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Salmonella outbreak linked to pulled pork served at church festival
An outbreak of salmonellosis that caused gastroenteritis in 64 church festival attendees in 2010 was linked to consumption of pulled pork that was prepared in a private home and sold at the festival, according to a report in MMWR.
On June 18, 2010, the Hamilton County Public Health (HCPH) in Ohio received reports of illness among attendees of the festival, which took place June 11 to 13. They confirmed the presence of Salmonella enterica serotype Typhimurium in three patients’ stool specimens.
The index patient developed symptoms on June 14. Two of the patients’ household contacts also were ill. The most common symptoms were diarrhea (97% of patients), cramps (68%) body ache (61%), fever (58%) and headache (55%). Four patients with diarrhea also reported having bloody diarrhea. The median duration of illness was 5 days.
The HCPH linked the illnesses to the church festival, which had an estimated 9,000 attendees. There were 15 food vendors at the festival and none were licensed or inspected by the HCPH because religious organizations are exempt from licensure requirements in Ohio. Because the outbreak was not reported until after the festival concluded, the investigation was limited to food handler interviews.
Several of the 64 people with illness reported consuming pulled pork and/or coleslaw served by a single vendor on the last day of the festival. The researchers conducted a matched case-control study to determine the risk factor for illness. Thirteen match sets, including 23 case patients and 30 controls, were included in the analysis.
Of the 51 food items that were evaluated as potential sources of infection, only pulled pork and coleslaw were significantly associated with the outbreak. All of the case patients ate the pulled pork, as did four of the controls, for a matched OR of 58.9. The matched OR for consuming coleslaw was 26.2.
The pork had been prepared in a private home. The vendor reported that it had been cooked to an internal temperature of 180°F, cooled in a residential refrigerator set at less than 41°F and reheated at the festival. The vendor could not confirm the time and temperature parameters of the reheating process.
“The results of the investigation underscore the risk associated with food service at large-scale events and the importance of rapid investigation to determine the cause of foodborne outbreaks in these environments,” the investigators wrote. “Although prevention measures are effective, a breakdown in food handling procedures, such as improperly cooked or stored meat or cross-contamination, can lead to pathogen exposure.”