SALT LAKE CITY — A nationwide outbreak of salmonella has infected two people in Utah, Centers for Disease Control and Prevention officials said on Feb. 20.

It is part of a larger salmonella outbreak that, as of Feb. 16, has infected 28 people and spanned across 20 states, including several Western states— California, Oregon, Arizona, Colorado, and now, Utah.

The outbreak has been linked to kratom, an herbal supplement often used as an alternative to prescription painkillers, according to Time. Eleven people have been hospitalized but there have been no reported deaths, the CDC said Tuesday.

What is salmonella?

Salmonella infection is a bacterial disease that affects the intestinal tract, according to the Mayo Clinic. It can lead to typhoid fever, according to the Centers for Disease Control and Prevention.

Salmonella bacteria live in the intestines of all people, animals and birds, and infection is usually caused by eating raw meat, poultry or eggs.

Every year, an estimated 19,000 people are hospitalized due to salmonella infection, CDC research has found. The disease causes an annual 380 deaths.

Symptoms

Most people infected with salmonella do not develop symptoms, the Mayo Clinic said. When symptoms do develop, they include diarrhea, fever, nausea, vomiting and abdominal cramps. Symptoms usually surface between eight and 72 hours after ingestion of contaminated food or item.

Most symptoms typically last between two and seven days, but diarrhea may last up to 10 days.

When did the outbreak start?

The CDC reported that the salmonella outbreak began on Oct. 13, 2017, with the most recent documentation of infection occurring on Jan. 30. The health protection agency noted that those infected after Jan. 23 might not have yet reported their illness yet because reporting often takes between two and four weeks.

The report did not specifically mention when the two cases from Utah were reported, or the circumstances surrounding them.

What is kratom?

Mitragyna speciosa, or kratom, is a tropical evergreen tree that grows naturally in Thailand, Malaysia, Indonesia and Papua New Guinea, as reported by the National Center for Complementary and Integrative Health.

Kratom is used to treat a number of conditions, including post-traumatic stress disorder and opioid addiction. The U.S. Food and Drug Administration has banned import of kratom and, in 2016, considered classifying it as a schedule I drug, a category reserved for drugs with high potential for abuse, according to the Integrative Health Center.

Kratom, which the FDA has said contains addictive opioid compounds, can be consumed as a pill, powder or tea. Other names for kratom include Thang, Kakuam, Thom, Ketom and Biak, the CDC said.

Of 11 infected people interviewed, eight of them reported consuming kratom in some form, the CDC said.

Most at risk

In its report, the CDC noted that those most at risk for salmonella infection are people with weakened immune systems, like those with HIV or who are receiving chemotherapy, as well as pregnant women, children younger than 5 years old and older adults.

Advice to consumers

No commons brands or suppliers of kratom have been linked to the outbreak, the CDC said, and therefore it recommends people not consume the product in any form. Further, the CDC recommends talking to a health care provider before taking any supplement.

If you show symptoms of salmonella infection or otherwise think you might be infected, the CDC recommended immediately contacting your health care provider. The Utah Department of Health has a 24-hour disease-reporting hotline, which can be reached at 1-888-EPI-UTAH (374-8824). The CDC has a webpage detailing how to report a foodborne illness.

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