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To the Editor: The article by Dr Cook and colleagues¹ on Salmonella infections associated with unpasteurized orange juice strongly suggests that unpasteurized orange juice has been responsible for outbreaks of foodborne diseases from typhoid fever to hepatitis A. After researching 5 of the 6 incidents the authors discussed, I found the following:

Incident 1.

A typhoid fever outbreak in Cleveland, Ohio, was traced to orange juice contamination as a result of improper handling of the juice by a woman infected with E typhosa (now called Salmonella typhi). This incident occurred in 1944 and information was sparse. The journal article was unclear as to whether the orange juice in question was pasteurized, unpasteurized, or concentrated.²

Incident 2.
Concentrated orange juice was determined to be responsible for a hepatitis A outbreak transmitted by a kitchen employee at a hospital in St Louis, Mo. The journal article clearly stated that "during June and July . . . [Full Text of this Article]

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RELATED ARTICLE

Outbreak of Salmonella Serotype Hartford Infections Associated With Unpasteurized Orange Juice
Kim A. Cook, Thomas E. Dobbs, W. Gary Hlady, Joy G. Wells, Timothy J. Barrett, Nancy D. Puhr, Gayle A. Lancette, Dean W. Bodager, Bill L. Toth, Carol A. Genese, Anita K. Highsmith, Keith E. Pilot, Lyn Finelli, and David L. Swerdlow
JAMA. 1998;280(17):1504-1509.
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