More Salmonella Cases Linked to Kratom

By Pat Anson, Editor

The Centers for Disease Control and Prevention says another 45 people have been sickened in a salmonella outbreak linked to the herbal supplement kratom.  A total of 132 people have been infected in 38 states, with 38 of them hospitalized. There have been no deaths.

Salmonella is a bacterial infection usually spread through contaminated food or water. Most people who become infected develop diarrhea, fever and stomach cramps. Salmonella causes an estimated one million food-borne illnesses a year in the United States.

This particular outbreak is small compared to previous ones, but it’s been long-lasting. While the vast majority of cases have only been reported in the last few months, CDC traced the first illnesses back to January 2017. Three different Salmonella strains have been identified – none of them resistant to antibiotics.

Millions of Americans use kratom to treat chronic pain, addiction, depression, anxiety and other medical conditions. The CDC says kratom is the “likely source” of the outbreak – although the evidence behind it is not entirely clear.

Several kratom samples have been found to be contaminated with salmonella bacteria, but less than half the people sickened in the outbreak say they consumed kratom. Their ages are also unusual, ranging from 1 to 73 years old.

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“State and local health officials continue to interview ill people to ask about the foods they ate and other exposures before they became ill. Fifty-seven (73%) of 78 people interviewed reported consuming kratom in pills, powder, or tea,” the CDC said in its latest update.

“People who reported consuming kratom purchased it from retail locations in several states and from various online retailers. Despite the information collected to date about where ill people purchased kratom, a single common brand or supplier of kratom has not been linked to the outbreak. CDC continues to recommend that people not consume kratom in any form because it could be contaminated with Salmonella and could make people sick.”

Earlier this week, the Food and Drug Administration ordered a Las Vegas company – Triangle Pharmanaturals -- to recall all of its dietary supplements containing kratom. The rare mandatory recall order was issued after the company refused to make a voluntary recall when some of its kratom capsules were found contaminated with salmonella.

There other kratom distributors – PDX Aromatics, Tamarack and NutriZone voluntarily recalled their products after samples tested positive for salmonella. A complete list of recalled kratom products can be found here.

Many kratom supporters remain suspicious of the motives behind the federal government’s salmonella investigation. The Drug Enforcement Administration tried unsuccessfully to list kratom as a controlled substance in 2016, which would have effectively banned its sale and use. In recent months, the FDA has also released several warnings that kratom should not be used to treat any medical conditions because it has opioid-like properties and could cause addiction.

The American Kratom Association (AKA) – a pro-kratom association of consumers and vendors -- is currently surveying members “to get a clearer picture” of the actions taken by the FDA and CDC in the salmonella outbreak.

“We are particularly concerned with reports that the FDA/CDC may be using the salmonella outbreak purportedly in kratom products as a pretext to allow the FDA to expand their war on kratom,” the AKA says on its website. “If your business was contacted by either the FDA or CDC regarding the salmonella outbreak that has been associated with kratom, we are asking that you take the following survey.”

Among other things, the survey asks vendors if they were given a laboratory analysis of any “alleged salmonella contamination” by the FDA or CDC, and if they were given time to conduct their own independent lab test.    

Salmonella Outbreak Linked to Kratom Spreading

By Pat Anson, Editor

The number of people infected by a Salmonella outbreak linked to the herbal supplement kratom has more than doubled – with 87 illnesses now reported. Twenty-seven people have been hospitalized, according to a new CDC report.

Although this particular outbreak is small – there are about one million Salmonella cases every year in the U.S. – it covers a lot of territory. Illnesses have been reported in 35 states from New York to California. No deaths have been reported.

Evidence is also increasing that the outbreak involves kratom, an herbal supplement that millions of Americans use to treat chronic pain, depression, anxiety and addiction.

In a survey of 55 patients sickened in the outbreak, 40 said they had consumed kratom in pills, powder, or tea. Most reported consuming kratom in powder form.

"People who reported consuming kratom purchased it from retail locations in several states and from various online retailers," the CDC said in a statement.  “At this time, CDC recommends that people not consume any brand of kratom in any form because it could be contaminated with Salmonella and could make people sick.”

