Three more states have reported illnesses linked to the outbreak of Salmonella infection likely caused by raw sushi tuna imported from India, and the total number of confirmed cases has risen to 258, the Centers for Disease Control and Prevention reported Wednesday.

The CDC’s previous update (April 26) on the Salmonella Bareilly and Salmonella Nchanga infections tied to the product called tuna scrape listed 200 cases from 21 states and the District of Columbia. California, Nebraska and Tennessee have now reported outbreak-related cases.

The 58 new cases include 13 reported by Pennsylvania, 8 by Illinois and New Jersey, 7 by Virginia, 6 by New York, 4 by Maryland, 3 by Massachusetts, 2 by California and Tennessee, and 1 each by Connecticut, Georgia, Nebraska, North Carolina and Wisconsin.

The number of ill people with the outbreak strain of Salmonella Bareilly reported in each state is: 39 from New York; 27 from Massachusetts; 25 from New Jersey; 24 from Maryland; 23 from Illinois; 20 from Pennsylvania; 16 from Virginia and Wisconsin; 10 from Georgia; 9 from Connecticut; 6 from Rhode Island; 4 from Missouri, North Carolina and Texas; 3 from Louisiana and South Carolina; 2 from Alabama, California, the District of Columbia, Mississippi and Tennessee; and 1 from Arkansas, Florida, Nebraska and Vermont.

Eleven people infected with the outbreak strain of Salmonella Nchanga have been reported from 5 states: 5 from New York, 2 from Georgia and New Jersey, and 1 from Virginia and Wisconsin.

Onset of the first illness was January 28 and the most recent illness onset date was April 20.

Those sickened range in age from 4 to 86 years, with a median age of 30. Fifty-seven percent of patients are female. At least 32 have been hospitalized.

Salmonella Bareilly with a pulsed-field gel electrophoresis (PFGE) pattern identical to the outbreak strain was found in two samples of Nakaochi Scrape yellowfin tuna. One of those samples also yielded a PFGE pattern indistinguishable from the cluster of Salmonella Nchanga infections.

Nearly 59,000 lbs. of the frozen yellowfish tuna scrape has been recalled by the distributor, Moon Marine Corp. of Cupertino, CA. Nakaochi Scrape is backbone meat that remains after the fish has been filleted. It is scraped off with a spoon-like device and used fresh or frozen to make sushi, sashimi, ceviche and similar dishes. Many of the people sickened in this outbreak reported eating “spicy tuna” sushi before they became ill.

CDC Outbreak Map