Salmonella Enteritidis Outbreak in Ontario 2005

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Salmonella Enteritidis Outbreakin Ontario 2005

• KFLA Public Health
• Environmental Health Department
• Jerry Zalewski, C.P.H.I.(C)

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Background

• In just over three weeks, from November 1st to
  November 17th, there were 127 cases of S.
  enteritidis.
• Normally expect approximately 20 25 cases per
  month.

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Chronology

• November 16th 17th
• Several patients visit local emergency
  departments.
• Many are symptomatic with marked diarrhea and
  some have fever.

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Chronology

• November 16th 17th
• Syndromic surveillance system detects an increase
  in gastro-intestinal illness.
• Similar demographics young adults, downtown
  postal code were primarily affected.
• Stool culture sampling instituted to assess the
  excess of g-i illness.

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Saturday, November 19, 2005

• Dr. Kieran Moore informed Dr. Ian Gemmill who
  informed Mr. Peter Moccio of a cluster of
  Salmonella cases isolated by KGH Laboratory.

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November 19 20, 2005

• The four people were interviewed. One was a
  patient at K.G.H.

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Sunday, November 20, 2005

• Called K.G.H. Laboratory. The four Salmonella
  species samples appear to be similar and two
  appear identical.
• Two people ate at a restaurant on November 12th
  and 13th.
• One person, who was ill on November 9th, only ate
  at home.

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Monday, November 21, 2005

• The third case was called again and it was
  confirmed he ate at the same restaurant on
  November 11th.
• Received several calls from ill people who ate at
  the restaurant on November 11th, 12th, or 13th.

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Monday, November 21, 2005 (cont.)

• The suspect food was Phad Thai (shrimp, chicken,
  bean sprouts, roasted peanuts, and fried
  noodles).
• The total number of suspect cases was twelve
  people.
• The restaurant is closed on Mondays.

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Tuesday, November 22, 2005

• Pam Landy (PHI) closed the restaurant while she
  conducted her investigation. The menu was
  reviewed and compared to what the ill people ate.
  Bean sprouts were part of the four different
  meals served to ill people.
• Called the one person who did not have bean
  sprouts with his dinner. His girlfriend had the
  Phad Thai and he ate her bean sprouts.
• Obtained invoice for bean sprouts.

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Tuesday, November 22, 2005 (cont.)

• Called the individual who was ill on November
  9th, and she had purchased bean sprouts from
  grocery store prior to onset of illness.
• Faxed Dr. Dean Middleton that our outbreak of
  twelve suspect cases all ate bean sprouts.

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Wednesday, November 23, 2005

• Spoke to Melanie Barbacsy (PHI), Hastings
  Prince Edward Counties Health Unit. She has
  three Salmonella cases and she suspected bean
  sprouts with two different suppliers. Advised
  her that the two suppliers have the same address
  and recommended she notify Dr. Dean Middleton.

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Wednesday, November 23, 2005 (cont.)

• There are three confirmed Salmonella Enteritidis
  cases, one Salmonella species and eleven suspect
  cases linked to eating bean sprouts. This
  information was faxed to Dr. Middleton.
• Dr. Gemmill and Mr. Moccio agreed all bean
  sprouts should be removed until such time a
  source of the contamination could be determined.
  If the seeds were the source then other bean
  sprout producers may have purchased them from the
  same supplier.
• Hospitals, Queens Student Health Services, and
  private physicians were to be notified of the
  outbreak.

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November 23, 24, 25, 2005

• Public Health Inspectors went to approximately
  100 food premises in the KFLA area suspected of
  serving or selling bean sprouts. Premises that
  had been sprouts disposed of them.
• On November 23rd, Pam Landy collected bean
  sprouts from a restaurant that purchased them
  from a grocery store. On December 5th, the
  Ministry of Health Laboratory confirmed three of
  the four samples contained Salmonella
  Enteritidis.
• Ministry of Health and Long-Term Care Telephone
  Conference. We spilled the beans!

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Thursday, November 24, 2005

• The Kingston Whig-Standard Salmonella Warning.

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Friday, November 25, 2005

• Toronto Public Health ordered the company to stop
  the distribution of bean sprouts. C.F.I.A.
  issued a recall.

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KFLA Salmonella Enteritidis outbreak linked to
bean sprout consumption November 2005

• 16 cases SE PT 13 bean sprout consumption
  within KFLA
• (Outbreak 0000-2005-058)
• Mean age 27
• Sex 9 female (56), 7 male (44)
• Onset dates 11/9/05 to 11/21/05
• Symptoms
• Diarrhea (16/16 100)
• cramps (13/16 81)
• chills (7/16 44)
• fever (7/16 44)
• headache (5/16 31)
• vomiting (3/16 19)
• nausea (2/16 13)
• other dehydration (1/16 6)

• 10 cases SE (not PT13 confirmed) bean sprout
  consumption within KFLA
• (Outbreak 2241-2005-044)
• Mean age 36
• Sex 7 female (70), 3 male (30)
• Onset dates 11/12/05 to 11/24/05
• Symptoms
• Diarrhea (10/10 100)
• cramps (9/10 90)
• fever (6/10 60)
• headache (6/10 60)
• chills (5/10 50)
• nausea (3/10 30)
• vomiting (1/10 10)
• other bloody diarrhea (1/10 10)

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KFLA Salmonella Enteritidis outbreak linked to
bean sprout consumption November 2005
NOTE 2 other Salmonella cases consumed bean
sprouts outside of KFLA Public Health
jurisdiction (Guelph and Toronto). These cases
were NOT included in the summary above.
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The End