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Outbreak of Salmonella javiana Infection at a Children's Hospital

Published online by Cambridge University Press:  21 June 2016

Alexis Elward*
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
Autumn Grim
Affiliation:
Infection Control and Healthcare Epidemiology Consortium, BJC Healthcare, St. Louis, Missouri
Patricia Schroeder
Affiliation:
St. Louis Children's Hospital, St. Louis, Missouri
Patricia Kieffer
Affiliation:
St. Louis Children's Hospital, St. Louis, Missouri
Patricia Sellenriek
Affiliation:
St. Louis Children's Hospital, St. Louis, Missouri
Rhonda Ferrett
Affiliation:
St. Louis Children's Hospital, St. Louis, Missouri
Hilda Chaski Adams
Affiliation:
St. Louis Department of Health, St. Louis, Missouri
Virginia Phillips
Affiliation:
St. Louis Department of Health, St. Louis, Missouri
Rhonda Bartow
Affiliation:
St. Louis Department of Health, St. Louis, Missouri
Debra Mays
Affiliation:
St. Louis Children's Hospital, St. Louis, Missouri
Steven Lawrence
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
Patrick Seed
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
Galit Holzmann-Pazgal
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
Louis Polish
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
Terry Leet
Affiliation:
Saint Louis University School of Public Health, St. Louis, Missouri
Victoria Fraser
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
*
Room 11W32, St. Louis Children's Hospital, One Children's Place, St. Louis, MO 63110 (Elward_A@kids.wustl.edu)

Abstract

Objective.

To determine the source of an outbreak of Salmonella javiana infection.

Design.

Case-control study.

Participants.

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.

Setting.

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.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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