CDC Reports Multi-State Salmonella Outbreak Linked to Chicken Across 13 States

Thirty-four people across 13 states have been infected with a drug-resistant strain of Salmonella Saintpaul traced to backyard poultry, the Centers for Disease Control and Prevention announced in April 2026 [1]. Thirteen have been hospitalized. No one has died — yet. But the details of this outbreak, from the antibiotic resistance profile to the demographics of those falling ill, expose fractures in the U.S. food safety apparatus that have persisted for decades.

What We Know: 34 Cases, 13 States, and a Resistant Strain

The CDC's investigation, updated April 23, 2026, identified illness onset dates ranging from February 26 to March 31, 2026 [1]. Of 29 patients interviewed, 23 — roughly 79% — reported direct contact with backyard poultry before becoming sick [2]. Among the 14 who confirmed owning backyard chickens, 13 had purchased or obtained their birds after January 1, 2026, many from agricultural retail stores [1].

The geographic distribution skews heavily toward the Upper Midwest and Great Lakes region. Michigan leads with six confirmed cases, followed by Wisconsin and Ohio with five each [3]. Indiana, Kentucky, and Maine each reported three cases, while Maryland and West Virginia had two apiece. Florida, Illinois, Mississippi, New Hampshire, and Tennessee each recorded a single case [1].

Source: CDC

Data as of Apr 23, 2026CSV

The clustering in Michigan, Wisconsin, and Ohio — which together account for nearly half of all confirmed cases — raises questions about whether specific hatcheries or feed stores in the region served as common suppliers, though the CDC has not yet publicly named any specific retailer or hatchery.

The Antibiotic Resistance Problem

The strain driving this outbreak carries a resistance profile that public health officials find concerning. Whole-genome sequencing of all 34 patient samples predicted resistance to fosfomycin [1]. Eight of those samples showed additional predicted resistance to chloramphenicol, streptomycin, sulfisoxazole, and tetracycline [4].

Fosfomycin resistance across all samples is notable because the drug, while not a first-line treatment for Salmonella, represents one tool in a shrinking arsenal. The additional multi-drug resistance in nearly a quarter of samples signals that this strain has acquired genetic elements conferring broader protection against antibiotics [5].

The CDC states that drug-resistant Salmonella infections "are among the most severe and likely to require hospitalization" [3]. For patients who develop invasive infections — where the bacteria enter the bloodstream — treatment options narrow to ciprofloxacin, azithromycin, and ceftriaxone [3]. If resistance spreads to those drugs, clinicians face genuinely dangerous territory.

This pattern is not new. A multidrug-resistant Salmonella Infantis strain, designated Pattern 1080, emerged in commercial chicken production in 2018 and was resistant to four of five commonly prescribed antibiotics [6]. The CDC estimated that strain caused 11,000 to 17,000 illnesses annually, finding it in more than 25% of samples at major processing plants including those operated by Perdue, Tyson, and Pilgrim's Pride [6].

Children Under Five Are Bearing the Brunt

The demographics of this outbreak are stark. Forty-one percent of confirmed cases occurred in children younger than five years old [1]. Patient ages range from less than one year to 78, with a median age of 12 [2]. Fifty-eight percent of patients were male, and 89% identified as White [2].

The overrepresentation of young children is consistent with the exposure pathway. Backyard chickens are handled frequently by children drawn to the animals, and the fecal-oral transmission route — Salmonella shed in droppings contaminates feathers, eggs, and surfaces — is particularly effective against young children who are less likely to wash their hands thoroughly after contact [5].

The CDC's guidance is direct: children younger than five should not handle poultry, including chicks and ducklings, and should be kept away from areas where birds live [1]. But enforcement of that guidance falls entirely on parents and caregivers.

Immunocompromised individuals and adults over 65 also face elevated risk of severe illness, though the current outbreak's demographic data does not break out those populations in detail [2].

How This Outbreak Compares to Recent Years

The 34 confirmed cases represent the early stage of what could become a much larger outbreak. Backyard poultry-linked Salmonella illnesses have been a recurring problem in the United States, with case counts fluctuating substantially from year to year.

