The U.S. Centers for Disease Control and Prevention reports that since the last update on November 19, 2015, 50 more ill people have been reported from 16 states.

Two additional deaths were reported from California, bringing the total number of deaths to 6. According to the California Department of Public Health, Salmonella infection was not considered to be a contributing factor in either of these 2 additional deaths.

Tennessee was added to the list of states with ill people, bringing the total number of states to 39.

The number of reported illnesses has declined substantially since the peak of illnesses in August and September; however, it has not returned to the number of reported illnesses that we would expect to see (about 1 every month during this time of year). The investigation into the source of these recent illnesses is ongoing.

CDC, multiple states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Poona infections.

Epidemiologic, laboratory, and traceback investigations identified cucumbers imported from Mexico and distributed by Andrew & Williamson Fresh Produce as a likely source of the infections in this outbreak.

Two recalls of cucumbers that may be contaminated with Salmonella were announced in September 2015 as a result of this investigation: Andrew & Williamson Fresh Produce and Custom Produce Sales.

888 people infected with the outbreak strains of Salmonella Poona have been reported from 39 states, an increase of 50 cases since the last update on November 19, 2015.

191 ill people have been hospitalized, and six deaths have been reported from Arizona (1), California (3), Oklahoma (1), and Texas (1). Salmonella infection was not considered to be a contributing factor in two of the three deaths in California.

Whole genome sequencing (WGS) showed that the strains of Salmonella Poona from ill persons and from contaminated cucumbers distributed by Andrew & Williamson Fresh Produce are closely related genetically.

WGS of isolates from people who became ill in October and November are also closely related genetically to isolates from people who became ill during the peak of the outbreak and to isolates from contaminated cucumbers.

The source of contamination for the cucumbers distributed by Andrew & Williamson Fresh Produce has not been identified.

The number of reported illnesses has declined substantially since the peak of illnesses in August and September; however, it has not returned to the number of reported illnesses that we would expect to see (about 1 every month this time of year). The investigation into the source of these recent illnesses is ongoing.

Whole genome sequencing results from recent illnesses suggest it is likely that there is a common source of ongoing contamination.

Interviews of persons who became ill after the end of September have not identified an additional food item linked to illness.

Investigations are under way to determine if cross-contamination within the distribution chain for the recalled cucumbers could explain recent illnesses.