Extensively Drug-Resistant Salmonella Outbreak Linked to Rosabella Moringa Capsules

CDC, public health officials in several states, and FDA are investigating a multistate outbreak of extensively drug-resistant Salmonella Newport infections linked to certain lots of Rosabella brand moringa powder capsules distributed by Ambrosia Brands LLC. The outbreak has sickened seven people from seven states, with illnesses starting on dates ranging from November 7, 2025, to January 8, 2026. Three of the patients have required hospitalization, which is a high percentage for Salmonella outbreaks. No deaths have been reported.

The sick people live in Arizona, Florida, Iowa, Illinois, Indiana, Tennessee and Washington. Of the three people interviewed, all three reported eating Rosabella brand moringa powder capsules. The age of patients ranges from 61 to 78 years with a median age of 66. Eighty-six percent of patients are female and 14% are male. All patients are White and non-Hispanic.

This outbreak is of particular interest because the Salmonella strain is resistant to all first-line and alternative antibiotics commonly recommended for the treatment of Salmonella infections. Based on whole genome sequencing analysis of seven samples collected, all seven samples had predicted resistance or nonsusceptibility to amoxicillin-clavulanic acid, ampicillin, azithromycin, cefoxitin, ceftiofur, ceftriaxone, chloramphenicol, ciprofloxacin, gentamicin, hygromycin, kanamycin, meropenem, streptomycin, sulfisoxazole, and tetracycline. Six of the seven samples had predicted resistance to trimethoprim-sulfamethoxazole. One sample had predicted resistance to colistin.

The strain also might be resistant to multiple β-lactam antibiotics, including meropenem and other carbapenems, because it carries an NDM-1 carbapenemase gene. Most people with Salmonella infection recover without antibiotics. However, if antibiotics are needed, Salmonella illnesses with this predicted resistance may not be treatable with commonly recommended antibiotics and may require a different antibiotic choice.

The FDA has recommended that Ambrosia Brands LLC recall all Rosabella-brand moringa powder capsules from the market. The firm has agreed to conduct a recall only of certain lots. The recalled capsules are sold in white plastic bottles with a green label and include 52 lot codes with expiration dates in 2027. Lot codes can be found on the bottom of the bottle. The products were available nationwide primarily online on the company's website (tryrosabella.com), Amazon, TikTok Shop, Shein, and eBay.

The recalled lot codes include:

• Lot codes 5020591-5020596 with expiration dates in March 2027
• Lot codes 5030246-5030251 with expiration dates in April 2027
• Lot codes 5040270-5040279 with expiration dates in May 2027
• Lot codes 5050053-5050056 with expiration dates in June 2027
• Lot codes 5060069-5060080 with expiration dates in July 2027
• Lot codes 5080084-5080086 with expiration dates in September 2027
• Lot codes 5090107-5090118 with expiration dates in October 2027
• Lot codes 5100039 and 5100048 with expiration dates in November 2027

There is great concern that consumers may have the moringa capsules in their homes because of their long shelf life, which stretches into late 2027. Consumers should not eat the affected capsules and should throw them away or return them to where they bought them. Items and surfaces that may have touched the capsules should be washed using hot soapy water or a dishwasher.

The FDA is conducting a traceback investigation to determine a source of contamination and is working with state partners to collect samples. CDC's National Antimicrobial Resistance Monitoring System (NARMS) laboratory is currently conducting standard antimicrobial susceptibility testing.

The true number of sick people in this outbreak is likely much higher than the number reported, and this outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.

This outbreak is separate from an outbreak of Salmonella Richmond infections traced to Member's Mark and other brands of moringa. That previous outbreak sickened 65 people across 28 states. Fourteen of the patients required hospitalization. The first patient became ill on May 12, 2025 and the most recent patient became ill on January 11, 2026.

Most people infected with Salmonella experience diarrhea, fever, and stomach cramps. Symptoms usually start 6 hours to 6 days after swallowing the bacteria. Most people recover without treatment after 4 to 7 days. Some people—especially children younger than 5, adults 65 and older, and people with weakened immune systems—may experience more severe illnesses that require medical treatment or hospitalization.

Patients should call their healthcare provider immediately if they have any severe symptoms including diarrhea and a fever higher than 102°F, diarrhea for more than 3 days that is not improving, bloody diarrhea, so much vomiting that they cannot keep liquids down, or signs of dehydration such as not peeing much, dry mouth and throat, or feeling dizzy when standing up. Patients should tell their healthcare provider if they have eaten this product so that if they need treatment, appropriate guidance can be followed. Healthcare providers should consider consultation with an infectious disease specialist for management of patients with extensively drug-resistant or complicated Salmonella infection.