Salmonella Infections in Food Workers Identified through Routine Public Health Surveillance in Minnesota: Impact on Outbreak Recognition
Abstract:The frequency of Salmonella-infected food workers identified through routine surveillance from 1997 to 2004 in Minnesota was determined in order to evaluate the impact of surveillance on the detection of outbreaks in restaurants and to quantify the duration of Salmonella shedding in stool. Of 4,976 culture-confirmed Salmonella cases reported to the Minnesota Department of Health, 110 (2.2%) were identified as food workers; this was less than one-half the number expected based on the incidence of Salmonella in the general population. Twenty food workers (18%) were associated with outbreaks. Twelve were involved in nine independent outbreaks at the restaurants where they worked. The identification of the index food worker in six of these outbreaks was critical to the initiation of outbreak investigations that revealed much larger problems. Among food workers who submitted specimens until at least one negative result was obtained (n = 69), the median duration of shedding was 22 days (range, 1 to 359 days). Among the four most common serotypes (Enteritidis, Typhimurium, Heidelberg, and Newport) the median duration of shedding was significantly longer for Salmonella Newport (80 days; P = 0.02) and for Salmonella Enteritidis (32 days; P = 0.04) than for Salmonella Heidelberg (8 days). Food workers should be considered an important source of Salmonella transmission, and those identified through surveillance should raise a high index of suspicion of a possible outbreak at their place of work. Food service managers need to be alert to Salmonella-like illnesses among food workers to facilitate prevention and control efforts, including exclusion of infected food workers or restriction of their duties.
Document Type: Research Article
Affiliations: 1: Acute Disease Investigation and Control Section, Minnesota Department of Health, P.O. Box 64975, St. Paul, Minnesota 55164-0975, USA 2: Center for Animal Health and Food Safety, College of Veterinary Medicine, University of Minnesota, 136F Andrew Boss, 1354 Eckles Avenue, St. Paul, Minnesota 55108, USA 3: Public Health Laboratory, Minnesota Department of Health, P.O. Box 64899, St. Paul, Minnesota 55164-0899, USA 4: Division of Environmental Health Sciences, School of Public Health, University of Minnesota, 1260 Mayo (MMC 807), 420 Delaware Street S.E., Minneapolis, Minnesota 55455, USA
Publication date: November 1, 2010
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