Salmonella Blog - Surveillance & analysis on salmonella news & outbreaks

Facing the largest food-borne illness investigation in recent history, the S.C. health department says it is "too early to say" whether the agency will look at how it inspects restaurants or issues public health advisories.

But Department of Health and Environmental Control spokesman Thom Berry said the state has fewer than 90 workers inspecting more than 17,000 food-service establishments. The agency has asked the legislature to fund more inspectors.

The number of peopled sickened from a salmonella outbreak in Camden grew to 287 on Saturday, with 50 hospitalized. The death of James Arledge, 58, has been linked to the outbreak, which affected those who ate at the Old South Restaurant.
 

Nine years ago, that Upstate city was swept by a salmonella outbreak from contaminated eggs that sickened more than 200 people. Until this week, it was the worst outbreak of salmonella in South Carolina history.

That record has been broken now that 272 people have reported being sickened by salmonella after eating at the Old South buffet restaurant in Camden last week. Salmonella has been blamed in the death of James Arledge, 58, of Lugoff.

The 1996 outbreak in Greenville stemmed from contaminated eggs used in spreads made by the Duke Sandwich Co., according to Thom Berry, spokesman for the state Department of Health and Environmental Control.

The sandwich company, based in Greenville, was not blamed for the contamination.
 

How inspectors traced origin of food poisoning
From a phone call Sunday to a surprise Tuesday, state officials scrambled to figure out what had gone wrong
By RODDIE BURRIS
Staff Writer
May 28, 2005

EDITOR'S NOTE: Through interviews with state and local health officials, The State's Roddie Burris pieced together the first critical hours of the public health crisis that unfolded last week, starting in Camden.

CAMDEN -- Emergency room director Tommy Norris saw the tip of the salmonella iceberg and knew what he was looking at.

Like the outdoor temperature, the potential for foodborne illnesses rises with the Memorial Day weekend and the official kickoff of backyard barbecue season.

Potentially hazardous foods are abundant at most cookouts, from ground beef burgers and grilled or fried chicken to cut melons, all of which can support bacterial growth if precautions are not taken. The risk of foodborne illness rises with warm weather and when food is taken away from the refrigerator or freezer.

The S.C. Department of Health and Environmental Control offers the following food safety tips that can keep consumers from ending up with the symptoms of a foodborne illness and a lousy ending to Memorial Day weekend;

Clean: Hands, utensils (bring plenty of extra utensils and platters), clean thermometers.

Wash Your Hands: Wash your hands often with warm to hot soapy water after every chance of contamination; from touching raw foods, before and after preparing foods, using the bathroom, smoking or blowing your nose. Use single-service paper towels to dry your hands.

Separate, Don't Cross-Contaminate: Separate raw and cooked/ready-to-eat foods to prevent cross-contamination. Separate utensils, platters and cutting boards used for raw foods (chicken, beef, pork) and cooked/ready-to-eat foods. Also separate unlike raw foods such as chicken and beef from one another. Do not use the same cooler for raw and cooked items or ready-to-eat products in storage. Do not use ice for beverages from a cooler used to store raw meats or other foods.

Cook: It is safe to eat steaks rare provided the exterior is seared on a hot grill. Hamburger meat needs to be fully cooked all the way through until all traces of pink are gone and there are only clear juices, if any. Use a metal-stem food thermometer with a range of 0 degrees F to 220 degrees F (available at most retail stores). Cook ground beef, veal or pork to an internal temperature of at least 155 degrees F. Cook beefsteak to at least 155 degrees F external temperature. Cook ground poultry (chicken or turkey) and whole poultry to an internal temperature of at least 165 degrees F. Cook whole fish fillets to a minimum internal temperature of 145 degrees F. Keep hot foods hot.

Whole eggs and egg products (includes liquid, frozen and dry eggs, along with any food containing eggs or egg products) need to be cooked to heat all parts of the food to 145 degrees F. If combined with meat or poultry, the higher temperatures for meat and poultry need to be used instead of 145 degrees F.

