title: An outbreak of Salmonella enteritidis infection at a fast-food restaurant: implications for foodhandler-associated transmission.
abstract: An outbreak of Salmonella enteritidis infection occurred in patrons and employees of a fast-food restaurant. Transmission took place over a 9-day period. A single employee (employee A) was identified who had onset of gastrointestinal illness 1 day before the first reported patron exposures and had S. enteritidis isolated from stool. A case-control study of 37 ill and 20 healthy patrons who ate during shifts worked by employee A demonstrated that curly-fried potatoes and ice (odds ratio [OR], 6.8; 95% confidence interval [CI], 1.5-33.7; P = .007), both food items handled bare-handed by employee A, were associated with illness. Employees who worked two or more shifts with employee A were more likely to be infected than those who did not work with employee A (OR, 4.4; CI, 1.0-19.5; P = .03). Foodhandlers who subsequently became infected apparently contaminated multiple food items with additional transmission to patrons. This outbreak illustrates the potential for foodhandlers in a fast-food restaurant setting who are infected with Salmonella to be a source of transmission.
authors.affiliation: Acute Disease Epidemiology Section, Minnesota Department of Health, Minneapolis 55440.
authors.forename: C W
authors.initials: CW
authors.lastname: Hedberg
authors.forename: K E
authors.initials: KE
authors.lastname: White
authors.forename: J A
authors.initials: JA
authors.lastname: Johnson
authors.forename: L M
authors.initials: LM
authors.lastname: Edmonson
authors.forename: J T
authors.initials: JT
authors.lastname: Soler
authors.forename: J A
authors.initials: JA
authors.lastname: Korlath
authors.forename: L S
authors.initials: LS
authors.lastname: Theurer
authors.forename: K L
authors.initials: KL
authors.lastname: MacDonald
authors.forename: M T
authors.initials: MT
authors.lastname: Osterholm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005243:Feces / Q000382:microbiology; D005260:Female; D005511:Food Handling; D005513:Food Inspection; D006801:Humans; D007053:Ice; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D012147:Restaurants; D012478:Salmonella Food Poisoning / Q000453:epidemiology / Q000635:transmission*; D012477:Salmonella enteritidis / Q000302:isolation & purification*; D011198:Solanum tuberosum
chemical_list: D007053:Ice