Arizona is part of a nine-state outbreak of salmonella linked to raw tomatoes, with at least five confirmed cases in four counties. One person in Maricopa County, two in Apache and one each in Pima and Coconino counties have fallen ill with salmonella.
One person has been hospitalized, state health officials said.
In addition, at least nine more Arizona cases are under investigation. State epidemiologist Ken Komatsu said that number likely will change as some are ruled out and additional cases are brought forward.
The outbreak is centered in Texas and New Mexico, where 40 confirmed cases of salmonella with the same genetic "footprint" have been identified since late April. And 30 other people have become infected with the same strain in nine states.
In Arizona, the first person became ill about May 6, Komatsu said.
The source of the outbreak hasn't been identified yet. Preliminary information, however, indicates that the contaminated vegetables are either Roma or red, round tomatoes not on the vine.
"The CDC recommendation, as well as ours, is for persons with increased risk of severe infection ... to not eat Roma or red round tomatoes," Komatsu said. "That's what the consumers in these cases had purchased and recall eating."
They also recommend that people avoid buying bruised or damaged tomatoes and throw away any that are spoiled. Tomatoes should be thoroughly washed under running water. Cut, peeled or cooked tomatoes should be refrigerated within two hours.
Federal and state officials are trying to determine where the contamination occurred. That includes asking people who have been sick about where they bought or ate the tomatoes and eventually backtracking to produce growers and distributors.
"It could be in the growing, it could be in the processing of the tomatoes," Komatsu said. "So it's hard to tell where they would've been contaminated."
As with other food-borne illnesses, those most at risk for severe infection from salmonella are infants, the elderly and those with compromised immune systems.
Symptoms include diarrhea, fever and abdominal cramps that can last four to seven days. Most people will recover without treatment.
Hundreds of cases of salmonella are reported in Arizona each year, and 66 were confirmed in April alone. That's a fraction of actual cases, however, since most are never reported or confirmed.
The most recent national salmonella outbreak was linked to turkey and chicken pot pies last year. Just one Arizona case was confirmed among 367 cases nationwide that included 76 hospitalizations and one death. The pot pies were recalled.
In these latest cases, there has not yet been a tomato recall.