IngentaConnect Restaurant Salmonella Enteritidis Outbreak Associated with an Asy...

Authors: Hedican, Erin¹; Hooker, Carol²; Jenkins, Timothy³; Medus, Carlota⁴; Jawahir, Selina⁵; Leano, Fe⁵; Smith, Kirk⁴

Source: Journal of Food Protection®, Volume 72, Number 11, November 2009 , pp. 2332-2336(5)

Publisher: International Association for Food Protection

Abstract:

Salmonella is the most common bacterial cause of foodborne outbreaks in the United States; approximately half of Salmonella outbreaks occur in restaurant settings. In February 2008, investigation of a cluster of Salmonella Enteritidis cases with indistinguishable pulsed-field gel electrophoresis (PFGE) patterns revealed that five cases had eaten at the same restaurant. Cases were identified through routine surveillance activities and by contacting meal companions of culture-confirmed cases. Well meal companions and well patrons contacted via check stubs served as controls. Illness histories and stool samples were collected from all restaurant employees. Sandwiches were the only menu item or ingredient significantly associated with illness (15 of 15 cases versus 17 of 37 controls; odds ratio, undefined; P < 0.001). None of the six restaurant employees reported experiencing recent gastrointestinal symptoms. The outbreak PFGE subtype of Salmonella Enteritidis was identified in two food workers. One of the positive employees began working at the restaurant shortly before the first exposure date reported by a case, and assisted in the preparation of sandwiches and other foods consumed by cases. The other positive employee rarely, if ever, handled food. The restaurant did not have a glove use policy. There was no evidence of ongoing transmission after exclusion of the positive food workers. This was a restaurant Salmonella Enteritidis outbreak associated with an asymptomatic infected food worker. Routine PFGE subtyping of Salmonella Enteritidis isolates, routine interviewing of cases, and an iterative approach to cluster investigations allowed for timely identification of the source of an outbreak of Salmonella Enteritidis infections.

Document Type: Research article

Affiliations: 1: Acute Disease Investigation and Control Section, Minnesota Department of Health, 625 Robert Street N., P.O. Box 64975, St. Paul, Minnesota 55164-0975, USA. erin.hedican@state.mn.us 2: Hennepin County Public Health Protection, 1101 South First Street, Hopkins, Minnesota 55343-9413 3: Division of Environmental Health, City of Minneapolis, 250 South 4th Street, Minneapolis, Minnesota 55415-1391, USA 4: Acute Disease Investigation and Control Section, Minnesota Department of Health, 625 Robert Street N., P.O. Box 64975, St. Paul, Minnesota 55164-0975 5: Public Health Laboratory, Minnesota Department of Health, 625 Robert Street N., P.O. Box 64975, St. Paul, Minnesota 55164-0975

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Restaurant Salmonella Enteritidis Outbreak Associated with an Asymptomatic Infected Food Worker