Kratom Likely Responsible for 28 Salmonella Infections in 20 States, CDC Says

Image of the opioid substitute kratom

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

Computer analysis of the herb found that almost all of kratom's major compounds bind to opioid receptors on human brain cells, and two of the top five most prevalent compounds activate those receptors, FDA Commissioner Dr. Scott Gottlieb said in the statement.

"There's no safe kratom product", Scott Gottlieb, MD, FDA Commissioner said in a statement.

CDC stated in an announcement that epidemiologic evidence points to use of kratom, which is also known as Thang, Kakuam, Thom, Ketom, and Biak. In the United States, kratom products are sold as powders, pills, capsules and even energy drinks.

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"Cases of mixing kratom, other opioids and other types of medication is extremely troubling because the activity of kratom at opioid receptors indicates there may be similar risks of combining kratom with certain drugs, just as there are with FDA-approved opioids", Gottlieb said. But the supplement made headlines a few weeks ago, when Food and Drug Administration (FDA) officials said that kratom contains the same addictive, potentially risky chemicals found in opioids, and submitted a review to that effect to the Drug Enforcement Administration (DEA). Since then, the FDA has been making efforts to better understand kratom's safety profile.

As of February 16, there have been 20 states to report that 28 people are infected with the outbreak strain, 11 people have been hospitalized and no deaths have been reported. It said the illness dates range from October 2017 to January 2018, with sufferers' ages 6 to 67 years.

The CDC recommends that people refrain from consuming kratom at this time. Whole genome sequencing performed on ill isolates are closely related genetically, meaning that people in the outbreak are more likely to share a common source of infection. Eleven people have gone to the hospital, but so far no one has died. The CDC could not identify a common brand or supplier linked with this outbreak.

Salmonella is a bacteria that most commonly associated with foods like eggs and poultry, but in recent months it has been cropping up in usually unsuspected foods like spices.

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