title: Investigation of a food-borne outbreak of salmonellosis among hospital employees.
abstract: An explosive outbreak of Salmonella enterocolitis developed in 27 hospital employees in an acute-care community hospital in Rhode Island in 1987. Salmonella typhimurium was isolated from the stools of 19 employees during the outbreak. In each patient the implicated organism had an identical antibiotic susceptibility pattern, biotype, plasmid profile, and restriction endonuclease digestion pattern. The outbreak was limited to health care workers and other hospital employees; there were no cases in hospitalized patients. Of the afflicted employees 96% ate in the hospital cafeteria on July 11 or 12, 1987. Food-specific attack rates, based on the dietary histories of ill employees and 50 healthy employees who ate in the cafeteria that weekend, indicated an association between the ingestion of salads and illness (p less than 0.01). One food service employee, in whom symptoms of abdominal cramping and diarrhea had developed 6 days earlier, had prepared the implicated foods. S. typhimurium with the identical characteristics of the outbreak strain was isolated from the stools of this food service employee. Environmental cultures and cultures of meat, poultry, and dairy sources for the cafeteria all showed negative results. Food service employees need to be counseled against working during any symptomatic enteric illness and require thorough instruction on hygienic food handling.
authors.affiliation: Brown University Program in Medicine, Providence 02912.
authors.forename: S M
authors.initials: SM
authors.lastname: Opal
authors.forename: K H
authors.initials: KH
authors.lastname: Mayer
authors.forename: F
authors.initials: F
authors.lastname: Roland
authors.forename: J
authors.initials: J
authors.lastname: Brondum
authors.forename: J
authors.initials: J
authors.lastname: Heelan
authors.forename: L
authors.initials: L
authors.lastname: Lyhte
mesh_terms: D000328:Adult; D004196:Disease Outbreaks; D004760:Enterocolitis / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005511:Food Handling / Q000592:standards; D006745:Hospital Bed Capacity, 300 to 499; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010564:Personnel, Hospital; D010957:Plasmids; D015183:Restriction Mapping; D012237:Rhode Island; D012478:Salmonella Food Poisoning / Q000175:diagnosis* / Q000453:epidemiology; D012486:Salmonella typhimurium / Q000302:isolation & purification; D012703:Serotyping