As California health officials confirmed the state's second case related to a multistate salmonella outbreak, Bay Area supermarkets and restaurants on Monday scrambled to pull tomatoes off their shelves and menus.

The U.S. Food and Drug Administration warned consumers nationwide during the weekend to avoid raw red plum, red Roma and round red tomatoes unless they were grown in certain states and countries.

California-grown tomatoes were among those cleared by the FDA. But because many tomatoes - especially those sold in large chain stores - are imported into the state, consumers here are being warned to be cautious to avoid an outbreak that has sickened nearly 150 people nationwide.

FDA officials said they are aggressively trying to track down the source of the outbreak caused by salmonella Saintpaul, a rare form of salmonella.

"We will work on it 24-7," said Alonza Cruz, the FDA's Los Angeles district director. "We'll look at the science and do the epidemiology, and that will govern where we go next with this."

Although the beginning of the outbreak apparently dates to mid-April, attention to the problem intensified Monday with an updated FDA advisory and a move by McDonald's to pull tomatoes from its restaurants nationwide.

"Oh my gosh, I hadn't heard," said Robert Ghastin, who was grocery shopping at PW Market on Oakland Road in North San Jose when told of the salmonella threat.

"I just had some tomatoes today. Am I going to be OK? I guess I'll find out."

The outbreak is the biggest consumer food scare since an E. coli outbreak from spinach grown in San Benito County killed at least three people and sickened at least 200 in the fall of 2006.

Salmonella is not as deadly as E. coli, but it can kill, said Bill Marler, a Seattle attorney who specializes in winning settlements for victims of food poisoning.

"About 1.4 million Americans get salmonella poisoning every year, and about 76,000 get E. coli poisoning," he said. Salmonella also kills more people - particularly the elderly, about 600 a year, he said.

The U.S. Centers for Disease Control and Prevention has said the outbreak has been tied to at least 145 infections. At least 23 people have been hospitalized, but no deaths have been reported. Two of the cases are in California: one in Contra Costa County and the other, announced Monday afternoon, in San Diego County.

The symptoms

Most people infected by salmonella suffer fever, diarrhea and stomach cramps within 12 to 72 hours after ingesting contaminated food. The illness usually lasts four to seven days.

Salmonella can be present in irrigation water and the guts of animals, said Trevor Suslow, a plant pathologist and food-safety expert at the University of California-Davis. But the FDA is probably more likely to be "looking at birds rather than cattle or pigs," he said.

Besides McDonald's, other restaurants pulling all three types of raw tomatoes from their menus include Burger King, Chipotle Mexican Grill, Sweet Tomatoes, Outback Steakhouse and Taco Bell. Cooked tomatoes are not a problem, but some restaurants are removing them as well to calm concerns.

The Sweet Tomatoes restaurant, with six Bay Area locations, is serving only grape tomatoes. The San Diego-based chain revised its entire menu by removing Roma and bulbous red tomatoes from all dishes.

Lunardi's supermarket pulled all raw tomatoes except for organic California-grown tomatoes and vine-ripened tomatoes.

Cosentino's followed by deciding to pull the unsafe varieties Monday evening.

"People were calling all day to ask if the tomatoes are safe," said produce buyer Rich Dilly. "I've been telling them to buy tomatoes other than the round red tomatoes."

Still, some customers are apparently so wild about tomatoes that they're throwing caution to the wind.

"One lady called me to say she was hell-bent on having tomatoes on her salad every day," Dilly said.

Whole Foods, the natural and organic food giant, withdrew all Roma and round red tomatoes last week. The chain also pulled tomatoes from prepared foods, such as pizza and sandwiches.

Most markets posted signs explaining the situation, as did fast-food chains like McDonald's.

Salsa pulled

Customers craving some fresh tomato salsa at Chipotle Mexican Grill won't find any of the salsa made with freshly diced tomatoes.

"We will keep fresh tomato salsa out of restaurants as long as there is a concern about the safety of the nation's tomato supply," said Chipotle spokesman Chris Arnold.

Local salsa maker Leah Aguayo worries that the tomato scare could hurt sales, even of products that are clearly safe.

"A small business like mine could really take a hit if people are scared," said Aguayo, a Saratoga High School teacher turned salsa maker who served more than 2,000 samples of her product during a busy weekend celebration.

She said her salsa is safe because it's made from California-grown canned organic tomatoes.

At the PW Market in North San Jose, Miguel Gutierrez bought tomatoes from the vine instead of his usual Roma tomatoes, which had been pulled from the supermarket.

Nonetheless, he said, "You can't be afraid of everything. We're all going to die someday. It's just a scare."

At the nearby McDonald's, a sign on the door alerted customers that no tomato slices would be served on any sandwiches.

Joseph Lee of San Jose saw the sign and didn't even bother to buy his usual burger, ordering fries and a shake instead.

Still hungry, Lee figured he would dig in on even more carbs across the way.

"I think," he said, "I'll go have Chinese food."