Salmonella Blog - Surveillance & analysis on salmonella news & outbreaks

16 of the 172 people sickened from the salmonella outbreak live in Kentucky, according to Patrick Howington of the Courier-Journal. In addition, one person in Indiana, and at least 155 people in 16 other states have all been infected by salmonella.

Health officials are still investigating the outbreak but believe it may have been caused by produce.

No one has died in the outbreak.
 

The term Salmonella refers to a group or family of bacteria that variously cause illness in humans. Salmonella serotype typhimurium and Salmonella serotype enteritidis are the most common in the United States. Salmonella has been known to cause illness for over 100 years. Salmonella javiana is the fifth most common serotype in the United States and accounted for 3.4% of Salmonella isolates reported to the CDC during 2002. See “Outbreak of Salmonella serotype javiana infections—Orlando, Florida, June 2002,” MMWR Weekly, August 9, 2002/51(31); 683-84. And of the Salmonella outbreaks that occurred from 1985 through 1999, “[f]ive hundred twenty-two (62%) outbreaks of S. Enteritidis infection were associated with food prepared at commercial food establishments (restaurants, caterers, delicatessens, bakeries, cafeteria, or market).” See Patrick ME, et al. “Salmonella Enteritidis infections, United States, 1985–1999,” Emerg Infect Dis [serial online] 2004.

Where Does Salmonella Come From?

Salmonella is an enteric bacterium, which means that it lives in the intestinal tracts of humans and other animals, including birds. Salmonella bacteria are usually transmitted to humans by eating foods contaminated with animal feces or foods that have been handled by infected food service workers who have practiced poor personal hygiene. Contaminated foods usually look and smell normal. Contaminated foods are often of animal origin, such as beef, poultry, milk, or eggs, but all foods, including vegetables, may become contaminated. Many raw foods of animal origin are frequently contaminated, but thorough cooking kills Salmonella. The food handler who neglects to thoroughly wash his or her hands with soap and warm water after using the bathroom may contaminate foods that have otherwise been properly prepared.

What are the Symptoms of Salmonellosis?

Once in the lumen of the small intestine, the bacteria penetrate the epithelium, multiply, and enter the blood within 24 to 72 hours. Variables such as the health and age of the host and virulence differences among the serotypes affect the nature of the diagnosis. Infants, the elderly, individuals hospitalized, and the immune-suppressed are the populations that are the most susceptible to disease and suffer the most severe symptoms.

“The majority of persons infected with Salmonella have diarrhea, fever, and abdominal cramps 12-72 hours after exposure. The illness usually lasts 4-7 days, and the majority of persons recover without treatment.” MMWR Weekly, supra at 684. The acute symptoms of Salmonella gastroenteritis include the sudden onset of nausea, abdominal cramping, and bloody diarrhea with mucous. As already noted, there is no real cure for a Salmonella infection; treatment, therefore, tends to be palliative – although prescription of antibiotics is common, even if usually contraindicated.

Medical treatment is acutely important if the patient becomes severely dehydrated or if the infection spreads from the intestines. Persons with severe diarrhea often require re-hydration, usually with intravenous fluids. Antibiotics are not necessary or indicated unless the infection spreads from the intestines, and then it can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin. Unfortunately, some Salmonella bacteria have become resistant to antibiotics, largely as a result of the use of antibiotics to promote the growth of feed animals.

Medical Complications that can arise from a Salmonella Infection

People infected with Salmonella usually recover without medical treatment in six to ten days. It may be several months, however, before their susceptibility to diarrhea and gastrointestinal distress disappears. “Although younger individuals usually face far higher infection rates from these pathogens, older adults are more likely to have more severe complications.” See J. Busby, “Older Adults at Risk of Complications from Microbial Foodborne Illness,” Food Review, Vol. 25, Issue 2, pp. 30-35, at 32, Summer-Fall, 2002. In addition, “the elderly are far more susceptible to death from Salmonella infections than the general population.” Id.