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The origin of the contaminated kratom has not been identified, but three brands of kratom sold by PDX Aromatics of Portland, Oregon have been recalled. Health officials in California collected leftover kratom powder from one of PDX's brands (Phytoextractum) from an ill person in California, and the outbreak strain of Salmonella was identified in the sample. PDX blames the contamination on an unidentified "supplier" that it is no longer taking shipments from.

(Update: On March 16, after "additional positive findings of Salmonella" in its kratom products, PDX expanded the recall.)

Investigators in Oregon and Utah have also collected kratom powder from retail locations and online retailers where ill people reported purchasing kratom. Outbreak strains of Salmonella Okatie and Salmonella Thompson were identified in those samples. No brand information was available for the kratom collected in Oregon. The ill person in Utah purchased kratom powder from the website kratoma.com.

In a statement on its website, Kratoma said it "would not restock any kratom in future" and would close its online store by March 31, 2018.

The CDC now traces the start of the outbreak back to January 2017. The CDC says there could be more than the current count of 87 cases, because it takes an average of two to four weeks for a Salmonella illness to be reported.

Salmonella is a bacterial infection usually spread through contaminated food or water. Most people who become infected develop diarrhea, fever and stomach cramps. Salmonella causes an estimated one million food-borne illnesses a year in the United States, with 19,000 hospitalizations and 380 deaths.

Last month the Food and Drug Administration recalled three brands of kratom made by Missouri-based Divinity Products. The company agreed to the “voluntary destruction” of its kratom products, even though there have been no reports of illnesses associated with them.

Kratom Linked to Salmonella Outbreak Recalled

By Pat Anson, Editor

A kratom wholesaler and retailer based in Oregon is recalling three brands of the herbal supplement that may be contaminated with Salmonella bacteria.

PDX Aromatics of Portland, Oregon said the recall involves 10,000 packages of kratom powder that were sold to customers between January 18, 2018 and February 18, 2018 through company websites, under the brand names Kraken Kratom, Phytoextractum and Soul Speciosa.

“PDX Aromatics has identified a supplier in our supply chain as the source of Salmonella. The company has removed that supplier from our supply chain and all associated products from our facility. We have ceased distribution of products in order to perform a facility audit and have initiated a voluntary recall," the company said in a statement on its website.

(Update: On March 16, after "additional positive findings of Salmonella" in its kratom products, PDX expanded the recall.)

The company said it was notified by health officials in California that “certain lots of the product” tested positive for Salmonella bacteria and that there was one confirmed illness associated with its kratom powder.

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Salmonella is a bacterial infection usually spread through contaminated food or water. Most people who become infected develop diarrhea, fever and stomach cramps. Severe cases can result in hospitalization or even death.

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The Centers for Disease Control and Prevention announced last month that it was investigating a Salmonella outbreak linked to kratom – an herbal supplement imported from southeast Asia that millions of Americans use to treat chronic pain, addiction, depression and anxiety.

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At least 40 people have been sickened by the outbreak in 27 states. Seventeen of them said they had consumed kratom in pills, powder or tea. Most said they had bought kratom online, but some purchased it at retail locations.

The first illnesses were reported in October 2017 – three months before the timeline of kratom products involved in the PDX Aromatics recall.  Until a common source of Salmonella bacteria is identified, the CDC has recommended that people stop consuming all kratom products.

PDX Aromatics said customers would receive a full refund once the recalled kratom products are returned. A complete list of the brands and lot numbers involved in the recall can be found here.

Last month the Food and Drug Administration recalled three brands of kratom dietary supplements made by Missouri-based Divinity Products. The company agreed to the “voluntary destruction” of its kratom products, even though there have been no reports of harm or illnesses associated with them.

Salmonella Outbreak Linked to Kratom Spreads

By Pat Anson, Editor

The Centers for Disease Control and Prevention says a dozen more people have been sickened by a Salmonella outbreak linked to the herbal supplement kratom – raising to 40 the number of suspected cases. The number of states where the illnesses have been reported rose from 20 to 27.

For the first time, investigators have also found Salmonella bacteria linked to the outbreak in kratom powder samples in North Dakota and Utah.

“The outbreak strain of Salmonella was identified in both samples. The ill person in North Dakota purchased S.K. Herbalist brand kratom powder from the website soapkorner.com. The ill person in Utah purchased kratom powder from the website kratoma.com,” the CDC said in a statement.

