During April-May 1998, a total of 11 states reported an increase in cases of Salmonella serotype Agona infections; as of June 8, a total of 209 cases have been reported and at least 47 persons have been hospitalized, representing an eightfold increase over the median number of cases reported in those states during 1993-1997. The states reporting increases were Illinois (49 cases), Indiana (30), Ohio (29), New York (24), Missouri (22), Pennsylvania (20), Michigan (15), Iowa (eight), Wisconsin (six), Kansas (four), and West Virginia (two). This report summarizes the outbreak investigation by local, state, and federal public health officials, which implicated Millville brand plain Toasted Oats cereal manufactured by Malt-O-Meal, Inc. as the cause of illness.
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