Source: CDC

Data as of Apr 23, 2026CSV

The year 2020 produced the highest recent toll, with 1,722 confirmed cases linked to backyard poultry, coinciding with a surge in home chicken-keeping during pandemic lockdowns [7]. The years 2022 and 2023 saw 1,230 and 1,072 cases respectively, with two deaths in 2022 [7]. In 2024, the total dropped to 470 cases with one death [7].

The current 2026 outbreak's 34 cases as of mid-April are not yet comparable to these full-year totals. Historically, backyard poultry outbreaks peak during spring and summer months when chick purchases and outdoor bird handling increase. The outbreak is likely still in its early trajectory.

Between 2017 and 2023, the CDC documented a total of roughly 9,923 cases of human salmonellosis linked to backyard poultry, with the majority involving multidrug-resistant strains [7]. The current outbreak's drug-resistance profile fits squarely within that pattern.

The Supply Chain Question: Backyard Flocks, Not Commercial Chicken

Unlike major commercial poultry outbreaks — where contamination traces back through slaughterhouses, processing plants, and retail distribution — this outbreak's source sits at the very beginning of a different supply chain: the sale of live chicks and poultry to backyard flock owners [1].

The CDC's traceback data indicates that 93% of poultry owners in this outbreak obtained birds after January 1, 2026, with agricultural retail stores — the type of seasonal chick suppliers found at farm supply chains nationwide — implicated as likely points of purchase [2]. The agency is still investigating associated hatcheries [1].

This means the contamination pathway is fundamentally different from a recall scenario involving packaged chicken at grocery stores. There is no single brand to pull from shelves, no processing plant to shut down. The bacteria travel with live birds sold through a diffuse retail network, making containment far more difficult.

Detection Timeline: From First Case to Public Warning

The first illness in this outbreak cluster began on February 26, 2026 [1]. The CDC published its investigation update on April 23, 2026 — a gap of roughly eight weeks from the earliest case [2].

That timeline reflects the structural delays built into the U.S. outbreak detection system. A person falls ill. They may or may not seek medical care. If they do, a physician may or may not order a stool culture. If a culture is obtained, the lab must identify the specific Salmonella serotype and upload its whole-genome sequence to PulseNet, the CDC's national molecular subtyping network. State health departments then investigate clusters, and only when a pattern emerges across multiple states does the CDC step in to coordinate a national investigation [8].

The CDC itself acknowledges this gap, noting on its investigation page that "the true number of sick people in an outbreak is likely much higher than the number reported" because many people recover without medical care and are never tested [1].

The 1-in-29 Problem: Why Cases Are Almost Certainly Undercounted

The CDC estimates that Salmonella causes approximately 1.35 million infections, 26,500 hospitalizations, and 420 deaths in the United States every year [8]. Only a fraction of those infections ever receive laboratory confirmation. The agency's current estimate is that roughly 1 in every 29 Salmonella cases is diagnosed through lab testing and reported to public health authorities [8].

Applied to this outbreak, the arithmetic is sobering. If 34 cases have been lab-confirmed, the actual number of people sickened by this strain could plausibly be closer to 1,000. Many will have experienced several days of diarrhea, fever, and abdominal cramping, assumed they had a stomach bug, and recovered at home without ever seeing a doctor.

The economic burden of Salmonella infections overall runs to an estimated $17 billion per year, representing roughly 23% of the entire $74.7 billion U.S. foodborne illness cost [8]. Chicken alone accounts for nearly one-fifth of all Salmonella illnesses annually [9].

The Regulatory Backdrop: USDA Retreats on Salmonella Standards

This outbreak lands at a moment of regulatory retreat. In April 2025, USDA's Food Safety and Inspection Service withdrew its proposed "Salmonella Framework for Raw Poultry Products," a rule that had been years in development [10]. The framework, published for public comment in August 2024, would have established enforceable limits — barring raw chicken products containing Salmonella at or above 10 colony-forming units per gram, and prohibiting any detectable level of certain high-risk serotypes from entering commerce [10].

FSIS received 7,089 comments during the public comment period, of which 1,415 were unique comment letters. The agency said it withdrew the rule to "further assess its approach" [10].

