Salmonella infections linked to the use of the popular botanical drug kratom now number 132 people in 38 states, the U.S. Centers for Disease Control and Prevention reported Friday.
Since the last outbreak update on March 15, 45 more cases and 19 additional states have been added to the investigation, the agency noted.
Forty percent of patients have been hospitalized, while no deaths have been reported, according to the CDC.
Most people infected with salmonella develop diarrhea, fever and abdominal cramps. The illness usually lasts about a week, and most people recover without treatment.
But in the salmonella outbreak linked with kratom products, an unusually high percentage of patients have required hospitalization, the U.S. Food and Drug Administration said.
Kratom products from several companies have already been recalled by the FDA due to possible salmonella contamination, but the CDC now advises that people avoid any brand of kratom in any form.
However, the Kratom Trade Association (KTA) defended the overall safety of the herbal supplement.
"KTA backs FDA actions to track and contain the tainted supply of kratom to keep users safe, as it would with any other product; however, advising against the product as a whole is unjustified and sets a dangerous precedent," the association said in a statement Friday.
"We support education and regulation, but not prohibition ... sick individuals are cause for concern and investigation, but it is no reason to ban the product altogether," KTA spokesman Ira Hecht said in the statement.
The association also said that more than 2 million people safely use kratom in the United States and have done so for decades, during which time there has never been an issue with salmonella.
But the FDA has raised other concerns with kratom.
In February, the agency declared that kratom acts like an opioid in the human brain. It is used as a stimulant and an opioid substitute.
"Evidence shows that kratom has similar effects to narcotics like opioids, and carries similar risks of abuse, addiction and, in some cases, death," FDA Commissioner Dr. Scott Gottlieb said at the time. "At a time when we have hit a critical point in the opioid epidemic, the increasing use of kratom as an alternative or adjunct to opioid use is extremely concerning."
Kratom is also called Thang, Kakuam, Thom, Ketom and Biak. The plant grows naturally in the Southeast Asian countries of Thailand, Malaysia, Indonesia and Papua New Guinea. It has been sold as a dietary supplement -- typically to help manage pain and boost energy.
The U.S. Centers for Disease Control and Prevention has more on salmonella.
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