title: Salmonella outbreak in a nursing home.
abstract: We performed a retrospective review of an outbreak of Salmonella gastroenteritis that occurred in a community nursing home in 1987. Forty-four of 199 residents had a diarrheal illness; Salmonella heidelberg was isolated from the stool in 19 cases. Although the distribution of cases suggested a common source for the outbreak, no common source of infection could be demonstrated, despite extensive investigation. The clinical presentation of symptomatic individuals ranged from mild diarrhea to a severe gastrointestinal illness, and 26% of symptomatic, culture-positive patients required hospitalization. The median duration of pathogen excretion during convalescence in untreated residents was six weeks, but six patients who were treated with antibiotics shed S. heidelberg for a median duration of 14.5 weeks. We conclude that (1) the clinical spectrum of Salmonella gastroenteritis in nursing-home patients is variable, ranging from mild to severe illness; and (2) nursing-home Salmonella outbreaks impose a high economic burden because of expense of epidemiologic investigation, prolonged isolation measures, hospitalization for severely ill residents, and potential institutional closure.
authors.affiliation: Geriatric Research Education and Clinical Center, Veterans Affairs Medical Center, West Los Angeles, California.
authors.forename: M
authors.initials: M
authors.lastname: Choi
authors.forename: T T
authors.initials: TT
authors.lastname: Yoshikawa
authors.forename: J
authors.initials: J
authors.lastname: Bridge
authors.forename: A
authors.initials: A
authors.lastname: Schlaifer
authors.forename: D
authors.initials: D
authors.lastname: Osterweil
authors.forename: D
authors.initials: D
authors.lastname: Reid
authors.forename: D C
authors.initials: DC
authors.lastname: Norman
mesh_terms: D000368:Aged; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D005243:Feces / Q000382:microbiology; D006707:Homes for the Aged; D006801:Humans; D015141:Los Angeles; D009735:Nursing Homes; D009740:Nursing Staff; D015995:Prevalence; D012189:Retrospective Studies; D012478:Salmonella Food Poisoning / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology