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The U.S. Department of Agriculture (USDA) is threatening to close three California poultry plants operated by Foster Farms blamed for an outbreak of salmonella poisoning that has sickened at least 278 people nationwide.

In a letter sent Monday to Foster Farms, the USDA said sanitary conditions at the facilities were so poor that they posed a “serious ongoing threat to public health.”

The agency has ordered Foster Farms, one of the nation’s largest privately owned poultry producers, to develop a plan by Thursday to clean up the plants.

The USDA first issued a health alert Monday warning consumers to avoid raw chicken from the three facilities after they detected strains of Salmonella Heidelberg, a strain that has been linked to human illness.

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Fears were heightened Tuesday when the Centers for Disease Control and Prevention (CDC) said 42 percent of the sick people were hospitalized — double the normal rate for such an outbreak. The CDC also reported that some of the salmonella strains detected were showing resistance to antibiotics.

“That helps explain the high rates of hospitalization,” said Caroline Smith DeWaal, food-safety director for the Center for Science in the Public Interest, which is calling for a recall of poultry from the problem plants.

Although the Food Safety Inspection Service, which issued the alert Monday, said people in 18 states had become ill after eating Foster Farms poultry, almost 80 percent of those affected were in California, said Dr. David Goldman, of the Office of Public Health Science at the service.

Authorities have not issued a recall, but the nation’s largest grocery chain, Kroger, said Tuesday that it was pulling chicken from the three Foster Farms plants off shelves. Kroger runs Fred Meyer and QFC stores in the Pacific Northwest.

The chicken in question can be identified in supermarkets with USDA marks of inspection P6137, P6137A or P7632.

Salmonella does not trigger an automatic recall like some forms of E. coli because it’s not deemed an adulterant. Instead, the USDA considers salmonella a naturally occurring bacteria that can be mitigated with proper cooking and handling.

For years the poultry industry has used antibiotics to promote faster growth in animals. But the trend has alarmed food-safety advocates, who worry that overuse is leading to human resistance to certain types of these drugs. Just last month a report by the CDC identified agriculture as an area of concern.

Consumers increasingly are demanding antibiotic-free meat. The Food and Drug Administration plans to phase out the use of several antibiotics on farms intended to promote growth in animals.

John Glisson, director of research for the U.S. Poultry & Egg Association, defends the use of antibiotics. He said most farmers don’t abuse antibiotics because the drugs are expensive.

Still, Glisson stressed that salmonella was a formidable challenge to the poultry industry.

The bacteria grows in animals’ intestinal tracts and is spread through feces. It can contaminate a chicken farm through water, feed, birds and rodents. When infected chicken waste dries, salmonella can spread through dust.

Food-safety experts urge consumers to cook chicken to at least 165 degrees Fahrenheit to kill the salmonella. They also recommend frequent hand washing and the use of separate cutting boards for meat and poultry.

One bit of counterintuitive advice: Don’t clean raw poultry in the sink. The splash can spread bacteria up to 3 feet and increase the chances of cross-contamination.

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