Salmonella outbreaks in the United States – possible links to consumption of kratom-containing products
The United States (US) Centers for Disease Control and Prevention (CDC) in conjunction with the Food and Drug Administration (FDA) are investigating a multi-state outbreak of salmonella linked to consumption of kratom products1. Kratom is a drug that originally comes from the leaves of a tree grown in South-East Asia. At low doses it has a stimulant effects, similar to cocaine, at higher doses it has a sedative effect, similar to narcotics. It comes in leaves, powder and resin form and can be chewed, smoked or made into tea2. It is a controlled drug in Ireland under the Misuse of Drugs Act3 and according to the 2016 Psychoactive Substances Act 2016, it is illegal to produce, supply, offer to supply, sell, import, and export kratom in the United Kindom4. However, it is readily available for purchase on the internet. Currently kratom continues to be a legal substance in most states in the US.
Since January 11th 2018, 132 people have been infected with outbreak strains of salmonella across 38 states in the US. The age-range of cases is 1 to 73 years and 38 (29%) cases required hospitalisation1. Symptoms of salmonella include diarrhoea, fever, vomiting and abdominal pain. Salmonella outbreak strains include Salmonella I 4,,12:b:-, Salmonella Javiana, Salmonella Okatie and Salmonella Thompson1. Fifty-seven of 78 people (73%) specifically asked about kratom reported consuming kratom before getting sick1. As of April 5 2018, thirty-seven different kratom-containing products have been tested and reported positive for salmonella1. Genetic analysis is ongoing on isolates from these substances and from ill cases to identify possible links1.
The US FDA has warned consumers not to consume any kratom-containing products1. There have been several voluntary recalls of kratom-containing products by manufacturers in the US. In one instance the FDA issued a mandatory recall order for all products containing powdered kratom manufactured, processed, packed, or held by a certain US-based company after several of these products were found to contain salmonella1. The outbreak investigation is ongoing.
- United States Food and Drug Administration. FDA Investigates Multistate Outbreak of Salmonella Infections Linked to Products Reported to Contain Kratom. Available at: https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm597265.htm Accessed 16/04/2018
- Drugs.ie. Kratom. Available at: http://www.drugs.ie/drugtypes/drug/kratom_opiate Accessed 16/04/2018
- Irish Statute Book. S.I. No. 551/2011 - Misuse of Drugs Act 1977 (Controlled Drugs) (Declaration) Order 2011
- Psychoactive Substances Act 2016. Available at: https://www.legislation.gov.uk/ukpga/2016/2/contents Accessed 16/04/2018