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. 2020 Sep/Oct;135(5):668-675.
doi: 10.1177/0033354920944861. Epub 2020 Aug 13.

Salmonellosis Outbreak After a Large-Scale Food Event in Virginia, 2017

Kelly A Shaw  1   2 , Kimberly Wright  3 , Keith Privett  3 , Kelsey Holloman  2 , Seth Levine  2 , Katherine McCombs  2 , Lauren Turner  4 , Caroline Holsinger  2 , Diane Woolard  2
Affiliations

Salmonellosis Outbreak After a Large-Scale Food Event in Virginia, 2017

Kelly A Shaw et al. Public Health Rep. 2020 Sep/Oct.

Abstract

Objectives: The Virginia Department of Health (VDH) identified an outbreak of Salmonella serotype Javiana infections in Virginia after a chili and chowder cook-off with 11 competitors and about 2500 attendees on September 30, 2017. The objectives of this study were to assess the extent of the outbreak and identify the most likely source of exposure.

Methods: To identify people with suspected Salmonella infection, VDH used press releases and social media posts to recruit event attendees to take an online survey about foods eaten at the cook-off and any gastrointestinal (GI) symptoms experienced. VDH defined a case as reported GI illness that occurred within 1 week after eating food from the cook-off. Confirmed cases required a clinical specimen culture positive for Salmonella. Probable cases reported diarrhea or related clinical symptoms. "Not ill" people did not report GI illness. Investigators calculated unadjusted relative risks of illness and performed stratified analysis to address potential confounding. Available food samples were tested for Salmonella. Environmental health specialists interviewed food handlers and inspected restaurants where 3 competitors had prepared food.

Results: Of 438 survey responses, 171 (39%) met the case definition. Of all chilies and chowders consumed, Chowder A was associated with the highest relative risk of illness (8.9; 95% CI, 5.7-13.7). A Chowder A sample tested positive for Salmonella serotype Javiana. The environmental investigation did not identify an original contamination source but did find deficiencies in maintaining safe cooking temperatures.

Conclusions: Epidemiologic and laboratory findings indicated that Chowder A was the most likely cause of outbreak. Recommendations to prevent future outbreaks include preparation of all food on-site to ensure safe temperatures during food preparation and service.

Keywords: foodborne outbreak; salmonellosis; stratified analysis.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure
Figure
Illness onset date and case status for cases associated with a salmonellosis outbreak after a chili and chowder cook-off, Virginia, 2017. The outbreak case definition included illness that occurred after consuming food from the chili and chowder cook-off. Confirmed cases were positive for Salmonella by culture. Probable cases reported ≥3 episodes of diarrhea in a 24-hour period OR unquantified diarrhea and ≥1 other symptom (nausea, vomiting, fever, chills, abdominal cramps, or dehydration).
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