Kratom, the controversial plant used by some as an opioid substitute, is at the center of a multistate Salmonella outbreak, prompting the Centers for Disease Control and Prevention (CDC) to issue a recommendation against the consumption of kratom in any form.

A total of 28 people from 20 states have been infected with the outbreak strain of Salmonella I 4,[5],12:b:-; 11 hospitalizations have been reported. Whole genome sequencing (WGS) performed on Salmonella bacteria isolated from these sickened individuals revealed that they were closely related genetically. Upon interview, 8 infected individuals reported consuming kratom in either pill, powder, or tea form.

The CDC says the epidemiologic evidence indicates kratom as the likely source of the outbreak, however no common brands or suppliers have been identified at this time. The illnesses began in October 2017 and have been recorded up to January 30, 2018. 

Additionally, the FDA today announced the voluntary destruction and recall of a large volume of kratom-containing dietary supplements. The products were manufactured and distributed by Divinity Products Distribution, MI, under the brand names Botany Bay, Enhance Your Life and Divinity. The Company has also agreed to stop selling kratom-containing products. 

“To protect the public health, we’ll continue to affirm the risks associated with kratom, warn consumers against its use and take aggressive enforcement action against kratom-containing products,” said FDA Commissioner Scott Gottlieb, M.D. “We appreciate the cooperation of companies currently marketing any kratom product for human consumption to take swift action to remove these products from circulation to protect the public.” 

The FDA recently completed a scientific analysis of kratom which showed that the plant contains compounds similar in structure to controlled opioid analgesics. “The extensive scientific data we’ve evaluated about kratom provides conclusive evidence that compounds contained in kratom are opioids and are expected to have similar addictive effects as well as risks of abuse, overdose and, in some cases, death. At the same time, there’s no evidence to indicate that kratom is safe or effective for any medical use,” said Gottlieb.

Kratom is also known as Thang, Kakuam, Thom, Ketom, and Biak.

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