“Most people can tell you that chicken meat may have salmonella on it,” said Casey Barton Behravesh of the Centers for Disease Control and Prevention. “But surprisingly, we found many people are not aware that live chicks and chickens can spread salmonella to people.”

Since 2004, at least 316 people in 43 states got sick in an outbreak tied primarily to one mail-order hatchery. Health officials believe thousands more illnesses connected to the business were probably never reported.

No one died, but three dozen people were hospitalized with bloody diarrhea or other symptoms. The illnesses were detailed Wednesday in the New England Journal of Medicine.

Salmonella can cause diarrhea, fever and stomach pain but is rarely fatal. It is most dangerous to very young children, the elderly and people with weakened immune systems. The infection is usually contracted from food, but live animals can transmit it, too, because it can be in their feces.

Salmonella outbreaks have been linked to hatcheries for more than 50 years. And health officials have long warned that people can get salmonella from touching chickens — especially children, who tend to put their fingers in their mouths. Indeed, the CDC says children under 5 shouldn’t be allowed to touch chickens at all.

Health officials also advise people not to bring birds into their homes and to wash their hands thoroughly after handling live poultry.

About 20 hatcheries mail live chicks overnight in the U.S., supplying not only feed stores and farms but amateurs with backyard coops. The mail-order houses have been seeing record sales in recent years.

“It’s all part of this greener, healthier lifestyle,” said Behravesh, a veterinary epidemiologist.

Jonah McDonald, a 32-year-old Atlanta man who keeps three hens and insists a backyard egg tastes better, said he does not know of anyone who has gotten salmonella from handling chickens.

“The kids in my neighborhood come over and feed scraps into the cages,” he said. “It’s a real community thing.”

The CDC described an eight-year investigation into salmonella illnesses, with more than 80 percent of the cases tied to a single hatchery in the western U.S. While CDC officials refused to identify the business, a previous report on the investigation by the health agency indicated it is in New Mexico.

Investigators interviewed victims and concluded many had caught salmonella from touching chicks or ducklings, often at home. From there, most of the illnesses were traced to the hatchery.

Behravesh said the hatchery has taken steps to curb the spread of salmonella — including replacing equipment, adopting new egg-cleaning procedures and vaccinating chickens — and is not considered a health threat. She said she was not aware of any fines or penalties against the business over the outbreak.

During the eight years studied, the annual number of illnesses linked to the hatchery ranged as high as 84, with 29 cases last year and only one so far in 2012.

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Online:

Journal: http://www.nejm.org

Leo and Diane Dillon met at the Parsons School of Design in 1953 and married four years later. An interracial couple, they worked on a wide range of children’s projects, mastering a bold, colorful style that helped introduce kids to stories of black people worldwide. They won the Caldecott for best illustration in 1976 for “Why Mosquitoes Buzz in People’s Ears: A West African Folktale” and again won Caldecott the following year for “Ashanti to Zulu: African Traditions.”

The Dillons received awards as diverse as their books, including a Hugo Award for science fiction illustration and an NAACP Image Award.

“People often comment on the ‘Dillon style,’” Leo Dillon said in 2000 during an interview with Locus Magazine. “I think that someplace, the two of us made a pact with each other. We both decided that we would give up the essence of ourselves, that part that made the art each of us did our own. And I think that in doing that we opened the door to everything.”

Their credits included more than 40 books, from cover designs for Ellison, Ray Bradbury and other science fiction and fantasy writers to illustrations for books by Margaret Wise Brown, Madeleine L’Engle and Verna Aardema, author of the two Caldecott winners.

They wrote and illustrated the picture books “Rap a Tap Tap” and “Jazz on a Saturday Night” and collaborated with their son Lee Dillon on “Pish, Posh, Said Hieronymus Bosch.” A new work by Leo and Diane Dillon, “If Kids Ran the World,” is scheduled for 2014.

With the Obama administration unwilling at this point to pursue military options in Syria, the U.S. has relied heavily on economic sanctions as a means for pressing Assad to leave power. The United States will host other nations in Washington next week to look at ways to tighten international sanctions further.

“We are strangling the regime economically,” White House deputy national security adviser Denis McDonough said.

David Cohen, Treasury undersecretary for terrorism and financial intelligence, said the toll taken by sanctions on Syria is “mounting day by day.”

“They’re drawing down their reserves without a ready means of replenishing those reserves,” Cohen said.

The White House also blamed Iran for stirring up violence inside Syria and said Assad’s fall would be a huge blow to Tehran. The United States is increasingly linking Syria and Iran rhetorically and tactically, applying economic pressure with and without help from the United Nations or other countries.

Iran is Syria’s only staunch defender in the Middle East, and the Syria crisis has united Sunni Arab neighbors who see in Syria a way to weaken Iran, their main Shiite enemy.

“The Assad clique will end up, ultimately, in the dustbin of history and the people of Syria will have the chance to determine their own destiny,” McDonough said. “When that happens, it will also be the most profound strategic setback that Syria’s closest ally, Iran, has faced in decades. That is surely why Iran has provided material support and advice to the regime in brutalizing the Syrian people.”

Speaking to a Brookings Institution forum in Doha, Qatar, McDonough pointed to what he called a recent “stunning” admission from Iran that its armed forces were joining the fight in support of the regime in Syria, and said Iran had tried to backtrack and “cover up” the announcement.

He blamed the Assad regime squarely for the massacre of 108 civilians last weekend in the town of Houla, and said claims that the killings were carried out by unaffiliated roughnecks are “a lie.” Assad’s associates pay the pro-government gunmen known as the shabiha, he claimed.

“Our objective is straightforward: Starve the regime of the resources it requires to pay the army, and deprive Assad’s cronies of the money they need to buy the shabiha’s brutal conspiracy.”

The violence in Syria is spiraling out of control as an uprising against Assad that began in March 2011 has morphed into an armed insurgency.

In the wake of the Houla massacre, the United States and several other countries expelled Syrian diplomats to protest the killings.

McDonough said the U.S. is also lobbying Russia to distance itself from its ally Syria and apply pressure on Assad to leave office. A negotiated exit similar to one the U.S. helped broker for Yemen’s longtime leader is one possibility, McDonough said, but he offered little optimism that U.S. arguments are gaining traction.

“I won’t speak for any other government,” White House press secretary Jay Carney said in Washington. “I would simply say that it is our belief, and it’s the belief that we express in these conversations, that supporting the Assad regime is placing oneself or one’s nation on the wrong side of history.”

The U.S. has also sought United Nations action against Syria, but those efforts have been stymied by Russia and China, both of whom have veto power on the U.N. Security Council.

Susan Rice, ambassador to the United Nations, said that the most likely scenario is that the peace plan crafted by special envoy Kofi Annan will fail.

Russia criticized the diplomatic expulsions, calling them “counterproductive,” and has said new Security Council action would be premature.

Cohen said he plans to travel to Russia to discuss Syria. He said he thinks Russia shares the goal of a more open political system, although so far Russia has been a dogged defender of Assad. He also said some of Russia’s commercial ties to Syria are troubling. He did not elaborate, but Russia is a trading partner to Damascus and has supplied the regime with weapons, food and medical supplies.