Published Date: 2007-01-16 00:00:00
Subject: PRO/AH/EDR> Salmonellosis, meat slicer - USA (GA): 2006
Archive Number: 20070116.0208
SALMONELLOSIS, MEAT SLICER - USA (GEORGIA): 2006
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri, 12 Jan 2007
From: ProMED-mail <firstname.lastname@example.org>
Source: Valdosta Daily Times [edited]
On 13 Sep 2006, the Georgia Public Health Laboratory (GPHL) contacted
the Notifiable Diseases Epidemiology Section (NDES) of the South
Georgia Health District (SGHD) that the lab had received 8
_Salmonella [enterica_ serotype] Montevideo isolates from South
Georgia Medical Center between 28 Aug to 5 Sep 2006, according to a
report filed by the Department of Human Resources Division of Public Health.
On average, Lowndes County reports approximately 5 cases per year of
Salmonella Montevideo infection. Due to the drastic increase in
cases, an investigation was initiated to determine whether or not the
cases represented an outbreak in the area and if a common source
could be identified amongst the patients, according to the report. A
questionnaire was developed to evaluate sources of possible exposure
including animal contact, water sources, grocery stores, restaurants
and specific food, according to the report.
Following the investigation and interviewing patients infected, 72
cases of serotype Montevideo infections with indistinguishable
patterns were reported with the onset of gastrointestinal illness
between 21 Aug and 15 Nov 2006, and investigators were able to
determine the outbreak strain, according to the report. Of the 72
cases, 19 patients were hospitalized and no deaths were reported,
according to the report.
Following interviews of 52 of the 72 patients, the investigation
revealed that a common fast food restaurant in Valdosta was the
source of the outbreak strain. Of those interviewed, 82 percent
reported that they had most likely eaten at the restaurant in the 7
days before symptoms began.
On 6 Oct 2006, the director of Environmental Health for the South
Georgia Health District, was notified by investigators that the fast
food restaurant Arby's was considered a possible source for the
outbreak. A Lowndes County Environmental Health specialist inspected
the restaurant and found no major violations as investigators
continued interviews with patients, according to the report.
Interviews continued to point toward the common restaurant as the
source. On 19 Oct 2006, local health officials as well as a
representative of the CDC met with the district manager and manager
at the restaurant. The meeting included discussions regarding sources
of food served, food preparation, cleaning of equipment and employee
health and hygiene, according to the report. During that visit, 10
swab samples were taken from surfaces in the restaurant and delivered
to GPHL and tested for Salmonella.
Investigators found that the restaurant had been closed for
remodeling and reopened on 18 Aug 2006, and was utilizing a brand new
meat slicer following the reopening. On 25 Oct 2006, 19 days after
the restaurant was identified as the possible source of the outbreak,
GPHL reported that one of the swab samples collected from the new
meat slicer was positive for the Salmonella outbreak strain and the
slicer was immediately removed from service. All food items that may
have been in contact with the slicer were thrown away and additional
food items were collected for testing, according to the report. That
same day 31 additional samples were taken from the restaurant. Though
the new slicer had been cleaned and sanitized, the organism was still
detected on the blade cover.
According to restaurant staff, the equipment was cleaned several
times a day and was disassembled and sanitized each night. The cause
of the problem was determined to be a faulty piece on the equipment,
which according to the manufacturer, should have been sealed with
silicone. The piece was not sealed as it should have been when it was
inspected by investigators, according to the report.
The report's discussion concluded that though the initial cause of
the salmonella was not discovered, salmonella persisted between the
blade cover and handle due to lack of a seal in spite of frequent
cleaning just after the restaurant reopened.
Control measures taken by the SGHD included removal of the slicer and
the discarding of all potentially contaminated foods. The restaurant
returned the slicer to the manufacturer, who has issued a lookout to
other restaurants with the same product to inspect the handle. The
restaurant chain is also conducting an internal investigation into
the possible source of salmonella contamination of the blade cover,
according to the report. No exposure to the outbreak strain was
identified after the slicer was removed from the restaurant 25 Oct
2006, according to the report.
[Byline: Kelli Hernandez]
[Although from several months ago in 2006, the outbreak investigation
and findings underscore the role of inanimate objects in a continuing
food-borne cluster of salmonellosis. Also in 2006, the salmonellosis
cluster in the UK due to chocolate was related to serotype Montevideo.
A map showing the location of Valdosta in southern Georgia can be
found at: <http://pics2.city-data.com/city/maps/fr792.gif>. - Mod.LL]