In July 2014 public health investigators in California learned of an increase of case patients diagnosed with Salmonella serotype Montevideo. The California Department of Public Health (CDPH) Microbial Disease Laboratory (MDL) conducted pulsed field gel electrophoresis (PFGE) on isolates cultured from patient specimens. Seven patients were infected with an indistinguishable genetic strain identified as JIXX01.0645, an uncommon genetic strain. Patients resided in Ventura and Los Angeles counties. Information gathered in interviews conducted by local health investigators revealed that just prior to onset of symptoms; all seven patients had eaten at Brent’s Deli, a restaurant located in Westlake Village, California. Health officials initiated active surveillance of patients diagnosed with Salmonella Montevideo strain JIXX01.0645. In total 19 patients infected with strain JIXX01.0645 were identified. Two additional patients were infected with strain JIXX01.1565, considered to be a clonal derivative of the main outbreak strain. Two of the 21 patients were employees of Brent’s Deli. Eight patients were hospitalized. Dates of illness onset ranged from April 30, 2014 to August 15, 2014. See Outbreak Investigation Timeline.
On July 9, 2014 environmental health staff at the County of Ventura Environmental Health Division conducted an on-site inspection at Brent’s Deli. Multiple food safety violations were noted including improper sanitation, cooling and storage issues. The restaurant manager was instructed to correct all violations immediately. A follow-up inspection was conducted on July 22. Major food safety violations were again noted. Specifically, potentially hazardous foods were not held at or below 41 degrees and were not properly cooled. Wiping cloths were not stored in a sanitizing solution between uses. The inspector observed an employee not properly washing hands before handling food or clean utensils. A refrigerator was not operating properly. Plumbing fixtures were leaking and in disrepair. Floor surfaces were damaged preventing adequate cleaning. These items were corrected by the next inspection conducted on July 29. Due to continuing reports of ill customers, Ventura County Environmental Health staff conducted another inspection on August 11. Violations included inadequate hot holding temperatures for corned beef and improper thawing. On August 12 the restaurant was closed and a third party company was hired to oversee cleaning. Stool specimens were collected from employees who were also required to attend training classes on proper food safety practices. Food and environmental samples were collected for testing. Tests showed that two employees were positive for Salmonella Montevideo, strain JIXX01.0645. None of the environmental samples was positive for Salmonella. None of the food samples was positive for Salmonella. The restaurant was allowed to reopen on August 13. Inspections continued to occur between August 14 and August 19. An inspection was conducted during the week of September 12 and no violations were noted. The outbreak investigation was closed on October 1, 2014 after no reports of illnesses had been received since August 16, 2014. See Inspection Reports.