Investigators at the Centers for Disease Control and Prevention and the Food and Drug Administration have tied at least 19 kratom products to a salmonella outbreak that has infected at least 87 people in 35 states.

Those products are made by two companies—PDX Aromatics and Torched Illusions—and sold under several other company and distributor names. 

The agencies say that the list is not yet complete, and advise consumers to avoid all forms of kratom while the investigation proceeds. “We don’t know every brand or product that's contaminated yet,” says Laura Gieraltowski, Ph.D., head of the CDC’s Foodborne Outbreak Team. “So we’re advising people to stay away from kratom altogether.”  

More on Kratom
The popular herb may act like a prescription opioid, and could be addictive, the FDA says.

The salmonella outbreak is the latest in a string of advisories about kratom issued by federal agencies including the FDA, which likened the substance to an addictive opioid, and the Drug Enforcement Agency, which moved to criminalize it. Some consumers have hailed kratom as a “natural” pain remedy, but medical experts say it can be dangerous, even deadly.

Here’s what health officials know about the salmonella outbreak. 

The Kratom-Salmonella Link

The salmonella outbreak began in mid-October, according to investigators, with cases occurring across the country. So far, victims range in age from 6 to 67, and the vast majority of them are male. No deaths have been reported, but at least 14 people have been hospitalized. 

Health officials have interviewed 55 of the 87 salmonella victims; 40 of them (73 percent) reported using some form of kratom—either in a pill, powder, or tea—before falling ill.

Investigators traced the infections back to several specific kratom products made by the company PDX Aromatics of Portland, Ore. PDX does business under several other names, including Kraken Kratom, Phytoextractum, and Soul Speciosa. The company has since recalled its offending products. 

On Friday, the FDA reported that a second company, Torched Illusions, was also found to have salmonella in its kratom products. The agency says that these products are distributed by Triangle Pharmanaturals and Pure Distribution, both of Las Vegas, Nev.

So far, Torched Illusions has yet to issue a recall. But a list of products that have tested positive for salmonella can be found here

The outbreak investigation is ongoing, and federal health officials expect to identify additional products in the weeks ahead. 

When to See a Doctor

Signs of salmonella infection include diarrhea, fever, and abdominal cramps that develop within 12 to 72 hours of being exposed to the bacteria. The CDC advises that you contact a healthcare provider if you develop these symptoms after taking kratom. 

The symptoms usually last from four to seven days. Most people recover with treatment, but if diarrhea becomes severe enough, you may need to go to the hospital.

In rare cases, salmonella can spread from the intestines to the bloodstream, and throughout the rest of the body from there. If untreated, such systemic infections can be fatal: The FDA estimates that about 400 people die every year from salmonella infection. 

Skip Kratom Supplements

The CDC advises consumers to talk to a healthcare provider before taking supplements of any kind, not just those containing kratom, especially if you are pregnant, older than 65, younger than 6, or have a weakened immune system.

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Because dietary supplements are regulated differently than prescription drugs, they pose unique health and safety risks. Supplement makers are not required to prove to federal regulators that what they’re selling is safe, effective, or accurately labeled. And supplements have been found to be mislabeled in some cases, and dangerously contaminated in others.

When it comes to kratom, health officials say the risks of addiction and even overdose are added to those concerns. 

"There were already plenty of reasons to stay away from this substance," said Marvin Lipman, M.D., Consumer Reports' chief medical adviser. "This is just one more to add to the list."