Epidemiologic Notes and Reports Salmonella heidelberg
Outbreak at a Convention -- New Mexico
Of approximately 1,000 persons attending a convention October
6-8,
1985, in Santa Fe, New Mexico, 91 reported a diarrheal illness with
onset of symptoms between 10 a.m., October 7, and 11 p.m., October
12. Salmonella heidelberg, sensitive to all antibiotics tested,
was
isolated from the stools of five attendees. Three persons were
hospitalized. The ill attendees reported spending over $11,000 on
medical costs and lost 117 days of work.
A telephone survey of 76 convention attendees living in New
Mexico
showed that, of four meals consumed at the convention, only the
breakfast of October 7 was significantly associated with illness (p
0.002).
In a subsequent mail survey of the approximately 550 convention
attendees who ate the breakfast, the only food significantly
associated with illness among the 60% who responded was eggs. All
of
91 ill attendees ate the eggs, compared with 189 (92%) of 206 well
attendees (p = 0.01). Eggs served at the meal were not available
for
culture; other eggs from the same distributor were culture-negative
for Salmonella. The eggs had been cracked and stored in tall
2-gallon
containers in a walk-in refrigerator the evening before the
breakfast. They were then cooked in batches in a steamer in the
morning. Several attendees commented that the eggs seemed "runny."
Of the staff who worked at the breakfast, three reported
illness
compatible with salmonellosis with onset during the same period as
the
conventioneers, and all three had eaten the eggs. S. heidelberg
was
isolated from the stools of two staff members who did not handle
food
but had eaten the eggs.
Reported by P Weisse, E Libbey, MD, St. Vincent's Hospital, Santa
Fe,
L Nims, MS, P Gutierrez, MS, New Mexico Scientific Laboratory Div,
T
Madrid, MPA, N Weber, MS, C Voorhees, V Crocco, C Hules, S Hill,
Environmental Improvement Div, TM Ray, R Gurule, F Ortiz, District
II
Health Office, M Eidson, DVM, CM Sewell, DrPH, S Castle, MPH, P
Hayes,
Office of Epidemiology, HF Hull, MD, State Epidemiologist, New
Mexico
Health and Environment Dept; Div of Field Svcs, Epidemiology
Program
Office, CDC.
Editorial Note
Editorial Note: In the 1960s, eggs were responsible for a large
proportion of salmonellosis outbreaks. With improvements in egg
processing and quality control, egg-related outbreaks decreased
dramatically in the 1970s (1). However, as this outbreak
illustrates,
egg-related illness remains an important public health concern.
Pathogens may proliferate in eggs or in other food refrigerated in
large containers, since the center of the container may be
inadequately cooled (2). In this outbreak, the fact that many well
attendees also ate eggs suggests that only some egg containers were
contaminated, that only some eggs were cooked sufficiently to kill
the
bacteria, or that susceptibility to infection may have varied among
the attendees.
For the 10-year period 1973-1982, 11 outbreaks of salmonellosis
due to eggs were reported to CDC's Foodborne Disease Surveillance
System. Of the 307 ill people in these outbreaks, 45 (15%) were
hospitalized, and nine (3%) died (3). S. heidelberg has been
frequently associated with poultry, accounting for 29% of
Salmonella
isolates from poultry submitted to the U.S. Department of
Agriculture
in 1982 (4).
Bryan FL. Foodborne diseases in the United States associated
with
meat and poultry. J Food Protection 1980;43:140-50.
CDC. Unpublished data.
CDC. 1982 Salmonella surveillance. Atlanta, Georgia: Centers
for
Disease Control.
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