), WV (1), and WY (2).

CDC said “because the main Salmonella Montevideo outbreak PFGE pattern is commonly occurring in the United States, public health investigators may determine that some of the illnesses are not part of this outbreak.”

No change was made in CDC findings about a second strain that may be associated with Daniele products.  It said: “Salmonella Senftenberg, a different serotype of Salmonella, has been found in food samples from retail and a patient household during this outbreak investigation.

CDC’s PulseNet system has identified five persons who had illness caused by Salmonella Senftenberg with matching PFGE patterns between July 1, 2009 and today.

It says public health officials have interviewed four of the five ill persons with this strain of Salmonella Senftenberg and determined that one consumed a recalled salami product during the week before their illness began.  These five cases are not included in the overall case count reported above.

In the Feb. 16 update, CDC says, “Further testing is ongoing at a state health partner laboratory, and might determine if the product tested in Illinois contained the Salmonella Montevideo strain associated with the multistate outbreak.”

Daniele has recalled 1.3 million pounds of product sold under its own and other labels.  The U.S. Department of Agriculture’s (USDA’s) Food Safety and Inspection Service (FSIS) regulates Daniele’s meats and the U.S. Food and Drug Administration (FDA) regulates its non-meat ingredients–like pepper.

Recent tests by the Rhode Island Department of Health revealed that an opened container of black pepper that was used in the manufacturing of at least some of the recalled products was positive for Salmonella Montevideo and that the DNA fingerprint matched.

FDA is left investigating the supply chain of the black pepper used in the manufacturing of the recalled meat products. The Agency has collected and is currently analyzing black pepper samples. To date, all the samples collected and analyzed by the FDA have tested negative for Salmonella, however, sample collection and analysis continues.

“CDC and its public health partners are continuing the epidemiologic investigation to verify that the outbreak is controlled,” the update says.  “CDC, FSIS, and FDA continue to work closely to identify the specific products or ingredients that became contaminated and how the contamination occurred and to identify any other food vehicles that may be involved.”