The National Chicken Council opposed the proposal, arguing it was "based on a mischaracterization of the presence of Salmonella in raw poultry, relies on misinterpretations of the science, and is legally unsound" [10].

In December 2025, FSIS announced a public meeting for January 14, 2026, to discuss "practical strategies" for reducing Salmonella — a step that consumer advocates viewed as a significant downgrade from the enforceable standards that had been proposed [11].

Then, in 2026, FSIS indefinitely delayed enforcement of its one concrete regulatory step — the 2024 designation of Salmonella as an adulterant in raw breaded stuffed chicken products, which applied a threshold of 1 colony-forming unit per gram to a narrow product category [12].

How the U.S. Compares to Other Nations

Under current federal standards, poultry processing plants can have up to 24% of ground chicken samples test positive for Salmonella and still meet FSIS performance standards [9]. In the European Union, Salmonella is treated as an adulterant across all poultry products, with testing and intervention requirements that begin at the farm level [13].

Several European countries — Denmark, Sweden, Norway, and the United Kingdom among them — have achieved dramatic reductions in poultry-linked Salmonella through farm-level programs including regular flock testing, destruction of infected flocks, vaccination programs, and strict litter management between production cycles [6].

The difference in regulatory philosophy is fundamental. In the U.S., the burden falls on consumers to cook chicken to 165°F and practice safe handling. In the EU, the burden falls on producers to deliver products that are substantially free of the pathogen before they reach consumers [13].

FSIS, unlike its European counterparts, has no authority to regulate Salmonella on farms, where the bacteria most commonly spreads among poultry [6]. A 1999 court ruling in Supreme Beef Processors v. USDA further constrained the agency's authority by holding that Congress had not granted FSIS the power to regulate Salmonella present in animals before they entered processing [6].

The E. coli Precedent the Chicken Industry Resists

Consumer advocates frequently point to the 1994 declaration of E. coli O157:H7 as an adulterant in ground beef as a model for what could be done with Salmonella in poultry [9]. When FSIS made that determination, the beef industry sued and lost. Federal courts upheld the agency's authority. Predicted price increases and industry collapse did not materialize [9].

E. coli O157:H7 infections from hamburger went from accounting for roughly 95% of food safety litigation between 1993 and 2002 to near zero in subsequent years [9]. FSIS extended the approach in 2012 to six additional non-O157 shiga toxin-producing strains.

Food safety attorney Bill Marler, who has litigated Salmonella cases since 1993, has argued: "Anything that can poison or kill a person, like Salmonella in chicken, should be an adulterant" [9]. Former USDA official Sandra Eskin, who served as deputy undersecretary for food safety, noted that industry cost arguments against Salmonella regulation mirror the arguments made — and disproven — in 1994 regarding E. coli [9].

A January 2020 petition asked FSIS to declare 31 outbreak-linked Salmonella serotypes as adulterants, including Enteritidis, Typhimurium, Newport, Heidelberg, and Infantis. The agency addressed only three serotypes in its subsequent rulemaking without engaging the scientific merits of the remaining 28 [9].

What Happens Next

The CDC continues to investigate associated hatcheries and supply chains [1]. State and local health departments are interviewing patients and tracing where birds were purchased. Whole-genome sequencing allows investigators to match the outbreak strain to potential environmental sources if samples from hatcheries or retail locations produce a genetic match.

For the 34 confirmed patients and likely hundreds more who were never tested, the illness has already run its course or is still being managed. For children under five who contracted a drug-resistant strain, the clinical stakes were higher than for a typical Salmonella infection.

The broader question — whether the United States will treat Salmonella in poultry with the same regulatory seriousness it brought to E. coli in beef three decades ago — remains unanswered. The USDA's withdrawal of its proposed framework and indefinite delay of its limited enforcement action suggest the answer, for now, is no.

Salmonella incidence in the U.S. sits at approximately 15.3 cases per 100,000 people, above the CDC's Healthy People 2030 target of 11.5 per 100,000 [9]. That rate has not substantially improved in two decades. Each spring, as agricultural retailers stock their shelves with fluffy chicks and American families bring them home, the cycle begins again.