Salmonella Outbreak Possibly Connected to Opioid Substitute

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FDA and CDC are investigating a multi-state Salmonella outbreak that appears to be caused by kratom, a plant used as an opioid substitute.

On Feb. 20, 2018, the Centers for Disease Control (CDC) announced that it was investigating, along with FDA, a multi-state outbreak of Salmonella that has infected 28 people in 20 states in the United States. To discover the possible source and route of the contamination, FDA and CDC are working with state and local health officials. Evidence suggests that the source of the outbreak is possibly kratom, which is a plant that is used as a substitute to opioids.

The outbreak started in October 2017, and 11 hospitalizations have occurred.  Information from the PulseNet system, which is used by public health investigators to identify illnesses, shows that DNA fingerprints of this outbreak strain of Salmonella I 4,[5],12:b: share a common source of infection.

CDC stated in an announcement that epidemiologic evidence points to use of kratom, which is also known as Thang, Kakuam, Thom, Ketom, and Biak. Seventy-three percent of people with the illness reported consuming kratom in pills, powder, or tea, according to CDC.

“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 stated in the announcement.


A plant grown in parts of Asia, kratom has been marketed as a treatment for pain, anxiety, and depression. The plant has a similar effect to narcotics and has led to recreational use as an alternative to opioids. FDA warned the public in November 2017 that the plant has the same risks of abuse and addiction as opioids. The agency also began taking action to prevent dietary supplements containing kratom from entering the US.

Sources: CDC, FDA