NCJ Number
191282
Journal
Journal of American Medical Association Volume: 278 Issue: 5 Dated: August 6, 1997 Pages: 389-395
Date Published
August 1997
Length
7 pages
Annotation
This document describes a large outbreak of salmonellosis caused by intentional contamination of restaurant salad bars.
Abstract
In September of 1984 the public health department in Oregon received reports of persons ill with gastroenteritis who had eaten at either of two restaurants in The Dalles, Oregon, several days before symptom onset. Local and State public health officials confirmed an outbreak of Salmonella Typhimurium. A case was defined as an illness with diarrhea and at least three of the following symptoms: fever, chills, headache, nausea, vomiting, abdominal pain, or bloody stools. Cases were identified through passive surveillance. Press releases encouraged reporting by case patients and health care professionals. This outbreak of salmonellosis, affecting at least 751 persons, was caused by intentional contamination of restaurant salad bars by members of a religious commune. It was the largest outbreak of food-borne disease reported to the Centers for Disease Control in the United States in 1984. Despite extensive investigation, the source of S Typhimurium initially went unrecognized. It was not until more than a year after the outbreak that sufficient evidence had accumulated to link the religious commune with the outbreak. Essential evidence was collected during the course of criminal investigations independent from the epidemiologic field investigation. Standard practices for maintaining salad bars may be inadequate to prevent similar outbreaks in the future with salmonellae or other pathogens. In the future, if investigation of a large and cryptic outbreak implicates a mechanism of contamination that does not resemble established patterns, then the possibility of intentional contamination should be considered and law enforcement officials should be asked to undertake an independent investigation. 20 references