Although tempeh has been named as a potential source of the Salmonella outbreak in North Carolina, officials say that avoiding this food may not guarantee safety from infection, as the tempeh has not been confirmed as the outbreak vehicle.

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After announcing a recall of locally produced Smiling Hara tempeh, the Buncombe County Health Department noted that only some of the outbreak victims ate this fermented soybean product.

Salmonella was detected in  a sample of the tempeh and additional tests are being conducted to see if it matches the outbreak strain. Until then, the vegetarian meat substitute isn’t definitively linked to the Salmonella bacteria that has sickened at least 37 people.

Nevertheless, Smiling Hara is recalling all varieties and sizes of its tempeh products made between Jan. 11 and April 11, 2012 with best-by dates of July 11, 2012 through Oct. 25, 2012. The company’s website says it makes organic, GMO-free, unpasteurized tempeh from soy, black beans and black-eyed peas using only three ingredients — the beans, distilled vinegar and culture. The company says the tempeh is a raw food intended to be cooked, and that once the frozen tempeh is thawed “you have 5 days to cook it.”

While North Carolina’s Agriculture Commissioner Steve Troxler said the suspect tempeh should not be eaten, the local health department said in a statement that, “At this time we cannot assure people that if they stay away from tempeh that they won’t get sick.” 

“The public is urged to continue taking precautions to prevent getting or spreading salmonella infection by washing hands properly, cooking foods fully, seeking medical care if they have symptoms and following the Department of Agriculture’s recommendations to discard the recalled tempeh.”

So far, case interviews have grouped outbreak victims into three categories – those who ate tempeh preceding illness, those with connections to others who contracted the Salmonella Paratyphi B, and those who are still being interviewed to determine if other sources might be associated with the outbreak.

What is Salmonella Paratyphi B?

The type of Salmonella causing this outbreak – Salmonella Paratyphi B – is relatively rare in the United States. Salmonella Paratyphi B is a type of typhoidal Salmonella, which leads to typhoid fever.

Most Salmonella outbreaks in the U.S. are caused by non-typhoidal bacteria, which produce symptoms commonly associated with foodborne illness, including diarrhea, nausea and abdominal cramps. Non-typhoidal Salmonella bacteria account for the greatest number of hospitalizations and deaths of all foodborne pathogens this country. 

Salmonella typhi is much less common in the U.S.. It is usually found in developing countries where it spreads in unsanitary water supplies. The current outbreak is the first in the U.S. to be linked to typhoidal Salmonella since 2010. 

According to Buncombe County officials, the type of typhoidal Salmonella associated with this outbreak “is unique and has a genetic fingerprint that is not common.” 

Symptoms of typhoid fever usually develop gradually, beginning 1 to 3 weeks after exposure, and include fever (commonly as high as 103 or 104 F), headache, weakness, sore throat, abdominal pain, diarrhea or constipation and a rash on the chest or abdomen lasting 2-5 days.