Epidemiology and Infection

Original Papers

Large Salmonella Enteritidis outbreak with prolonged transmission attributed to an infected food handler, Texas, 2002

M. E. BEATTYa1a2 c1, G. SHEVICKa3, K. SHUPE-RICKSECKERa3, E. BANNISTERa4, A. TULUa4, K. LANCASTERa4, N. ALEXANDERa1, D. E. ZELLNERa1, E. LYSZKOWICZa1 and C. R. BRADENa1

a1 Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial and Mycotic Diseases, National Center for Zoonotic, Vectorborne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

a2 Epidemic Intelligence Service, Career Development Division, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA, USA

a3 Texas Department of State Health Services, Austin, TX, USA

a4 Dallas County Department of Health and Human Services, Dallas, TX, USA

SUMMARY

In March 2002, an outbreak of Salmonella Enteritidis (SE) infections occurred at a convention centre in Dallas, Texas and continued for 6 weeks. We conducted epidemiological studies, obtained clinical and environmental cultures, and interviewed employees to identify risk factors for infection. From 17 March–25 April 2002, the implicated hotel kitchen catered 41 multi-day conferences attended by 9790 persons. We received 617 illness reports from residents of 46 states. Sauces or items served with sauces were implicated in three cohort studies. SE phage-type 8 was identified as the agent. Eleven food service employees, including one who prepared sauces and salsa, had stool cultures that yielded SE. Although the original source was not determined, prolonged transmission resulted in the largest food handler-associated outbreak reported to date, affecting persons from 46 US states. Transmission ended with implementation of policies to screen food handlers and exclude those whose stool cultures yielded salmonellas.

(Accepted August 27 2008)

(Online publication September 26 2008)

Correspondence:

c1 Author for correspondence: M. Beatty, M.D., M.P.H., Pediatric Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, San 4-8 Bongcheon-7-dong, Kwanak-gu, Seoul, Republic of Korea 151-919. (Email: mbeatty@pdvi.org)

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