After cooking potentially hazardous foods to their proper temperatures, do not let the foods fall below a 130 degrees F holding temperature. It is always best to serve hot foods right off the grill, oven or rangetop after cooking.

Chill: The temperature of potentially hazardous foods such as meats (cooked or raw) should be kept at 45 degrees F or below when chilled or stored cold. Prepare coolers for keeping foods to be stored cool at 45 degrees F by using ice packs or similarly approved methods. Potentially hazardous foods, fully cooked, but which will be served cold, should be brought quickly to the desired temperature of 45 degrees F or below. If the food is bulky or in a deep pan, it is best to break the food down into smaller portions to reduce the amount of time it takes to chill it to the desired temperature.
 

Memorial Day weekend, with its cookouts, picnics and family outings, offers a perfect opportunity to contract food-borne illness.

The death of a South Carolina resident from salmonella Sunday serves as a reminder that improperly prepared food can make a person very sick and even be fatal. The South Carolina fatality has been linked to a salmonella outbreak at a Camden buffet restaurant, and health officials say at least 176 others have become ill after eating there.

Frequent culprits are raw or undercooked eggs, meat or poultry, the CDC said. When hands, utensils and cutting boards are not properly washed, cross-contamination is possible. To guard against salmonella, avoid raw or undercooked meat, poultry or eggs. That includes homemade salad dressing and cookie dough. The CDC urges careful hand washing before handling food and in between handling different types of food.
 

James Curry "Buzzy" Arledge was a man who cared about his family and his church and who loved music. That was how he was remembered Wednesday afternoon by his pastor, the Rev. Greg Allen of Camden's Malvern Hill Baptist Church.

Arledge, 58, died Sunday. His death has been linked to a salmonella outbreak at Old South Restaurant, a popular Camden buffet, state health officials said.

Arledge was "extremely active" at Malvern Hill, Allen said. He sang in the choir and frequently played acoustic guitar at the church, "mostly bluegrass, country and gospel style."

Arledge also volunteered regularly in a nursing home ministry at the church, Allen said, visiting elderly residents of several nursing facilities in Kershaw County. "He was an all-around really good guy."
 

Researchers still haven't found the source of the salmonella outbreak after spending five days studying food from the Old South restaurant in Camden.

Using left over turkey, Microbiologist Beth Johnson has to liquify the food. She then pours it into tubes and places them into an incubator where the salmonella has a chance to grow if it's there, "This black one right there could possible be salmonella."

After four days of being examined in the food lab, samples that could be some form of salmonella are sent to bacteriology for confirmation. It's off to yet another lab if it's a positive.

The DHEC Molecular Department processes the positive cultures from humans and the food to see if they are related. It could take several days before all tests are done.
 

The number of people in Camden reporting food poisoning due to salmonella symptoms has climbed to 204, as of 11:00am Wednesday. A total of 37 people have been hospitalized.

The DHEC has issued a statewide advisory due to cases being reported in Rock Hill and Charleston. They are asking anybody with food poisoning symptoms that ate at the Old South restaurant between Thursday and Sunday to get tested. Many of the people who showed symptoms ate at the Camden restaurant over the weekend.

The restaurant, believed to be the source of the outbreak, decided to shut down on Tuesday. Missy Reese with the Department of Health and Environmental Services says it was Old South's call to close its doors, but loyal regulars still consider the place a safe place to eat.
 

According to the Kershaw County Coroner Johnny Fellers, 58-year-old James Arledge died from cardiac arrhythmia due to sepsis, an infection in the blood stream, caused by salmonella poisoning.

Alredge ate at the Old South restaurant in Camden last Thursday evening. Many of the people who showed symptoms ate at the Old South restaurant in Camden over the weekend.While many are recovering from the symptoms, several people remain hospitalized.

The number of people in Camden with food poisoning symptoms has climbed to over 150. The restaurant, believed to be the source of the outbreak, decided to shut down on Tuesday.
 

