In a follow-up on the multistate outbreak of Salmonella infections linked to kratom, the Centers for Disease Control and Prevention (CDC) is reporting forty-five more ill people from 19 states, bringing the outbreak total to 132 cases from 38 states.

Four outbreak strains have been identified: Salmonella I 4,[5],12:b:- (61), Salmonella Javiana (15), Salmonella Okatie (21), or Salmonella Thompson (35).

Connecticut, Iowa, and Idaho reported their first outbreak case(s). Thirty-eight people required hospitalization for their illness. No deaths have been reported.

Whole genome sequencing analysis did not identify any predicted antibiotic resistance in isolates from 60 ill people and three Kratom samples.

At this time, CDC recommends that people not consume any brand of kratom in any form because it could be contaminated with Salmonella.

Kratom products from several companies have been recalled because they might be contaminated with Salmonella. The list of recalled kratom products is available on the U.S. Food and Drug Administration website. Kratom is also known as Thang, Kakuam, Thom, Ketom, and Biak.

Kratom is a plant consumed for its stimulant effects and as an opioid substitute.