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Venkat H, Matthews J, Lumadao P, Caballero B, Collins J, Fowle N, Kellis M, Tewell M, White S, Hassan R, Classon A, Joung Y, Komatsu K, Weiss J, Zusy S, Sunenshine R. Salmonella enterica Serotype Javiana Infections Linked to a Seafood Restaurant in Maricopa County, Arizona, 2016. J Food Prot 2018; 81:1283-1292. [PMID: 29985066 PMCID: PMC6309180 DOI: 10.4315/0362-028x.jfp-17-494] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
On 10 August 2016, the Maricopa County Department of Public Health identified culture-confirmed Salmonella enterica serotype Javiana isolates from two persons who reported eating at a seafood restaurant; seven additional cases were reported by 15 August. We investigated to identify a source and prevent further illness. We interviewed persons with laboratory-reported Salmonella Javiana infection. Pulsed-field gel electrophoresis (PFGE) and whole genome sequencing of isolates were performed. A case was defined as diarrheal illness in a person during July to September 2016; confirmed cases had Salmonella Javiana isolate yielding outbreak-related PFGE patterns; probable cases had diarrheal illness and an epidemiologic link to a confirmed case. Case finding was performed (passive surveillance and identification of ill meal companions). A case-control study assessed risk factors for Salmonella Javiana infection among restaurant diners; control subjects were chosen among meal companions. No restaurant workers reported illness. Foods were reportedly cooked according to the Food Code. Food and environmental samples were collected and cultured; Salmonella Javiana with an indistinguishable PFGE pattern was isolated from portioned repackaged raw shrimp, halibut, and a freezer door handle. We identified 50 Salmonella Javiana cases (40 confirmed and 10 probable); illness onset range was from 22 July to 17 September 2016. Isolates from 40 patients had highly related PFGE patterns. Thirty-three (73%) of 45 patients interviewed reported eating at the restaurant. Among 21 case patients and 31 control subjects, unfried cooked shrimp was associated with illness (odds ratio, 6.7; 95% confidence interval, 1.8 to 24.9; P = 0.004). Among restaurant diners, laboratory and case-control evidence indicated shrimp as the possible outbreak source; poor thermal inactivation of Salmonella on shrimp is theorized as a possible cause. Cross-contamination might have prolonged this outbreak; however, the source was not identified and highlights limitations that can arise during these types of investigations.
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Affiliation(s)
- Heather Venkat
- 1 Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service Program, Division of Scientific Education and Professional Development, 1600 Clifton Road, Atlanta, Georgia 30333.,2 Maricopa County Department of Public Health, 4041 North Central Avenue, Phoenix, Arizona 85012.,3 Arizona Department of Health Services, 150 North 18th Avenue, Phoenix, Arizona 85007
| | - James Matthews
- 2 Maricopa County Department of Public Health, 4041 North Central Avenue, Phoenix, Arizona 85012
| | - Paolo Lumadao
- 4 Maricopa County Environmental Services, 1001 North Central Avenue, Phoenix, Arizona 85004
| | - Blanca Caballero
- 3 Arizona Department of Health Services, 150 North 18th Avenue, Phoenix, Arizona 85007
| | - Jennifer Collins
- 2 Maricopa County Department of Public Health, 4041 North Central Avenue, Phoenix, Arizona 85012
| | - Nicole Fowle
- 2 Maricopa County Department of Public Health, 4041 North Central Avenue, Phoenix, Arizona 85012
| | - Marilee Kellis
- 3 Arizona Department of Health Services, 150 North 18th Avenue, Phoenix, Arizona 85007
| | - Mackenzie Tewell
- 3 Arizona Department of Health Services, 150 North 18th Avenue, Phoenix, Arizona 85007
| | - Stacy White
- 5 Arizona State Public Health Laboratory, 250 North 17th Avenue, Phoenix, Arizona 85007
| | - Rashida Hassan
- 6 CDC Division of Foodborne, Waterborne, and Environmental Diseases, 1600 Clifton Road, Atlanta, Georgia 30333; and
| | - Andrew Classon
- 6 CDC Division of Foodborne, Waterborne, and Environmental Diseases, 1600 Clifton Road, Atlanta, Georgia 30333; and
| | - Yoo Joung
- 6 CDC Division of Foodborne, Waterborne, and Environmental Diseases, 1600 Clifton Road, Atlanta, Georgia 30333; and
| | - Kenneth Komatsu
- 3 Arizona Department of Health Services, 150 North 18th Avenue, Phoenix, Arizona 85007
| | - Joli Weiss
- 3 Arizona Department of Health Services, 150 North 18th Avenue, Phoenix, Arizona 85007
| | - Scott Zusy
- 4 Maricopa County Environmental Services, 1001 North Central Avenue, Phoenix, Arizona 85004
| | - Rebecca Sunenshine
- 2 Maricopa County Department of Public Health, 4041 North Central Avenue, Phoenix, Arizona 85012.,7 CDC Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Division of State and Local Readiness, 1600 Clifton Road, Atlanta, Georgia 30333, USA
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Hlavsa MC, Roellig DM, Seabolt MH, Kahler AM, Murphy JL, McKitt TK, Geeter EF, Dawsey R, Davidson SL, Kim TN, Tucker TH, Iverson SA, Garrett B, Fowle N, Collins J, Epperson G, Zusy S, Weiss JR, Komatsu K, Rodriguez E, Patterson JG, Sunenshine R, Taylor B, Cibulskas K, Denny L, Omura K, Tsorin B, Fullerton KE, Xiao L. Using Molecular Characterization to Support Investigations of Aquatic Facility-Associated Outbreaks of Cryptosporidiosis - Alabama, Arizona, and Ohio, 2016. MMWR Morb Mortal Wkly Rep 2017; 66:493-497. [PMID: 28520707 PMCID: PMC5657643 DOI: 10.15585/mmwr.mm6619a2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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