Consumer advocates are sharply questioning the government’s handling of the ongoing, 26-state Salmonella Heidelberg outbreak that sparked a 36 million pound ground turkey recall from meat giant Cargill Wednesday night.

Advocates and food safety experts are blasting federal authorities for taking months to take action after multi-drug resistant Salmonella Heidelberg infections linked to ground turkey were first reported in early March. So far 78 illnesses, including one death in California, have been linked to the outbreak. The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) issued a public health alert on Friday, July 29, urging consumers to use caution cooking and handling ground turkey, but it wasn’t until August 3 that Cargill announced the recall.

It is the third largest recall on record, according to the U.S. Department of Agriculture.

The recalled meat came from a single processing facility in Springdale, Arkansas, but ended up in dozens of different ground turkey products sold nationwide under a variety of brand names, including Honeysuckle White, Shady Brook Farms, Riverside, Aldi’s Fit and Active Fresh, Spartan, Giant Eagle, Kroger and Safeway.

Officials from the Centers for Disease Control and Prevention and FSIS indicated Thursday that they suspected a link between Salmonella illnesses and Cargill’s Springdale turkey plant as early as mid-July, but said they did not have enough evidence to warrant a recall in response to the “slowly building outbreak” until very recently. Officials told reporters on a media call that their investigation has been “aggressive.”

“We need to be sure everything has lined up in a way that we’re convinced,” said Dr. David Goldman, assistant administrator for the Office of Public Health Science for the Agriculture Department’s Food Safety and Inspection Service.

Some consumer advocates believe the response has been inadequate.

“The Salmonella Heidelberg outbreak shows a troubling lapse in coordination between federal agencies that are duty bound to protect the public,” said Caroline Smith DeWaal, director of food safety at the Center for Science in the Public Interest, in a statement Thursday. She believes officials may have had preliminary evidence by late May linking illnesses to the Arkansas plant.

FSIS and CDC officials told reporters that routine sampling of retail ground turkey for the National Antimicrobial Resistance Monitoring System (NARMS) tested positive for the outbreak strain as early as March — they found four positive total between March and June –leading investigators to hypothesize there was a link. Epidemiological evidence, however, according to those involved, did not back up the hypothesis until late last week.

Still, there are questions about whether consumers, or the Cargill plant, could have been notified of the potential link sooner.

“Given the severity of the outbreak, involving over 20 hospitalizations and one death, prompt consumer warnings and notification of the company are essential to stem the outbreak,” says DeWaal. “The failure to issue a public alert earlier or to even notify the company shows a troubling lack of coordination that potentially contributed to the size and severity of the outbreak.”

DeWall is calling for a full review of the government’s handling of the outbreak. In May, CSPI petitioned USDA to declare antibiotic-resistant Salmonella Heidelberg, Salmonella Newport, Salmonella Hadar, and Salmonella Typhimurium “adulterants” under federal law, making products that contain them illegal to sell.

Bill Marler, the nation’s leading food poisoning attorney, reiterated his support for declaring certain resistant strains of Salmonella as adulterants.

“We’ve had many calls from concerned people, many of them victims in this Cargill Salmonella outbreak, who are wondering how this type of pathogen got in their food,” said Marler, whose firm Marler Clark, publisher of Food Safety News, has been retained by a number of ground turkey Salmonella outbreak victims. “It’s a real shock for them to hear that the government doesn’t currently ban this sort of bug.”

USDA only recalls products contaminated with antibiotic-resistant Salmonella after those products have been definitively tied to illnesses.  Poultry plants are tested periodically for Salmonella, according to Goldman, and Cargill’s Springdale plant was tested last year.

“USDA should take action before people get sick, and require controls and testing for these pathogens before they reach consumers,” says Smith DeWaal. “The research shows that antibiotic-resistant Salmonella in ground meat and poultry is a hazard and it’s time to move to a more preventive system of controlling the risks at the plant and on the farm.”

Congresswoman Rosa DeLauro (D-CT) also joined the chorus of criticism, calling for Congress to fund the federal food safety agencies.

“This massive recall is yet another example of how critical it is to fully fund and support the agencies that are responsible for protecting our food supply,” said DeLauro in a statement. “It has been over four months since the first illness was identified and yet we just identified the facility and we still do not know definitively where the contamination occurred. In addition, the simple fact that this outbreak involves a foodborne bacteria resistant to multiple antibiotics heightens the risk to the health of American consumers. The length of time already passed and the volume of this recall are outrageous, and it has already claimed the life of one American.”

Cargill is recalling products produced between February 20 through August 2, and halting production of ground turkey products at the facility until the source of contamination is identified and corrected. Products subject to recall bear the establishment number “P-963” inside the USDA mark of inspection, and were sold by several retailers.

Consumers should check their fridges and freezers to figure out if their ground turkey has been recalled. Local, state, and federal public health officials are working to identify and link illnesses to the outbreak. The outbreak numbers are likely to grow as more consumers learn of the recall. Normally, a low percentage of foodborne illnesses are ever reported to public health authorities, let alone definitively linked to outbreaks.

Salmonella infections can be life-threatening, especially to those with compromised immune systems, including the young and the elderly. The most common manifestations of salmonellosis are diarrhea, abdominal cramps, and fever within six to 72 hours. Additional symptoms may be chills, headache, nausea and vomiting that can last up to seven days. Individuals concerned about an illness should contact a health care provider.