title: Outbreak of Salmonella javiana infection at a children's hospital.
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, St. Louis, MO, USA. Elward_A@kids.wustl.edu
authors.forename: Alexis
authors.initials: A
authors.lastname: Elward
authors.forename: Autumn
authors.initials: A
authors.lastname: Grim
authors.forename: Patricia
authors.initials: P
authors.lastname: Schroeder
authors.forename: Patricia
authors.initials: P
authors.lastname: Kieffer
authors.forename: Patricia
authors.initials: P
authors.lastname: Sellenriek
authors.forename: Rhonda
authors.initials: R
authors.lastname: Ferrett
authors.forename: Hilda Chaski
authors.initials: HC
authors.lastname: Adams
authors.forename: Virginia
authors.initials: V
authors.lastname: Phillips
authors.forename: Rhonda
authors.initials: R
authors.lastname: Bartow
authors.forename: Debra
authors.initials: D
authors.lastname: Mays
authors.forename: Steven
authors.initials: S
authors.lastname: Lawrence
authors.forename: Patrick
authors.initials: P
authors.lastname: Seed
authors.forename: Galit
authors.initials: G
authors.lastname: Holzmann-Pazgal
authors.forename: Louis
authors.initials: L
authors.lastname: Polish
authors.forename: Terry
authors.initials: T
authors.lastname: Leet
authors.forename: Victoria
authors.initials: V
authors.lastname: Fraser
mesh_terms: 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*