Several bacteria, including Salmonella, induce septic arthritis. See J. Lindsey, “Chronic Sequellae of Foodborne Disease,” Emerging Infectious Diseases, Vol. 3, No. 4, Oct-Dec, 1997. The resulting joint pain and inflammation can resolve completely over time or permanent joint damage can occur. Id. In a small number of persons, the joint inflammation is accompanied by conjunctivitis (inflammation of the eyes), and uveitis (painful urination). Id. This triad of symptoms is called Reiter's Syndrome. Id. Reiter’s Syndrome is a special form of reactive arthritis, autoimmune disorder triggered by the Salmonella infection. It occurs in persons with a genetic predisposition and can last for a year or more. Antibiotic treatment does not make a difference in whether or not the person later develops arthritis.

The CDC has announced that at least 172 people in 18 states had been confirmed ill with Salmonellosis as part of a nation-wide outbreak of Salmonella typhimurium infections. Eleven people have been hospitalized.

An ongoing investigation indicates that contaminated produce, possibly tomatoes, is the source of the outbreak. The CDC has announced that the Food and Drug Administration is working to help trace the source of the outbreak.

“When the FDA is involved, there’s a pretty good chance that a fruit or vegetable is the source,” said Bill Marler, an attorney who has represented thousands of victims of foodborne illness outbreaks, including 93 victims of the most recent E. coli O157:H7 outbreak traced to contaminated spinach, 30 victims of a Salmonella outbreak traced to foods served at an Indiana Wal-Mart this summer, and 128 victims of a 2004 Salmonella outbreak traced to contaminated tomatoes served at Sheetz convenience stores.
 

A salmonella outbreak potentially linked to produce has sickened at least 172 people in 18 states, reports KARE11 News.

Health officials think the bacteria may have spread through some form of produce -- the list of suspects includes tomatoes. But the illnesses have not been tied to any specific product, chain, restaurants or supermarkets.

No one has died in the outbreak, which stems from a common form of salmonella bacteria. Eleven people have been hospitalized, health officials said.

"We're very early in the investigation," said Dave Daigle, a spokesman for the CDC.

Health officials estimate that more than 1.4 million cases of salmonellosis occur in the U.S. each year. About 1.3 million of those cases come from food.
 

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

The number of peopled sickened from a salmonella outbreak in Camden grew to 287 on Saturday, with 50 hospitalized. The death of 58-year-old James Arledge has been linked to the outbreak, which affected those who ate at the Old South Restaurant between May 19-22.

The Department of Health and Environment Control issued a statewide public health advisory Wednesday, a day after the restaurant voluntarily closed and two days after the buffet was inspected and received an "A" rating.

The DHEC tries to quickly notify people who might have been affected by a food-borne illness, and the situation in Camden is "very rare."
 

State and local public health officials have cleared Margaritas restaurant to reopen in Canton, Connecticut, six days after the Tex-Mex eatery was ordered to close because of an outbreak of salmonella.

Of the 15 customers who contracted the bacteria after eating at the restaurant, 4 were hospitalized. No other outbreaks were reported in the state during that time.

The source of the contamination has yet to be found. At least one food sample, containing fresh produce, is still being tested.
 

A team led by Liang Shi, staff scientist at the Department of Energy's Pacific Northwest National Laboratory, has turned up a suspect protein that may hold the key to controlling salmonella outbreaks, reports the PNNL Newsroom.

The discovery of the protein, dubbed STM3117, allowed the researchers to subsequently crippled the microbe's ability to multiply inside macrophages.

Drug and vaccine designers armed with this mouse-model information can target chemicals or immune responses that disrupt peptidoglycan synthesis and other processes linked to Salmonella's colonization of macrophages in humans. A quick identification of these proteins could also help physicians assess the virulence of a given strain.

The work was funded by PNNL and the National Institutes of Health's National Institute of Allergy and Infectious Diseases, and much of the work was performed at the PNNL-based W.R. Wiley Environmental Molecular Sciences Laboratory.
 

The Daily Globe has reported that a settlement has been reached regarding the salmonella outbreak at a nursing home in Michigan last year.

