Update: 39 sick, 24 Hospitalized as Salmonella Outbreak Toll Increases

In what has become the state's worst food-borne illness outbreak recent memory, the state Department of Health continues to try to pinpoint the exact source of a salmonella outbreak that has sickened 39, hospitalized 24 and taken the life of an elderly man in his 80s.

Eleven people remain hospitalized.

Health Department Spokeswoman Annemarie Beardsworth said in an interview that she can't remember a time during which so many people have gotten sick from tainted food. 

She noted the health department has not yet obtained laboratory evidence that conclusively links the strain of salmonella showing up in the cases of illnesses and bad zeppoles from in Cranston and Johnston. But the anecdotal evidence is hard to ignore: nearly all of those reported sick ate zeppoles that came from DeFusco's.

And there's a possibility the health department will never find the smoking gun.

"We do have food samples at our state lab and we expect to have results soon," she said. "But the food items that might have been contaminated might not be the ones we sampled. We might not have gotten the right piece of food."

What they do know is "we have a group of people who have the same strain of salmonella," Beardsworth said.

DeFusco's passed health department inspections in Dec. and April of 2010 with satisfactory inspections, Beardsworth said. The owners of DeFusco's have been working with health department officials to ensure the violations discovered on Friday's inspection are resolved before they're allowed to reopen.

The elderly man who died passed away on March 23, Beardsworth said. He tested positive for salmonella.

The outbreak most likely started from poor food handling practices. Workers at the bakery reportedly used egg crates to store pastry shells, the health department said. Raw egg residue on the crates could have transferred salmonella to the shells. Additionally, the health department found cream stored above safe temperatures. 

The egg crates aren't the kind found in the supermarket aisle. The ones used by restaurants and bakeries are much larger and come stacked in large boxes. 

During the investigation, the health department discovered another bakery in Providence, Buono's Bakery, using crates to store pastry shells. Zeppole, cream puff and eclair shells were stored in the crated. As a result, the health department is advising anyone who bought those items from Buono's Bakery to discard them.

Salmonella will incubate in the body from one to three days after being ingested. Symptoms include diarrhea, vomiting, cramps and fever that lasts from four days to a week. Young children and the elderly are at higher risk. For more information, visit http://www.cdc.gov/salmonella/

For an updated list of locations that served the zeppoles, visit http://1.usa.gov/RI-salmonella.