Skip to main content
    • Aa
    • Aa

Large Salmonella Enteritidis outbreak with prolonged transmission attributed to an infected food handler, Texas, 2002

  • M. E. BEATTY (a1) (a2), G. SHEVICK (a3), K. SHUPE-RICKSECKER (a3), E. BANNISTER (a4), A. TULU (a4), K. LANCASTER (a4), N. ALEXANDER (a1), D. E. ZELLNER (a1), E. LYSZKOWICZ (a1) and C. R. BRADEN (a1)...

In March 2002, an outbreak of Salmonella Enteritidis (SE) infections occurred at a convention centre in Dallas, Texas and continued for 6 weeks. We conducted epidemiological studies, obtained clinical and environmental cultures, and interviewed employees to identify risk factors for infection. From 17 March–25 April 2002, the implicated hotel kitchen catered 41 multi-day conferences attended by 9790 persons. We received 617 illness reports from residents of 46 states. Sauces or items served with sauces were implicated in three cohort studies. SE phage-type 8 was identified as the agent. Eleven food service employees, including one who prepared sauces and salsa, had stool cultures that yielded SE. Although the original source was not determined, prolonged transmission resulted in the largest food handler-associated outbreak reported to date, affecting persons from 46 US states. Transmission ended with implementation of policies to screen food handlers and exclude those whose stool cultures yielded salmonellas.

Corresponding author
*Author for correspondence: M. Beatty, M.D., M.P.H., Pediatric Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, San 4-8 Bongcheon-7-dong, Kwanak-gu, Seoul, Republic of Korea151-919. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1.  C Hedberg , An outbreak of Salmonella Enteritidis infection at a fast-food restaurant: implications for foodhandler-associated transmission. Journal of Infectious Disease 1991; 164: 11351140.

4.  N Khuri-Bulos , Foodhandler-associated Salmonella outbreak in a University Hospital despite routine surveillance cultures of kitchen employees. Infection Control and Hospital Epidemiology 1994; 15: 311314.

5.  A Faustini , An outbreak of Salmonella hadar associated with food consumption at a building site canteen. European Journal of Epidemiology 1998; 14: 99106.

6.  ME Patrick , Salmonella Enteritidis infections, United States, 1985–1999. Emerging Infectious Diseases 2004; 10: 17.

10.  U Skibsted , Random amplification of polymorphic DNA, pulsed-field electrophoresis and phage-typing in the analysis of a hospital outbreak of Salmonella Enteritidis. Journal of Hospital Infection 1998; 38: 207216.

17.  JV Campbell , An outbreak of Salmonella serotype Thompson associated with fresh cilantro. Journal of Infectious Disease 2001; 183: 984987.

18.  JA Adachi , Enteric pathogens in Mexican sauces of popular restaurants in Guadalajara, Mexico, and Houston, Texas. Annals of Internal Medicine 2002; 136: 884887.

19.  TW Hennessy , A national outbreak of Salmonella Enteritidis infections from ice cream. New England Journal of Medicine 1996; 334: 12811286.

21.  DS Buchwald , MJ. Blaser A review of human Salmonellosis II. Duration of excretion following infection with nontyphi Salmonella. Reviews of Infectious Diseases 1984; 6: 345355.

22.  CR Braden . Salmonella enterica serotype Enteritidis and eggs: a national epidemic in the United States. Clinical Infectious Diseases 2006; 43: 512517.

24.  C Wheeler , An outbreak of Hepatitis A associated with green onions. New England Journal of Medicine 2005; 353: 890897.

27.  CW Hedberg , Outbreaks of salmonellosis associated with eating uncooked tomatoes: implications for public health. Epidemiology & Infection 1999; 122: 385393.

28.  CK Bower , MA Daeschel . Resistance responses of microorganisms in food environments. International Journal of Food Microbiology 1999; 50: 3344.

31.  MS Dryden , Asymptomatic food handlers as the source of nosocomial salmonellosis. Journal of Hospital Infections 1994; 28: 195208.

33.  JVS Pether , RJD Scott . Salmonella carriers are the dangerous? A study to identify finger contamination with salmonellae by convalescent carriers. Journal of Infection 1982; 5: 8185.

35.  B Imhoff , Burden of self-reported acute diarrheal illness in FoodNet surveillance areas, 1998–1999. Clinical Infectious Diseases 2004; 38 (Suppl.): 219226.

36.  M Kuusi , Internet use and epidemiologic investigation of gastroenteritis outbreak. Emerging Infectious Diseases 2004; 10: 447450.

37.  LM Fox , Emergency survey methods in acute cryptosporidiosis outbreak. Emerging Infectious Diseases 2005; 11: 729731.

38.  P Srikantiah , Web-based investigation of multistate salmonellosis outbreak. Emerging Infectious Diseases 2005; 11: 610612.

39.  TK Schleyer , JL Forrest . Methods for the design and administration of web-based surveys. Journal of the American Medical Informatics Association 2000; 7: 416425.

40.  TS Ghosh , Internet- versus telephone-based local outbreak investigations. Emerging Infectious Diseases 2008; 14: 975977.

42.  JH Pryor , Rapid response to a conjunctivitis outbreak: the use of technology to leverage information. Journal of American College Health 2002; 50: 267271.

43.  KA Viney , JM McAnulty . The evaluation of web-based data collection for enhanced surveillance of cryptosporidiosis. NSW Public Health Bulletin 2008; 19: 1519.

44.  H Raat , Feasibility, reliability, and validity of adolescent health status measurement by the Child Health Questionnaire Child Form (CHQ-CF): internet administration compared with the standard paper version. Quality of Life Research 2007; 16: 675685.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 1
Total number of PDF views: 11 *
Loading metrics...

Abstract views

Total abstract views: 103 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th May 2017. This data will be updated every 24 hours.