Cafe Santa Fe served 300 customers Monday when the Benton restaurant reopened after being closed almost a month because of a salmonella outbreak. "We have apparently regained the confidence and trust of all our patrons," owner Herb Flores said.

Cafe Santa Fe closed voluntarily May 1 after the Health Department said nine cases of salmonella had been confirmed and linked to the restaurant. The state Health Department gave approval Monday for the restaurant to reopen after officials tested employees and inspected the restaurant.

Flores and his crew have spent hours at the restaurant training and recruiting employees in compliance with state Health Department regulations. "We're abiding by the new 178-page regulation and requirements for all food-handling organizations,” Flores said, including the installation of a light on the dishwasher that alerts when the machine is low on cleaning chemicals.

At least 71 diners became ill from what state health officials are calling a possible salmonella outbreak at a Camden restaurant late last week, and officials are investigating whether the death of a Camden man is related. 16 people had been hospitalized at four hospitals.

Missy Reese, spokeswoman for DHEC's Wateree Health District, said Monday that her office had identified the possible cases from roughly 108 interviews of people who ate at the buffet-style Old South Restaurant on DeKalb Street.

Kershaw County Coroner Johnny Fellers said his office is investigating the death either late Saturday or early Sunday of Camden resident James Arledge, 58, who exhibited similar symptoms but otherwise appeared healthy.

Reese said it could take up to two weeks for DHEC's investigation to identify the food source at Old South. The popular country buffet restaurant received an "A" rating during a DHEC inspection Monday, Reese said, the highest a restaurant can get and which it must maintain to stay open. Old South held the same rating before Thursday.
 

Suppertime at Lizard's Thicket in Columbia and one of the most popular dishes is fried chicken. The summer months are usually the time of year when the most cases of salmonella are reported.

Thicket president Bobby Williams says the best way to prevent salmonella poisoning is to cook poultry enough, "We cook all our chicken to at least 170 or 175 degrees, and once we cook it, we hold it at at least 140 degrees."

They also use thermometers to determine if the meat is thoroughly cooked all the way through.

Williams also says there's also mom's oldest lesson, "We wash our hands constantly. You can't make them wash their hands too much."

Williams recommends consumers thaw frozen meats in the refrigerator or microwave and not leave them out all day to thaw. “Other foods can be contaminated if you use the same fork or knife that touched raw meat,” he says. The foods most likely to contain the bacteria are poultry eggs and beef.
 

Shrimp is the number one seafood choice in the nation. Most of it is farm-raised in other countries and imported to the United States. But some can come from China, India, Malaysia, Peru, Thailand, and Vietnam, reported WBAL-TV in Baltimore.

"They use antibiotics that are banned in the United States for use in shrimp farms, but still use them to ward off viruses," said Andrianna Natsoulas of Public Citizen. One of those banned antibiotics is chloramphenicol -- widely used in third-world countries because it's so inexpensive.

The FDA said there's also a potential side effect that comes with chloramphenicol -- a rare blood disease called aplastic anemia that causes damage to bone marrow, rendering the body incapable of producing red blood cells.

In addition, "If you happen to get a salmonella strain, which also happens to be carrying a resistance gene, then your doctor may not be able to use certain antibiotics in terms of treating you," said Dr. Glen Morris, a specialist in infectious diseases at the University of Maryland School of Medicine.
 

KidsHealth.Org recently published an article on their site in regards to salmonella and salmonellosis, and how people can recognize the symptoms as well as prevent contracting the disease:

Signs and Symptoms:
Salmonellosis is a foodborne illness caused by the bacteria salmonella. Symptoms include nausea, vomiting, abdominal cramps, diarrhea (sometimes bloody), fever, and headache. Because many different kinds of illnesses can cause these symptoms, salmonella gastroenteritis should be diagnosed by laboratory tests that can identify the bacteria in an infected person's stool.

