TUESDAY, June 10 (HealthDay News) -- To avoid the current outbreak of salmonella in tomatoes, consumers will need to employ a little detective work and forgo certain types of tomatoes for a while.

"The best advice right now is to be extremely careful in trying to find out exactly where the tomatoes they're purchasing are from," said Tony Corbo, legislative representative for Food & Water Watch, a Washington, D.C.-based nonprofit consumer group that works to ensure clean water and safe food.

"The other problem with tomatoes is that they have shown up in restaurants and in salsa. So, maybe for the time being, consumers should stay away from anything that is processed," Corbo said.

According to the U.S. Centers for Disease Control and Prevention (CDC), 167 persons have been infected with Salmonella saintpaul, an unusual and virulent form of salmonella, since mid-April. Infections have occurred in 17 states and at least 23 people have been hospitalized.

The Associated Press reported that one man died, apparently after eating pico de gallo, a tomato-based condiment, at a Texas restaurant in May. The 67-year-old man also suffered from cancer, however, and the death has been officially attributed to that disease, the news service reported.

The U.S. Food and Drug Administration has alerted consumers that the outbreak of salmonella contamination seems to be linked with certain types of raw red tomatoes and products containing these tomatoes. In particular, the agency said, raw red plum tomatoes, raw red Roma tomatoes and raw round red tomatoes should be avoided at this time.

Cherry tomatoes, grape tomatoes, home-grown tomatoes and tomatoes sold with the vine still attached appear to be safe. But all tomatoes should be washed before eating, officials advised.

"The tomatoes that are being grown at home or in local gardens in the area should be fine," said Sharon Wilkerson, acting dean of the Texas A&M Health Science Center College of Nursing in College Station. "The main thing is to really wash things, and [tomatoes] should be washed before removing the hull or stem. Tomatoes you see in stores that are multiples on stems are usually grown in hot houses, and they should be OK."

Several large fast food, restaurant and grocery chains, including McDonald's, Wal-Mart, Burger King, Kroger and Outback Steakhouse, have voluntarily withdrawn red plum, red Roma or round red tomatoes not grown in certain states and countries. Also, the Los Angeles Unified School District has suspended serving raw tomatoes, the AP said.

The FDA recommends consuming raw red plum, raw red Roma or raw red round tomatoes only if grown and harvested from these areas: Alabama, Arkansas, California, Georgia, Hawaii, Louisiana, Maine, Maryland, Minnesota, Mississippi, New York, Nebraska, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, West Virginia, Belgium, Canada, the Dominican Republic, Guatemala, Israel, the Netherlands and Puerto Rico.

Salmonella is a bacteria that can cause bloody diarrhea in humans. Some 40,000 cases of salmonellosis are reported in the United States each year, although the CDC estimates that, because milder cases are not diagnosed or reported, the actual number of infections may be 30 or more times greater. Approximately 600 people die each year after being infected.

The risk of infection is greater in the summer than winter. And children, the elderly and people with weakened immune systems are most at risk for serious complications.

People become infected with salmonella by eating contaminated foods, usually ground beef, eggs, improperly pasteurized dairy products, undercooked pork and, increasingly, poultry products.

During the past several years, the United States has been beset by a series of food-safety crises. In fact, the U.S. Academy of Sciences this week declared that vegetables and fruits have become "leading vehicles" of food-borne illness in the United States.

The problem with tomatoes comes just as the U.S. Department of Health and Human Services proposed an additional $275 million for the FDA to improve food and medical product safety. More than $125 million of the proposed amount would go toward implementing the FDA's Food Protection Plan, designed to help ensure the safety of both imported and domestic-grown food.

An outbreak of E. coli bacteria in spinach in 2006 essentially destroyed the national spinach crop that year, Corbo said. "They put a blanket ban on consumption of spinach and, of course, it affected people who had nothing to do with it," he said.

By detailing which types of tomatoes from which regions are safe and not safe, officials seem to be trying to avoid what happened with the spinach outbreak, Corbo said.

But that means consumers will have to be vigilant, at least for a while. "People should be careful in terms of the plum and Roma and round tomatoes to make sure they're buying them from states and countries cleared by the FDA and CDC," Corbo said. "There is a lot of information to sift through."

More information

Visit the CDC for more on the current salmonella outbreak.

SOURCES: Tony Corbo, legislative representative, Food & Water Watch, Washington, D.C.; Sharon A. Wilkerson, Ph.D., R.N., acting dean, Texas A&M Health Science Center College of Nursing, College Station

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