Multistate Salmonella Epidemic Linked to Kratom Use

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The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), along with several state public health and regulatory offices, are investigating the cause of a multistate Salmonella outbreak.

The outbreak is thought to have started between October 2017 and January of this year. A reported total of 28 people— from 20 different states— have contracted a strain of salmonella I as of February 16, 2018. While there have been 11 cases of hospitalization, there have been no deaths so far.

About Salmonella

What is salmonella? Quick FactsSalmonella is the name of the bacteria that causes salmonellosis, more commonly called ‘food poisoning.’ However, salmonella can spread through more than just food. Common sources of this bacteria include:

  • Raw foods like eggs, chicken, beef, and pork
  • Animals like birds, reptiles, and even dogs
  • Animal waste or fertilizer
  • Poor bathroom hygiene
  • Contaminated water

Symptoms of the infection can range from mild to severe, and can also become life-threatening if it spreads beyond the intestines. Symptoms of a salmonella infection include:

  • Headache or migraine
  • Nausea or vomiting
  • Abdominal cramps
  • Bloody stools
  • Diarrhea
  • Chills
  • Fever

Most of the time, these (or other similar symptoms) tend to pass after about a week. However, there are some cases where the bowels don’t recover for weeks or even months. It all depends on the severity and persistence of the infection.

Findings from the Investigation So Far

Following the first signs of the breakout, the CDC launched an investigation to find the cause of it. Eleven people who contracted salmonella came forward and answered questions about the exposures to food and water they’ve had in the few months before they became sick. Eight of those eleven people (73%) admitted to consuming kratom in some form or another, whether as pills, as powder, or in tea. This accounts for 29% (8 of 28) of the salmonella cases so far— possibly more, as we don’t know whether or not the other seventeen people affected had also consumed kratom before getting sick. Still, further epidemiologic evidence found during PulseNet Whole Genome Sequencing (WGS) suggests that kratom is the most likely source of the salmonella outbreak.

Salmonella - Kratom Outbreak Map

Since these findings, reports indicate that the CDC is still investigating if or how this strain of salmonella came into contact with the kratom that was consumed. Also, state and federal officials are working to identify the currently unknown brand(s) or suppliers of the contaminated kratom. This would not be the first time that salmonella has contaminated supplements. In fact, a similar salmonella outbreak occurred in 2016 after the bacteria contaminated the supplies of a food powder plant, resulting in 27 sick and 13 product recalls.

About Kratom

Mitragyna speciosa, more commonly called kratom, is a natural herb with pain-relieving properties that is native to Southeast Asia. Kratom also goes by other names, including ketom, kakuam, biak, thang, and thom. It grows in areas like Thailand, Malaysia, Indonesia, and Papua New Guinea. At low doses, kratom induces stimulant-like effects similar to but less intense than amphetamine. These include:

  • More energy and alertness
  • Increased amiability
  • Appetite reduction
  • Heightened libido

According to the CDC, kratom’s pain relieving properties make it a favored “opioid substitute,” especially in recent years since many are looking for new ways to manage chronic pain. The opiate-like effects that come about in moderate doses of kratom include:

  • Pain relief
  • Drowsiness
  • Mild sedation
  • Cough suppression

Kratom can be taken several different ways, including:

  • Swallowing it as a capsule
  • Drinking it as a tea
  • Chewing it
  • Smoking it

Controversial Consumption

Like with most naturally occurring substances, there is a bit of controversy surrounding the use of this herbal supplement. While kratom does have its advantages, like countering withdrawal symptoms, it also has uncomfortable side effects that can be quite severe. These include:

  • Decreased motor control
  • Nausea or vomiting
  • Tremors or shaking
  • Constipation
  • Sweating
  • Dizziness
  • Itchiness

Despite these side effects, many believe that kratom use is still safe to use. Enthusiasts claim that since kratom “is not a drug,” it won’t cause any harm if it’s used responsibly. The American Kratom Association made the following statement on its website:

Kratom is not an opiate. Kratom is not a synthetic substance. Naturally-occurring Kratom is a safe herbal supplement that’s more akin to tea and coffee than any other substances.

However, it’s been proven that kratom has the same potential for misuse as any other painkiller. In other words, kratom is addictive. In fact, some of its addictive properties are similar to heroin and share many of the same withdrawal symptoms— and it’s marketed as a safer alternative to opioids painkillers.

The CDC Issued a Health Warning and Encourages Caution

In response to the salmonella outbreak, the CDC issued a public statement on their website:

At this time, CDC recommends that people not consume kratom in any form. The investigation indicates that kratom products could be contaminated with Salmonella and could make people sick. CDC’s recommendation may change as more information becomes available. This investigation is ongoing, and we will provide updates as needed.

Will Kratom Be Pulled from the Shelves?

The Department of Health and Human Services’ (HHS) stance on kratom contributes heavily to the controversy surrounding its use. Both the FDA and the CDC recognize that the herb acts like an opioid drug and have issued several public warnings, advising people not to use it. Now, since the salmonella outbreak has been linked to kratom use, it is more ammunition for the herb may be banned entirely.

Up until this point, kratom has been sold and traded without much restriction both on the internet and in some store in the United States. Recently, the FDA has submitted a review of kratom’s effects to the Drug Enforcement Administration (DEA). The DEA is now looking to implement a firm restriction on the sales of kratom and is also pushing for its eventual categorization as a Schedule I drug— the same class of illegal drugs like heroin and LSD.

Although kratom is still legal in most states, import alerts have been set in place to prevent people from bringing it into the country illegally. So far, the FDA has already seized several shipments of kratom. States and local jurisdictions that banned kratom consist of:

  • Alabama
  • Arkansas
  • Indiana
  • Rhode Island
  • Tennessee
  • Vermont
  • Wisconsin
  • San Diego (CA)
  • Sarasota County (FL)
  • Washington, D.C.

Programs at The Treatment Center’s Outpatient Services

While the investigation into the cause of the salmonella outbreak continues, we at The Treatment Center strongly advise against the use of kratom, recreationally or otherwise. If you are struggling with an addiction to opioids or kratom, please call us at (844) 211-7944 for more information about our outpatient treatment options.