Once the salmonella bacteria has been identified, further testing can determine its specific type and which antibiotics can be used to treat it. The most common types of salmonella are typhimurium and enteriditis; they have been causing illness for more than 100 years. A new strain of typhimurium, DT104, is resistant to seven different antibiotics that normally would kill any salmonella strain, making treatment options more limited.

Description:
Salmonella are bacteria that cause an infection of the gastrointestinal system in humans. The bacteria can be found in water, soil, kitchen surfaces, animal feces, raw meats, poultry, and eggs. The disease is usually limited to the intestinal tract, but the salmonella organisms can spread to other parts of the body, such as blood or bone. Salmonella can cause typhoid fever, the symptoms of which include fever, abdominal pain, headache, malaise, lethargy, skin rash, constipation, and delirium.

Salmonella is usually transmitted to humans by foods contaminated with animal feces. Contaminated foods usually do not look or smell unusual. Food may also become contaminated by an infected food handler who neglected to wash his hands after using the bathroom.

Salmonella can also be found in the feces of some pets, particularly reptiles. Even healthy reptiles (especially turtles and iguanas) are not appropriate pets for small children and should not be in the same house as an infant for this reason.

Prevention:
Since salmonella appears most often in animal foods, raw or undercooked eggs, poultry, or meat should never be eaten. Cooking kills the salmonella bacteria. Poultry and meat should always be well cooked, until they are no longer pink in the center.

Some foods may contain unrecognized raw food products and should be avoided. Caesar salad dressing, the Italian dessert tiramisu, homemade ice cream, chocolate mousse, cookie dough, and frostings are all items that can contain raw eggs. Unpasteurized milk and juices can also be contaminated with salmonella.

Egg-associated salmonellosis is a health problem in the United States because the bacteria can live inside normal-looking eggs that we buy in a grocery store. Salmonella can grow within the ovaries of otherwise healthy hens and contaminates the eggs before the shells are formed. Strict procedures for cleaning and inspecting eggs were implemented in the 1970s that made infection from contamination of the outside of the eggshell much less common. Salmonella, however, can affect intact and disinfected grade A eggs and still presents a danger when raw or undercooked eggs are consumed. This means sunny-side-up or poached eggs with a soft center pose a risk of salmonellosis.

Cross-contamination is another means of spreading salmonella. Uncooked meats should be kept separate from cooked and ready-to-eat foods. Hands, cutting boards, counters, and knives should be washed thoroughly after handling uncooked foods.

Incubation:
Symptoms of salmonellosis usually appear within 2 days of contamination with the bacteria, but are usually obvious within 24 hours. As few as 15 to 20 salmonella germs can cause an infection, but not everyone who ingests the bacteria will become ill. Many factors contribute to whether someone will be affected by ingestion of salmonella, including age, general health, and immune system status.

Children, especially young infants, are the most likely candidates to become ill from salmonella ingestion, and may even need to be hospitalized.had in common.
 

According to a Toronto Star story, at least 75 people are sick and three are in hospital after eating a Mother's Day buffet tainted with salmonella bacteria last Sunday at the Royal Botanical Gardens in Burlington, Ontario. About 300 people attended the brunch and that health officials have only been able to contact about 170 and are expecting the number of ailing people to rise.

Dr. Bob Nosal, medical officer of health for the Halton Region said, "This is a very high attack rate for salmonella. Right now about 40 per cent of those contacted are ill. We usually don't see numbers that high."

The story explains that public health investigators are trying to pinpoint how the salmonella poisoning occurred, which specific foods were involved and who was to blame. They obtained 14 food samples from the buffet, which have been sent off to the Ontario Public Health Laboratory in Toronto for testing. Results are expected in a few days.
 

The Southeastern District Health Department is reporting four confirmed cases of salmonella in the Pocatello area. Salmonella is a bacterial infection generally associated with contaminated foods.

