Outbreak of Salmonella javiana infection at a children's hospital.
OBJECTIVE
To determine the source of an outbreak of Salmonella javiana infection.


METHODS
Case-control study.


METHODS
A total of 101 culture-confirmed cases and 540 epidemiologically linked cases were detected between May 26, 2003, and June 16, 2003, in hospital employees, patients, and visitors. Asymptomatic employees who had eaten in the hospital cafeteria between May 30 and June 4, 2003, and had had no gastroenteritis symptoms after May 1, 2003, were chosen as control subjects.


METHODS
A 235-bed academic tertiary care children's hospital.


RESULTS
Isolates from 100 of 101 culture-confirmed cases had identical pulsed-field gel electrophoresis patterns. A foodhandler with symptoms of gastroenteritis was the presumed index subject. In multivariate analysis, case subjects were more likely than control subjects to have consumed items from the salad bar (adjusted odds ratio [aOR], 5.3; 95% confidence interval [CI], 2.3-12.1) and to have eaten in the cafeteria on May 28 (aOR, 9.4; 95% CI, 1.8-49.5), May 30 (aOR, 3.6; 95% CI, 1.0-12.7), and/or June 3 (aOR, 4.0; 95% CI, 1.4-11.3).


CONCLUSIONS
Foodhandlers who worked while they had symptoms of gastroenteritis likely contributed to the propagation of the outbreak. This large outbreak was rapidly controlled through the use of an incident command center.
Elward
Alexis
A
Division of Infectious Diseases, Department of Pediatrics, St. Louis, MO, USA. Elward_A@kids.wustl.edu
Grim
Autumn
A
Schroeder
Patricia
P
Kieffer
Patricia
P
Sellenriek
Patricia
P
Ferrett
Rhonda
R
Adams
Hilda Chaski
HC
Phillips
Virginia
V
Bartow
Rhonda
R
Mays
Debra
D
Lawrence
Steven
S
Seed
Patrick
P
Holzmann-Pazgal
Galit
G
Polish
Louis
L
Leet
Terry
T
Fraser
Victoria
V
D016022:Case-Control Studies; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious; D005511:Food Handling; D005516:Food Microbiology; D005759:Gastroenteritis / Q000453:epidemiology / Q000382:microbiology*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control; D008923:Missouri; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000635:transmission*