title: A multi-state outbreak of Salmonella serotype Thompson infection from commercially distributed bread contaminated by an ill food handler.
abstract: Foodborne transmission is estimated to account for 95% of non-typhoidal Salmonella infections reported in the United States; however, outbreaks of salmonellosis are rarely traced to food handlers. In August 2000, an increase in Salmonella serotype Thompson infection was noted in Southern California; most of the cases reported eating at a restaurant chain (Chain A) before illness onset. A case-control study implicated the consumption of burgers at Chain A restaurants. The earliest onset of illness was in a burger bun packer at Bakery B who had not eaten at Chain A but had worked while ill. Bakery B supplied burger buns to some Chain A restaurants in Southern California and Arizona. This outbreak is notable for implicating a food handler as the source of food contamination and for involving bread, a very unusual outbreak vehicle for Salmonella . Inadequate food-handler training as well as delayed reporting to the health department contributed to this outbreak.
authors.affiliation: Infectious Diseases Branch, California Department of Health Services, Gardena, CA 90248, USA. akimura@dhs.ca.gov
authors.forename: A C
authors.initials: AC
authors.lastname: Kimura
authors.forename: M S
authors.initials: MS
authors.lastname: Palumbo
authors.forename: H
authors.initials: H
authors.lastname: Meyers
authors.forename: S
authors.initials: S
authors.lastname: Abbott
authors.forename: R
authors.initials: R
authors.lastname: Rodriguez
authors.forename: S B
authors.initials: SB
authors.lastname: Werner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001939:Bread / Q000382:microbiology; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005511:Food Handling; D005516:Food Microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012147:Restaurants; D012475:Salmonella / Q000145:classification / Q000302:isolation & purification*; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000382:microbiology; D012703:Serotyping