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Salmonella hindmarsh outbreak in Sachkhere, Georgia, 2011

2012; Elsevier BV; Volume: 16; Linguagem: Inglês

10.1016/j.ijid.2012.05.426

1878-3511

Marina Lashkarashvili, K. Galdavadze, Lia Tevzadze, Marika Geleishvili, Thomas Rush, E F Maes,

Bacillus and Francisella bacterial research

Background: On October 16, 2011, Sachkhere Public Health Center notified Georgia NCDC regarding an outbreak of diarrhea among persons who attended a dinner together. We investigated to verify the outbreak, reveal risk factors and implement preventive measures. Methods: We conducted a cohort study among dinner participants and active surveillance for persons with diarrhea (case definition: three loose stools/day) at nearby clinics. We collected demographic, clinical, and food history data for participants via questionnaire and medical record review of persons hospitalized or visiting clinics. Food storage, transportation and handling conditions were also evaluated. Results: Fifty-three persons attended the dinner; 32 met the case definition of diarrhea. (attack rate = 60%). Case-patients were 1-71 years of age (median = 41); 23 (72%) were female, 2 (6%) were hospitalized, 15 (47%) were outpatients. Other symptoms included chill and high fever 30 (94%), stomach ache 28 (88%), weakness 26 (81%), nausea 21 (66%), and vomiting 16 (50%). Salmonella hindmarsh was isolated from four clinical samples. We identified two risk factors, cutlet and dolma; both contained cooked pork and beef mince-meat. The risk ratio (RR) for dolma consumption was 2.0 (95% CI 1.3-3.1), for cutlet consumption RR = 3.9 (1.9-7.8), for cutlet and dolma consumption versus neither product RR = 5.2 (95% CI 2.1–12.7). RR(Mantel-Haenszel) for cutlet consumption stratified by dolma consumption was 3.9 (95% CI 1.9-7.8); RR(M-H) for dolma stratified by cutlet was 2.0 (95% CI 1.4-3.1). Investigation revealed that meats were stored at room temperature overnight prior to cooking; food samples were unavailable for analysis. Conclusion: The outbreak was most likely caused by undercooked meat items, inadequate food storage, and possible cross contamination. Participants were instructed in the importance of meat refrigeration and proper food preparation and cooking.