title: Massive outbreak of antimicrobial-resistant salmonellosis traced to pasteurized milk.
abstract: Two waves of antimicrobial-resistant Salmonella typhimurium infections in Illinois totaling over 16 000 culture-confirmed cases were traced to two brands of pasteurized 2% milk produced by a single dairy plant. Salmonellosis was associated with taking antimicrobials before onset of illness. Two surveys to determine the number of persons who were actually affected yielded estimates of 168 791 and 197 581 persons, making this the largest outbreak of salmonellosis ever identified in the United States. The epidemic strain was easily identified because it had a rare antimicrobial resistance pattern and a highly unusual plasmid profile; study of stored isolates showed it had caused clusters of salmonellosis during the previous ten months that may have been related to the same plant, suggesting that the strain had persisted in the plant and repeatedly contaminated milk after pasteurization.
authors.affiliation: Division of Bacterial Diseases, Centers for Disease Control, Atlanta, GA 30333.
authors.forename: C A
authors.initials: CA
authors.lastname: Ryan
authors.forename: M K
authors.initials: MK
authors.lastname: Nickels
authors.forename: N T
authors.initials: NT
authors.lastname: Hargrett-Bean
authors.forename: M E
authors.initials: ME
authors.lastname: Potter
authors.forename: T
authors.initials: T
authors.lastname: Endo
authors.forename: L
authors.initials: L
authors.lastname: Mayer
authors.forename: C W
authors.initials: CW
authors.lastname: Langkop
authors.forename: C
authors.initials: C
authors.lastname: Gibson
authors.forename: R C
authors.initials: RC
authors.lastname: McDonald
authors.forename: R T
authors.initials: RT
authors.lastname: Kenney
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003612:Dairying; D004196:Disease Outbreaks; D004352:Drug Resistance, Microbial; D004812:Epidemiologic Methods; D005243:Feces / Q000382:microbiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007087:Illinois; D007223:Infant; D008297:Male; D008875:Middle Aged; D008892:Milk / Q000382:microbiology*; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000382:microbiology; D012486:Salmonella typhimurium / Q000187:drug effects; D011795:Surveys and Questionnaires; D014922:Wisconsin