Keith Anderson of Newport Heights in Ironwood, filed a lawsuit against Lawrence, Laureen and John Kutz, the Villa Maria Health and Rehabilitation Center, Sky View Nursing Center and Lexington Insurance Company.

He claimed a salmonella bacteria spreading throughout the Sky View and Villa Maria nursing homes in Hurley was a 'substantial factor in contributing to the illness, infection, and death of his mother.'

Anderson and Lexington Insurance Company reached a settlement on Sept. 27. The case was dismissed by Iron County Circuit Court Judge Patrick Madden and court documents were sealed, Ransanici said.
 

The community of Canton, Connecticut continues to support the local restaurant, Margaritas, after the recent salmonella outbreak. The source of the outbreak is still under investigation.

When it comes time to get local businesses to support a community event or charity, Margaritas restaurant owner Dan Garza is one of the first names that comes to mind in the community. Whether raising money to send care packages to soldiers overseas or volunteering to organize Sam Collins Day, Garza has been there to help.

Now people are lining up behind Garza as health officials continue to investigate what led to a possible rare outbreak of salmonella that sickened at least 10 people before the restaurant was closed Friday.
 

Health officials are investigating a salmonella outbreak at Margaritas Restaurant in Canton, Connecticut.

Ten people who ate at Margaritas between Sept. 21-27 became ill and all were found to have the same strain of the salmonella bacteria. Two of the 10 had to be hospitalized.

Health officials recommend that anyone who patronized at the restaurant from Sept. 21 to the present and becomes ill within seven days of eating there, should inform their doctor about possible exposure.
 

The recent spinach-borne E. coli outbreak that sickened nearly 200 Americans does not mean that the United States has been lax in trying to improve food safety, reports the Southern Illinoisian. Rather, it means that there is more work to be done.

Sickness caused by spinach grown in essentially one California location spread to nearly half of all states within just a few days of the first case being reported. Such are the risks when large agricultural operations are efficient, in part, because of their ability to quickly distribute food - be it produce, meat or seafood - to all corners of the country.

The solution is not to slow down the delivery of food or restrict distribution patterns, says the Southern Illinoisian. The answer is, in part, to do more mandatory inspection and record keeping of all foods, similar to changes the U.S. Department of Agriculture already has made in the handling of beef and poultry, adjustments that have contributed to the declining rates of E. coli and salmonella in the past decade.
 

State health officials confirmed three more salmonella cases in the Sierra Vista area, raising the number investigated to 24.

The cause of the outbreak remains unknown.

A cluster of salmonella was first identified last week in the area when 20 confirmed cases were reported, mostly in young children and adults.
 

 Puget Sound Business Journal (Seattle)

Clay Holtzman
Full Story

For 13 years, Seattle attorney William Marler has made a name for himself as the E. coli lawyer. Food service companies, vendors and manufacturers fear him like bacteria fear penicillin. Marler was quoted as saying, "I hope so. We're really good at what we do."
The six-lawyer practice of Marler and Clark LLP specializes in suing producers and manufacturers accused of selling tainted food products. Its clients have received combined settlements and verdicts of more than $250 million. That includes the famous 1993 Jack in the Box E. coli case in Washington state.
Today Marler is tracking the nationwide outbreak of E. coli illnesses tied to bagged spinach. The outbreak has been linked to 183 illnesses in 26 states, according to The Wall Street Journal, including at least one death. Marler is representing 81 of those, including, he says, two deaths that have yet to be announced.

Scientists at Pacific Northwest National Laboratory have identified a protein in Salmonella bacteria that enables it to infect immune cells called macrophages.

Salmonella, which causes food poisoning, slips unnoticed and multiplies inside macrophages - immune system cells on which the body relies to seek and destroy the invading microbes.

To date, it has been almost impossible and extremely complicated to determine how Salmonella escapes detection by macrophages.

A team led by Liang Shi of the Department of Energy's Pacific Northwest National Laboratory has identified a suspect protein. The discovery of the protein would now enable the scientists to cripple the microbe's ability to multiply inside macrophages.