title: High incidence of extra-intestinal infections in a Salmonella Havana outbreak associated with alfalfa sprouts.
abstract: OBJECTIVE
  To determine a vehicle and point source for an outbreak of Salmonella Havana.
  
  
  METHODS
  The authors conducted a case-control study and traceback investigation of 14 residents of California and four from Arizona with onsets of illness from Apr 15, 1998, to June 15, 1998, and Salmonella Havana infections with identical PFGE patterns.
  
  
  RESULTS
  Seventeen of 18 patients were women. Seventeen were adults 20-89 years of age. Nine (50%) had diarrheal illness, 6 (33%) had urinary tract infections, 2 (11%) had sepsis, and one had an infected surgical wound after appendectomy. Four patients were hospitalized, and one died. Eating alfalfa sprouts was associated with S. Havana infection (OR = 10.0; 95% confidence interval 1.2, 83.1; P = 0.01).
  
  
  CONCLUSIONS
  This outbreak resulted in a high incidence of extra-intestinal infections, especially urinary tract infections, and high morbidity. Raw alfalfa sprouts, often considered a safe "heath food," can be a source of serious foodborne disease outbreaks.
authors.affiliation: Preventive Medicine, University of California, San Francisco, USA.
authors.forename: H D
authors.initials: HD
authors.lastname: Backer
authors.forename: J C
authors.initials: JC
authors.lastname: Mohle-Boetani
authors.forename: S B
authors.initials: SB
authors.lastname: Werner
authors.forename: S L
authors.initials: SL
authors.lastname: Abbott
authors.forename: J
authors.initials: J
authors.lastname: Farrar
authors.forename: D J
authors.initials: DJ
authors.lastname: Vugia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona / Q000453:epidemiology; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D003967:Diarrhea / Q000382:microbiology; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005516:Food Microbiology; D006801:Humans; D015994:Incidence; D008297:Male; D000455:Medicago sativa / Q000382:microbiology*; D008875:Middle Aged; D012475:Salmonella / Q000235:genetics / Q000302:isolation & purification*; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000382:microbiology; D018805:Sepsis / Q000382:microbiology; D013530:Surgical Wound Infection / Q000382:microbiology; D014552:Urinary Tract Infections / Q000382:microbiology