ACCOMACK, Va. (Delmarva Now) -- About 150 people from eight states have reported becoming ill after attending a cook-off in Chincoteague in September.
More than 20 cultures from different laboratories in Virginia and Maryland tested positive for salmonella, after scores of people became ill after attending the Chincoteague Chili and Chowder Cook Off on Sept. 30.
Together with additional samples the local health district sent to a state laboratory, the evidence points to one thing, a health official said.
"We are positive it is a salmonella outbreak," said Dr. David Matson, director of the Eastern Shore Health District.
Most of the samples tested were submitted by physicians who saw people who were ill.
About 150 people reported becoming ill after eating food at the Chincoteague Chili and Chowder Cook Off on Sept. 30, according to the health district.
About half of those who became ill sought medical care, including some who were hospitalized, although that exact number is not known.
Another 200 people who filled out an online survey said they did not get sick after attending the event.
The survey was created after the health district received so many phone calls after the event that they overwhelmed the office's telephone system, causing it to shut down, Matson said.
Some people whose reports initially were taken by telephone later also filled out the online survey, meaning health district workers had to go through the reports to weed out duplicates.
Matson urged anyone who attended the event to fill out the survey if they have not done so yet, even if they did not become ill.
Some 2,000 people attended the cookoff.
Most who reported illness became sick either the day after or two days after the cook-off, but a few fell ill days later — which Matson said can be the case with salmonella.
"That's not unexpected with salmonella. Salmonella can make you feel sick even up to two or three weeks after you are exposed — and that's because it stays in the intestine," he said.
Sometimes the bacteria also escapes the intestine and gets into the blood, causing other types of illness beside gastrointestinal symptoms.
"They can get an infected joint or have an abscess some place," Matson said.
If the bacteria spreads to the bloodstream and other places in the body, salmonella can cause death unless the person is treated promptly with antibiotics, according to the Centers for Disease Control and Prevention.
The Centers for Disease Control estimates about 1.2 million illnesses and about 450 deaths occur due to non-typhoidal salmonella annually in the United States.
Children younger than 5 have higher rates of salmonella infection than any other age group. Young children, older adults and people with weakened immune systems are the most likely to have severe infections, according to the CDC.
Most people infected with salmonella develop diarrhea, fever and abdominal cramps between 12 and 72 hours after infection.
The illness usually lasts four to seven days, and most people recover without treatment. Still, diarrhea may be so severe in some cases that the patient needs to be hospitalized.
It is important that anyone who becomes ill — even weeks after they attended the event — tell their doctor they were at the cook-off and could have been exposed to salmonella, Matson said.
"The doctors can put the two factors together and do the right thing," he said.
Most of those stricken are Virginia residents, followed by Maryland residents.
Additionally, cases have been reported from Delaware, New Jersey, New York, Pennsylvania, West Virginia and North Carolina residents who attended the event.
"It's a popular event," Matson noted.
Nothing in the health district's investigation points to contamination from an outside source, such as a food processor or a store, to which others could be exposed.
"We think that this all happened on a single day at a single place," Matson said, adding it is not yet known exactly how the sick people were exposed to the bacteria.
Still, pinpointing the source of the outbreak is difficult because many different food providers were at the event and numerous people handled the food for each kitchen there, Matson said.
Samples voluntarily given by food handlers and samples of some foods at the cook-off have been sent to a state laboratory for additional testing.
"We'll know more next Monday than we do today," Matson said.