I'm almost getting too paranoid to travel. In August I blogged about the Cyclospora
outbreak that was affecting 16 states and linked back to lettuce used by
several restaurant chains including one that I had eaten at while on a trip to
Michigan and Massachusetts. I just got
back from San Fran on Sunday and wouldn't you know it, by Monday I was reading
about a Salmonella outbreak that is currently circulating around 17 states
across the US with California being the hardest hit. I was under the weather for a few days while
on this trip. I did eat some chicken
while there, but can't say that food was the true cause.
As of October 7, 2013, a total of 278 persons infected
with seven outbreak strains of Salmonella Heidelberg have been reported from 17
states. Of these cases, 42% of ill
persons have been hospitalized, but no deaths have been reported. Illness onset
dates range from March 1 to September 24, 2013 with a range in age from <1
year to 93 years. The median is age of
20 years and 51% percent of ill persons are male (can we say beer, chicken
wings and Monday Night Football?).
The on-going outbreak investigations conducted by local,
state, and federal officials indicate that consumption of Foster Farms brand
chicken is the likely source of this outbreak of Salmonella Heidelberg
infections. The outbreak strains associated with the outbreak are resistant to
several commonly prescribed antibiotics which may be associated with an
increased numbers of hospitalizations seen thus far. While it is not unusual for raw poultry from
any producer to have Salmonella bacteria, it is uncommon to have
multidrug-resistant Salmonella bacteria.
Salmonella is a
rod-shaped, gram-negative, non-spore-forming bacteria. In the US, there approximately 42,000 cases
of salmonellosis reported each year, but because many milder cases are not
diagnosed or reported, the actual number of infections may be twenty-nine or
more times greater. Most persons
infected with Salmonella bacteria develop diarrhea, fever, and abdominal cramps
12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most
persons recover without treatment. Salmonella bacteria can survive for weeks
outside a living body, and they are not destroyed by freezing.
Salmonella can be transmitted both by direct and indirect
contact through a number of ways as listed below, but basically, you're eating
poop:
• Infected or contaminated food;
• Poor kitchen hygiene, especially problematic in
institutional kitchens and restaurants because this can lead to a significant
outbreak;
• Excretions from either sick or infected but apparently
clinically healthy people and animals;
• Polluted surface water and standing water (such as in
shower hoses or unused water dispensers);
• Unhygienically thawed fowl;
• An association with reptiles (pet tortoises, snakes,
iguanas, aquatic turtles, and also amphibians (frogs)
In healthcare facilities, high touch surfaces are often
contaminated with nosocomial pathogens, and may serve as vectors for
cross-transmission. While Salmonella is
typically associated with eating of contaminated food a study that investigated
the degree of pathogen transfer from contaminated surfaces to hands showed that
transmission to hands occurred 100% of the time with Salmonella spp.,
Escherichia coli, and Staphylococcus aureus.
As hand hygiene compliance rates for healthcare workers is around 50 %
at best, the risk of transmission from contaminated surfaces cannot be
overlooked.
The best way to avoid any type of direct contact with
Salmonella is to immediately wash your hands and all contaminated surfaces
after every use. Surfaces that are reused in the kitchen such as countertops
and food prep areas should be cleaned and sanitized in order to kill off
bacteria. Surfaces within a patient's
room infected with Salmonella should be cleaned and disinfected daily and
healthcare workers and visitors should be vigilant with hand hygiene.
Let's hope that thawing a turkey in a cooler is
considered hygienic! I'd hate to be the
cause of a Salmonella outbreak at the Canadian Thanksgiving Dinner I'm hosting
on Saturday....
Bugging Off!
Nicole
