This article is more than 5 years old. Information may no longer be current.
Faulty food handling led to Salmonella outbreak at two prisons
Click Here to Manage Email Alerts
Multiple-serotype Salmonella outbreaks at two prisons in Arkansas were linked to problems with food preparation, hand washing and food safety training, according to a report by the CDC and the Arkansas Department of Health.
On Aug. 7, 2012, the Arkansas Department of Health began an investigation after learning of a diarrhea outbreak among 260 inmates in prison A. Stool specimens from seven inmates tested positive for Salmonella, and three serotypes were identified: S. anatum, S. cerro and S. heidelberg. On Aug. 14, prison B sent stool specimens from 16 inmates with diarrhea for testing. S. anatum was isolated from eight of the inmates. The pulsed-field gel electrophoresis (PFGE) patterns were indistinguishable from the S. anatum isolates from prison A inmates.
The Arkansas Department of Health interviewed 505 inmates from prison A, 440 inmates from prison B and all staff at both prisons. They identified 309 probable cases and 51 confirmed cases of Salmonella at prison A and 133 probable cases and 85 confirmed cases from prison B. All inmates assigned to the kitchen submitted stool specimens for testing, identifying 19 additional cases.
In case-control studies, the investigators found that 75.1% of the people interviewed at prison A reported consuming chicken salad on Aug. 4, and these people were more likely to have probable or confirmed illness than those who did not have chicken salad. People who became ill before the chicken salad lunch were examined. Among the 50 cases, two were kitchen workers. One had S. heidelberg and the other did not have Salmonella isolated from a stool specimen.
At prison B, 57% of the people interviewed reported consuming chicken salad on Aug. 10 and were more likely to have probable or confirmed illness than those who did not. An additional 23 food items were also associated with illness. One inmate who developed symptoms on Aug. 2 had S. anatum infection and had prepared vegetables in the kitchen. Two additional kitchen workers reported symptom onset on Aug. 6.
Of the 314 inmates who had cultured stool specimens, 155 had positive stool cultures for Salmonella. Among the 314 inmates with cultured stool specimens, 122 reported diarrhea and 70.5% of those tested positive for Salmonella. Of the 140 who did not report diarrhea, 35.7% tested positive for Salmonella. The remaining 52 inmates were kitchen workers who were not interviewed. Among them, 36.5% tested positive for Salmonella.
The investigators identified 15 PFGE patterns. Seven of those were common to both prisons and represented 78% of all stool samples that were positive for Salmonella. Six of the seven patterns were not previously isolated in Arkansas.
Investigations of the kitchen and dining facilities at both prisons revealed multiple violations of food handling regulations, including neglecting hand-washing, inadequate freezing, cooling and reheating procedures, moldy ceilings, unclean equipment and surfaces and cracked, noncleanable food storage containers, food preparation surfaces, walls and floors. Additional research of a hen house at prison B, which provided eggs to itself and other state prisons including prison A, found that some of the eggs provided during this time were positive for S. adelaide and S. cerro.
Click Here to Manage Email Alerts