Local Kratom-related Salmonella Infection Reported

Image of actual kratom pills with a faux prescription logo.

A 44-year-old San Diego County resident is one of three California cases in a multi-state outbreak of salmonella infections linked to the herbal supplement kratom, the County Health and Human Services Agency announced today.

The San Diego patient became ill in January, but was not hospitalized and has fully recovered.

Kratom is a plant in the coffee family that is grown in Southeast Asia. It is consumed for its stimulant effects and as an opioid substitute. Kratom is also known as thang, kakuam, thom, ketom, biak, and Mitragyna speciosa.

The Centers for Disease Control and Prevention reported today that 40 cases of salmonellosis in 27 states have been caused by salmonella I 4,[5],12:b:-, a less common type of salmonella bacteria. Fourteen patients have been hospitalized. None have died. The CDC has identified kratom as a likely source of this outbreak, although a single common brand or supplier of kratom products have yet been named.

The CDC, Food and Drug Administration and HHSA recommend that people do not consume kratom in any form. Last week, the Food and Drug Administration oversaw the voluntary recall and destruction of several kratom products.

The herb is currently legal in most of California and the United States, although the FDA has had an import ban for kratom products since 2014. In 2016, the City of San Diego passed an ordinance outlawing the sale, possession and distribution of mitragynine and hydroxyl-mitragynine, which are the active components in kratom.

The County Medical Examiner’s Office has determined that ten deaths in the county since 2014 were associated with mitragynine. Nine of those cases also had other drugs or alcohol noted, and one was associated with mitragynine alone. One possible mitragynine-associated death in 2018 is currently under investigation.

More information about kratom may be found at the National Institute on Drug Abuse kratom website.

Salmonellosis is an infection caused by salmonella bacteria, and it is one of the most common intestinal infections in the United States. There were 575 cases reported in San Diego in 2017, but the actual number of cases is likely to be much higher because many people do not seek care for their illness or are not tested by their providers.

Most salmonella infections occur after eating undercooked poultry or eggs, unpasteurized dairy products, or foods or water contaminated with the bacteria. The symptoms of salmonellosis include diarrhea, fever, vomiting, and abdominal cramps that start 12 to 72 hours after infection. Most people with salmonellosis are sick for four to seven days and then recover without treatment.

Some people, especially the elderly, infants, and those with weakened immune systems, may develop complications from salmonellosis that require hospitalization. In rare cases, salmonellosis can cause long-lasting symptoms such as joint pain, eye irritation, and painful urination.

More information about salmonellosis may be found at the CDC salmonella website.

Tom Christensen is a communications specialist with the County of San Diego Communications Office. Contact