The peanut butter salmonella outbreak that has sickened 486 people and killed six may continue to pop up in more peanut butter products, federal officials warned in a press conference today.
Within a week and a half, 125 brands of cookies, cakes, energy bars and even doggie treats have made the U.S. Food and Drug Administration's recall list.
Officials say store-bought jars of peanut butter are believed to be safe, but more investigation is needed into peanut-flavored products.
More than 70 companies have used peanut butter and peanut paste from the Peanut Corporation of America's (PCA) processing plant in Blakely, Ga., which is believed to be the source of the salmonella outbreak in 43 states.
"We are sending our inspectors out to every place where we know that there has been a sale, and eventually we hope to get to the end of the line," said Dr. Stephen Sundlof, director of the Center for Food Safety and Applied Nutrition.
"Even a small amount of material can find its way into a number of different food products; that's just the nature of the food business, and it makes our jobs a lot more complicated," he said.
The FDA has created a searchable list on its Web site for consumers to check in on the latest affected products. If a brand is not on that list, the FDA recommends people call the food company to check if the product has been cleared before eating it.
Popular brands on the recall list include seven different kinds of PetSmart dog biscuits, Keebler Cheese & Peanut Butter Sandwich Crackers and NutriSystem Peanut Butter Granola bars.
NutriSystem representative Craig Alperowitz told ABC News that the company switched from PCA to a different peanut butter supplier in November before news broke about the salmonella outbreak. However, the U.S. Centers for Disease Control now reports that illnesses from the salmonella outbreak started in early September.
Some brands have been quick to clear their name from the salmonella outbreak. Both the Hershey Company and Girl Scout® Cookies have announced they believe their products are safe, and their companies do not use PCR as a supplier.
Representatives from Peanut Corporation of America told ABCNews.com to expect the investigation to continue to unfold for weeks or months to come.
"It's really on two fronts," said a spokesman for Peanut Corporation of America. "One is on the Georgia facility, then everything after the plant: What do those customers do with those products?"
News of the outbreak first broke in September, when the CDC traced salmonella to a brand of peanut butter called King Nut, sold to cafeterias and not grocery stores.
Only seven states remain free of salmonella reports: Montana, Alaska, New Mexico, Louisiana, Florida, South Carolina and Delaware.
Peanut butter from the Blakely, Ga., plant ships to food companies in 5- to 1,700-pound containers. Once out of those containers, food companies may use the peanut butter in a variety of products.
Studies out of the University of Georgia have shown salmonella can live in the peanut butter paste used in vending machine snacks for months. Once someone eats a contaminated product, it may take the CDC weeks to a month to fully investigate the case.
"There's a lag time of two weeks," said Lola Russell, a spokeswoman for the CDC. Russell explained it takes time for a person to become ill, seek help and get test results. "If you get something that has food-borne illness, there's a wait."
Food safety experts and the spokesman from the Peanut Corporation of America, who declined to be named for this story, said it might be easier to find out how the salmonella got into the peanut butter than to track what happened to the peanut butter after it was shipped.
"If you think about where salmonella comes from, it lives in the intestinal tract of warm-blooded animals," said Catherine Donnelly, a professor of nutrition and food science at the University of Vermont in Burlington.
"It's coming from fecal matter," she said.
Donnelly said finding the source of the fecal matter can become quite complicated in a large processing plant. A single worker might contaminate the food, but the ceiling, walls or roof can contaminate the food as well.
"The first [and only] opportunity to kill salmonella lurking around is when the peanuts are roasted," said Donnelly, who explained that cooking temperatures for peanut butter are not high enough to kill the pathogen.
"The nuts are roasted, but the roasted nuts are stored. That leaves a lot of opportunity for the nuts to get salmonella again," she said.
For example, the source of the 2007 outbreak of salmonella in Peter Pan peanut butter turned out to be a leaky roof. Donnelly said vermin and birds lived in the roof, and a leak transferred their salmonella to the peanut products below.
"You have to test the lines themselves, but you also have to test floors and coolers, and drains, and walls and roofs," said Donnelly.
In the food safety industry, these types of contaminations are deemed "environmental."
FDA officials announced they found two such environmental sources of salmonella contamination on the Georgia plant floors. However, the salmonella found on the floors was a different strain than the salmonella found in peanut butter previously shipped from the Blakely plant.
The PCA peanut butter salmonella recall followed shortly on the heels of the 2007 ConAgra and Peter Pan recall. However, food safety experts said peanut butter has historically been a very safe food.
"It's not a common event," said Michael Doyle, a professor and director of the University of Georgia Center for Food Safety in Griffin, Ga., of salmonella contamination.
"We have had three outbreaks in the world now attributed to peanut butter," said Doyle. The first was in Australia a decade ago, followed by last year's outbreak in the United States and the current salmonella outbreak.
Donnelly worries that consumers will only hear the first reports of the ongoing investigation and not realize the dangers of this recall.
"When you think about salmonella, for most of the population, we're healthy enough that if we get it, it won't likely end in any symptoms," Donnelly said.
However with big cafeterias serving peanut butter in schools, nursing homes and hospitals, it's likely that any contaminated peanut butter will be fed to those most at risk -- the sick, the elderly and the young.
"Therein lies the problem," she said.
Donnelly advised the public to pay attention to the food sources of grandparents and children, who may be at risk for salmonella infection.
"When you see recalls happening, in reality only about 20 percent of the recall product comes back to the plant," Donnelly said. "It wouldn't hurt to just check in with the food service director or the school or hospital to make sure they're aware of the recall."
The FDA keeps an updated list, and a searchable site for recalled peanut butter products on its Web site.