“Despite the information collected to date about where ill people purchased kratom, a single common brand or supplier of kratom has not been linked to the outbreak. At this time, CDC recommends that people not consume kratom in any form because it could be contaminated with Salmonella and could make people sick.”

STATES reporting SALMONELLA ILLNESSES

STATES reporting SALMONELLA ILLNESSES

State and local health officials have interviewed 24 people sickened by Salmonella, asking them about food and other substances they were exposed to before they became ill.

Seventeen of the 24 reported consuming kratom in pills, powder, or tea. Three said they purchased kratom from retail locations and 10 said they bought kratom online.

Illnesses from the Salmonella outbreak began last October, with the most recent case reported on February 13. Fourteen people have been hospitalized. No deaths have been reported.

Salmonella is a bacterial infection usually spread through contaminated food or water. Most people who become infected develop diarrhea, fever and stomach cramps. Salmonella causes an estimated one million food-borne illnesses a year in the United States, with 19,000 hospitalizations and 380 deaths.

It generally takes about two to four weeks before a person infected with Salmonella is reported, so its possible there could be more than 40 cases in the current outbreak. 

Kratom comes from the leaves of a tree that grows in Southeast Asia, where it has been used for centuries for its medicinal properties. In recent years, millions of Americans have started using kratom to treat chronic pain, depression, anxiety and addiction, conceivably costing the pharmaceutical industry billions of dollars in lost revenue.

FDA Warns Utah Company

In a move apparently unrelated to the Salmonella outbreak, the Food and Drug Administration warned a Utah company this week not to launch a new dietary supplement that is based on mitragynine -- one of the alkaloids found in kratom.

The FDA said Industrial Chemicals was using “inaccurate and misleading statements” on its website to promote Mitrasafe. Among other things, the company said that Mitrasafe was “fully compliant with all FDA laws and rules.”  

“Today, we notified a company making claims for a compound in kratom that its product is an unapproved new drug and an adulterated dietary supplement,” FDA commissioner Scott Gottlieb, MD, said in a statement.

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“The company is claiming that its product is a ‘natural substitute for opium,’ that it has ‘morphine-like effects,’ and that it can help relieve pain along with a litany of other ailments. Just as troubling, this company promotes kratom as effective in ‘curing addiction’ and treating ‘withdrawal symptoms.’ These unlawful practices not only mislead consumers, but can also prevent people suffering from addiction from seeking effective treatments.”

Industrial Chemicals planned to start selling Mitrasafe on February 28. A spokesman for the company said the launch date has been postponed while it appeals the FDA decision.

“We did not make any drug claims. On the contrary. We did not claim that Mitrasafe itself could do these things or have opium like qualities at all. We never even came close,” said attorney John VanOphem. “The FDA wants to be taken seriously on this stuff? I’m sorry, they haven’t followed their own guidance. This is alarming to me. To have us become the whipping boy poster child on this is just outrageous."

VanOphem told PNN the company has spent years trying to work with the FDA to get Mitrasafe approved.

“The FDA has done nothing to prove that they’re actually interested in addressing the substance of this. They’re just not credible and it’s a shame,” said VanOphem. “All they intend to do is ban kratom, period. There’s no other option for them. They’ve never acknowledged any other option.”  

Unlike pharmaceutical drugs, dietary supplements like kratom are -- for the most part -- loosely regulated by the FDA. But in recent months the agency has launched an unprecedented public campaign to discourage people from using kratom.

In November, the FDA released a public health advisory warning about kratom's potential health risks, especially when used to treat opioid addiction. Last month the agency released a computer analysis that alleged kratom contains over two dozen opioid-like substances that share structural similarities to painkillers such as morphine.

“Kratom should not be used to treat medical conditions, nor should it be used as an alternative to prescription opioids. There is no evidence to indicate that kratom is safe or effective for any medical use. And claiming that kratom is benign because it’s ‘just a plant’ is shortsighted and dangerous,”  Gottlieb said in a statement.

In 2016, the Drug Enforcement Administration attempted to ban kratom by scheduling it as an illegal controlled substance, but a public outcry and lobbying campaign forced the DEA to suspend its scheduling decision. Many kratom supporters fear that another attempt to ban kratom is imminent.

“We’re in for a fight,” said David Herman, president of the American Kratom Association, a pro-kratom consumer group. “There’s no question they want to ban it.”