Outbreak of Salmonella javiana Infection at a Children’s Hospital

• Published in: Infection control and hospital epidemiology 2006-06, Vol.27 (6), p.586-592
• Main Authors: Elward, Alexis, Grim, Autumn, Schroeder, Patricia, Kieffer, Patricia, Sellenriek, Patricia, Ferrett, Rhonda, Adams, Hilda Chaski, Phillips, Virginia, Bartow, Rhonda, Mays, Debra, Lawrence, Steven, Seed, Patrick, Holzmann‐Pazgal, Galit, Polish, Louis, Leet, Terry, Fraser, Victoria
• Format: Article
• Language: English
• Subjects: Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Cafeterias; Case-Control Studies; Disease Outbreaks; Disease Transmission, Infectious; Food Handling; Food history; Food Microbiology; Foodborne illnesses; Foodways; Gastroenteritis; Gastroenteritis - epidemiology; Gastroenteritis - microbiology; General aspects; Hospitals, Pediatric - statistics & numerical data; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; Infection Control; Infections; Infectious diseases; Medical sciences; Miscellaneous; Missouri; Original Article; Public health. Hygiene; Public health. Hygiene-occupational medicine; Salads; Salmonella; Salmonella Food Poisoning - epidemiology; Salmonella Food Poisoning - transmission; Salmonella javiana; Symptoms
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1086/506483

To determine the source of an outbreak of Salmonella javiana infection. Case-control study. A total of 101 culture-confirmed cases and 540 epidemiologically linked cases were detected between May 26, 2003, and June 16, 2003, in hospital employees, patients, and visitors. Asymptomatic employees who had eaten in the hospital cafeteria between May 30 and June 4, 2003, and had had no gastroenteritis symptoms after May 1, 2003, were chosen as control subjects. A 235-bed academic tertiary care children's hospital. Isolates from 100 of 101 culture-confirmed cases had identical pulsed-field gel electrophoresis patterns. A foodhandler with symptoms of gastroenteritis was the presumed index subject. In multivariate analysis, case subjects were more likely than control subjects to have consumed items from the salad bar (adjusted odds ratio [aOR], 5.3; 95% confidence interval [CI], 2.3-12.1) and to have eaten in the cafeteria on May 28 (aOR, 9.4; 95% CI, 1.8-49.5), May 30 (aOR, 3.6; 95% CI, 1.0-12.7), and/or June 3 (aOR, 4.0; 95% CI, 1.4-11.3). Foodhandlers who worked while they had symptoms of gastroenteritis likely contributed to the propagation of the outbreak. This large outbreak was rapidly controlled through the use of an incident command center.