Chia seeds are an increasingly popular ingredient in the health food world. The Dr. Oz Show and various health magazines have been highlighting them, and recipes with this “superfood” have been popping up all over Pinterest and BuzzFeed. But before you go adding chia powder to your morning smoothie, check to be sure it isn’t on the list of recalled products that might be contaminated with Salmonella. At least 73 Salmonella infections in the U.S. and Canada have been linked to such products since May. The 21 cases in the U.S. are in people aged 1 to 81 across 12 states. Among 15 ill persons with available information, two report being hospitalized — not an unusual rate for standard infections. No deaths have been reported to date. The outbreak strains include Newport, Hartford and Oranienburg. The 52 cases reported across four Canadian provinces include these, as well as the Saintpaul strain. Cases are found in British Columbia (13), Alberta (10), Ontario (26) and Quebec (3)

Six of the Canadian victims have been hospitalized.  Antimicrobial resistance levels are unclear as test results are still pending.

“This is the first time that chia seeds have been identified as a food that transmits Salmonella,” said Dr. Laura Gieraltowski, an epidemiologist with the U.S. Centers for Disease Control and Prevention (CDC) and one of the lead investigators on the outbreak. The list of recalled products has been expanding since the first one issued by Navitas Naturals on May 28. Two other U.S. companies have since recalled their chia powder products, and Navitas has expanded its recall to include a broader date range. “The traceback investigation is still ongoing, but [the U.S. Food and Drug Administration] did trace back chia products reported by the ill people that did show that it came from a particular farm,” Gieraltowski said. Eight brands in Canada have announced their own recalls of seeds, powders, trail mix, and fruit and nut bars. “I don’t think it was surprising that it’s in a lot of other products, but it’s definitely worrisome,” Gieraltowski said. Most of the people CDC officials talked to have reported putting chia powder in their smoothies, but it can be a bit of a “stealthy” ingredient if people don’t realize it was an ingredient in their smoothie mix or other food. So folks at CDC are concerned that information about the recall isn’t getting out. Because chia seeds have a long shelf-life, it’s possible that people are still eating potentially contaminated product. “My own family members — two of which use chia seeds — had no idea about the recall,” Gieraltowski noted. Chia products are usually eaten raw, so there’s not much consumers can do to minimize their risk. CDC, FDA, the Public Health Agency of Canada, and the Canadian Food Inspection Agency are telling consumers not to eat the recalled foods. Instead, they’re advised to throw them out or return them to the place of purchase for a refund. While first investigating the cluster of Salmonella Newport illnesses identified in PulseNet, Gieraltowsk said the initial signals pointed to “health food.” Vegan, vegetarian and dairy-free diets were being reported by victims. Investigators decided to do open-ended interviews rather than a longer standardized questionnaire in which a health food product or supplement was unlikely to be covered. When the same brand of chia powder came up in the first three interviews, “We knew that we had it from there,” Gieraltowski said. After starting their investigation, CDC noticed similar cases in Canada via PulseNet and reached out to their counterparts up north. When the Canadians looked into their cases, they also found the chia product commonality. “It was a really great joint investigation with our international partners as well,” Gieraltowsk said. The agencies are still trying to determine the relationship between the actual chia seeds and the powder. Chia powder is made by sprouting the seeds and then grinding up the sprouts. Since sprouts are a common vehicle for pathogens, Gieraltowski said this process may be amplifying the contamination of the seeds. Editori’s Note:  This article was updated since its original publication to include updated case counts in Canada.