title: An outbreak of Salmonella Infantis gastroenteritis in a residential aged care facility associated with thickened fluids.
abstract: Twenty-two confirmed cases of Salmonella Infantis were identified in 70 residents of high-level care areas of a residential aged care facility in Sydney in April 2010 during an outbreak of gastroenteritis. A retrospective cohort study was conducted to identify a possible cause. Consuming a soft diet, puréed diet, or thickened fluid were each independently associated with illness. A logistic regression showed consumption of thickened fluid to be the only significant exposure associated with illness (adjusted odds ratio 11·8, 95% confidence interval 1·9-75·9). It was postulated that the thickened fluid had been contaminated by chicken mince, a sample of which also cultured S. Infantis. This finding reinforces the need to educate food-handlers on the risk of potential cross-contamination; it also highlights the need to consider all dietary components, such as thickened fluids, as potential vehicles for transmission in an outbreak.
authors.affiliation: Communicable Diseases Branch, NSW Department of Health, Sydney, NSW, Australia.
authors.forename: Z
authors.initials: Z
authors.lastname: Najjar
authors.forename: C
authors.initials: C
authors.lastname: Furlong
authors.forename: N
authors.initials: N
authors.lastname: Stephens
authors.forename: C
authors.initials: C
authors.lastname: Shadbolt
authors.forename: P
authors.initials: P
authors.lastname: Maywood
authors.forename: S
authors.initials: S
authors.lastname: Conaty
authors.forename: G
authors.initials: G
authors.lastname: Hogg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001628:Beverages / Q000382:microbiology*; D016001:Confidence Intervals; D003967:Diarrhea / Q000382:microbiology; D004032:Diet; D004196:Disease Outbreaks; D005260:Female; D005516:Food Microbiology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000382:microbiology; D006707:Homes for the Aged; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012480:Salmonella Infections / Q000453:epidemiology* / Q000382:microbiology; D019779:Salmonella enterica; D014783:Viscosity; D014839:Vomiting / Q000382:microbiology