Salmonella Tomatoes: Liver Transplant Patient at Risk?


. By Jane Mundy

Barbara (not her real name) had a successful liver transplant in 2002 and she was feeling good. However, last month she wound up in hospital with her platelet count dangerously low and nobody could figure out the reason why. But she had recently been sick, with symptoms of food poisoning—could Salmonella tomatoes have been to blame?

"I had just flown into Dallas, Texas on business and had a BLT for lunch when I arrived," says Barbara. "That night I got sick; I was throwing up and had diarrhea. I've had food poisoning before and it felt the same. I had these symptoms for four days; I tried to eat and would keep food down for a little while then throw up again—I must have lost five pounds. I just drank a lot of water and was able to work through it: because of everything I have been through with the liver transplant, I have a high tolerance…

But I was feeling really weak by the time I got home—five days later. And I was black and blue, bruising very easily. I had to see my doctor and get blood work done (I get it done once a month) and that's when I got quite the scare.

My doctor phoned with the blood results: he told me to move very slowly, not to bump my head and have someone drive me to emergency, immediately. My platelets were down to 7,000: this level means you can bleed to death—250,000 is normal. When I got to ER they gave me three bags of platelets and put me on a very heavy dose of steroids.

I was more scared when this happened than I was when I had the transplant. I was in hospital for eight days and they have no idea what caused my levels to drop.

There was absolutely no reason why my platelets dropped; there was no sign of blood disease and no infectious disease. But they also didn't know what went on in my life just ten days beforehand. I didn't link it to tomatoes and salmonella poisoning until I got home. I thought about the time I was sick in Dallas and what I ate that day. And I saw ads about the tomatoes being a problem. I know exactly where I ate and what I had—the BLT. I was with a friend who hates tomatoes; she had a roast beef sandwich.

I was in Dallas on April 19 and 20 and was hospitalized April 30th. But the recall happened in June. Who knows when this started? People could get sick way before a recall is announced.

The hospital didn't take a stool sample—they did CTs because they were mainly concerned about internal bleeding. Even if I did get a stool sample, could it be traced back to that long ago? I am seeing my doctor tomorrow, to make sure I'm OK. My first question will be whether salmonella poisoning could cause my platelets to decrease to such a dangerously low level."

And if Barbara's doctor thinks there is a connection, Barbara will call the FDA and the Centers for Disease Control (CDC). Both agencies urge people to report any signs of salmonella poisoning. It might help their investigation: the FDA is still trying to track down the source of this latest salmonella outbreak that has sickened at least 500 people nationwide (most food poisoning cases are unreported). Illnesses were first reported in mid-April, around the same time that Barbara got sick. At that time, farms in Florida and Mexico were harvesting tomatoes so federal regulators are targeting farms, warehouses and tomato packing facilities in these areas in an effort to determine how the Salmonella outbreak occurred.

Salmonella can be particularly dangerous for children, the elderly and people with weakened immune systems such as Barbara. She may also want to seek legal help.


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