Symptoms include diarrhea, fever, and abdominal cramps 6 to 72 hours after infection. Symptoms that can last anywhere from 4 to 7 days. In some cases, it can be severe enough to require hospitalization of elderly or infants or those with weakened immune systems.

As a precaution, the health department is urging everyone to take special care when handling foods. They recommend always refrigerating foods and cooking foods thoroughly. Avoid raw foods, especially those containing eggs. Additionally, wash all cutting boards, counters, and utensils used in food preparation.
 

Bacteria acquired up to 90 percent of their genetic material from distantly related bacteria species, according to new research from The University of Arizona in Tucson. The finding has important biomedical implications because such gene-swapping, or lateral gene transfer, is the way many pathogenic bacteria pick up antibiotic resistance or become more virulent.

Being able to classify bacteria is crucial for medicine, says Howard Ochman, a UA professor of biochemistry and molecular biophysics and a member of UA's BIO5 Institute. "If you go to the doctor with strep throat he can be pretty certain that it's the result of an infection with a species of Streptococcus and can therefore prescribe an appropriate antibiotic. If you couldn't classify bacteria because they have genes from all over, doctors wouldn't be able to do this."

Ochman thinks the team's findings will stir new research in bacterial evolution. "It should be exciting to see whether gene transfer has been so widespread in other groups of bacteria, too."
 

Vienna Elementary School has learned that a person had salmonella Tuesday after they went to the doctor with diarrhea and stomach cramps, reports Katie Sabatino of WTAP News.

While this is the only confirmed case within the school, officials aren't taking any chances. The cafeteria, bathrooms, hallways, and classrooms have been disinfected and letters have been sent home to parents.

Cases of salmonella in Washington, Oregon and Idaho have been linked by public health officials to baby chicks from a Walla Walla hatchery. About a dozen people from the three states have fallen ill, reports the Tri-City Herald.

Phinney Hatchery mails about 1 million baby birds each year from Alaska to Utah. The birds also go to Tri-City-area feed stores and homes where they end up as fryers, layers or pets. "All chicks pretty much have salmonella," said Kathy Peters, part-owner of Phinney Hatchery in Walla Walla. "Just be sure to wash your hands after you handle them."

Emilio DeBess, an Oregon public health veterinarian, said some of the people who were infected didn't handle the chicks directly but had been in rooms where the chicks were kept. He said areas can easily become contaminated from bacteria in animal wastes.

Hatchery officials are cooperating with Washington health officials to determine if anything can be done to reduce the risk of salmonella infection in their operation.
 

Nine people from New Mexico and four other states have been reported with salmonella infections in the past two months, and six of those cases are linked to young poultry from a New Mexico hatchery. The state Health Department is not identifying the hatchery pending the completion of the investigation.

Seven of the nine cases in March and April were in children age 1 or younger, the New Mexico agency said. Most people recover without medication or treatment, but that young children can suffer from more severe symptoms.

Health officials recommend that young children avoid contact with poultry and that people who handle baby chicks, ducks or other poultry thoroughly wash their hands with soup and water afterward. Poultry also should be kept outdoors in an area separate from young children or sources of food.
 

A popular Benton restaurant closed Sunday after at least nine of its patrons tested positive for exposure to salmonella bacteria.

Cafe Santa Fe at 178324 Highway I-30, Benton, Arkansas has been closed.

The Health Department does not believe that any other area restaurants are affected.
 

Nine people have been diagnosed with salmonella infections in an outbreak in New Mexico, Colorado, Kansas, Texas and Oklahoma. Of the nine cases, seven were children one year old or younger. There have been three salmonella cases in New Mexico, in Taos, Roosevelt and Curry counties.

Officials said six of the nine cases have been linked to young poultry from a hatchery in New Mexico. The New Mexico Department of Health said it won't release the name of the hatchery until the investigation is completed.

Poultry can shed salmonella in their feces. Health officials said thorough hand-washing following contact with these animals is important to prevent salmonella infection. Human infection occurs when contaminated food, hands, or other objects are placed in the mouth.