Mystery Salmonella Outbreak in Perry County

Posted in Outbreaks & Recalls,Salmonella on August 11, 2018

With ages of the ill ranging from 2 to 68 years old, another Salmonella outbreak has manifested out of Perry County, Missouri. With cases emerging in the emergency room and physician offices, three have required acute hospital admission, two have required short-term hospital admission and treatment, one has been transferred to a Cape Girardeau hospital, and others are recovering with prescribed medicine, hydration, and rest at home. What are the details of this Missouri outbreak?

What is Salmonella?

First off, the term “Salmonella” refers to a specific group of bacteria that cause an infection in the intestinal tract, a diarrheal illness, called salmonellosis. Salmonella is a gram-negative, rod-shaped bacterium, and there are well over 2,300 subtypes of the Salmonella enterica bacterium, including but not limited to serovars enterititis, Salmonella Agbeni, and typhimurium. Salmonella poisoning is usually linked to the ingestion of contaminated water or foods–especially meat, poultry, and eggs. Apart from food and water, salmonella poisoning can be caused by certain reptiles, as was the case in March through August of 2017 where 33 people in 13 states fell ill due to pet turtles. Additionally, salmonella can be found on surfaces.

Typhoid fever, food poisoning, gastroenteritis, enteric fever, and other illnesses are common results of a salmonella infection. Symptoms include stomach pains, chills, fever, nausea, diarrhea, and vomiting, which usually begin anywhere from 12 to 72 hours after the infection has taken root. Infections tend to last 4 to 7 days, and patients tend to recover all on their own without hospitalization, though some with severe cases of diarrhea may need hospital treatment and recover at alternative rates. Salmonella poisoning statistically affects around 1.4 million Americans every year, making it responsible for nearly half of the bacterial infections in the United States, leading to 19,000 hospitalizations and 380 deaths.

Prevention techniques include regular hand washing, proper cleaning of food preparation surfaces and utensils, as well as maintaining appropriate food-handling habits such as fully cooking all meats, poultry, and eggs, thoroughly washing all fruits and vegetables, and keeping raw meats separate from other food items. Not keeping reptiles as pets is an additional salmonella infection prevention option.

What Happened in Perry County?

The Perry County Health Department announced that more than 30 cases of Salmonella infection have been reported in the last week, which is more than six times the number of cases that the agency normally comes into contact with in a full year. On Thursday, August 9th, Perry County Memorial Hospital reported seeing at least 23 cases of salmonella infection since the previous Monday. They said that patients varied in age, from 2 to 68, and they’d been tended to by the PCMH emergency department as well as at local doctors’ offices. By Friday, August 10th, the number of salmonella cases had risen to 32.

While the health department officials admit that they don’t have nearly enough information yet in order to determine and eliminate the source of the outbreak, the investigation is ongoing. According to Perry County’s health department communicable disease coordinator, Sheila Hahs, “We are speaking with Department of Health and Senior Services in St. Louis, our counterparts up there. They have specialists who do all the calculations and figure out what caused what.” Hahs explained the investigatory process of putting together a survey, saying it would be used as part of the inquiry to help determine the source of the outbreak. “It depends on how many people come up symptomatic,” Hahs said. “This could go on for a while. We could be having secondary cases.”

Of the 32 cases, many range on the more severe side of salmonella infections. Three have required acute hospital admission, two were admitted for hospital observation and treatment for a short time, and one was transferred to a hospital in Cape Girardeau for special treatment. While the remainder of the salmonella infected patients have been sent home with medication and hydration prescriptions, the health department is currently unclear as to the source of the infection.

Thankfully, the department is doing it’s best to get to the bottom of the issue. According to Hahs, “Laboratories are required to report communicable diseases such as this. There is a reportable list that all labs and doctors’ offices have and when one of them comes across as the diagnosis, then that has to be reported.”

According to doctors at the Perry County hospital (PCMH), they were able to make rapid diagnosis due to a recent upgrade in their equipment and technology in the hospitals laboratory department. The upgrade included new, highly specialized gastrointestinal test panels that can correctly and quickly identify 22 organisms that tend to cause abdominal symptoms like salmonella. “It’s something that we purchased earlier this year,” said the PCMH vice-president of operations, Chris Wibbenmeyer. Wibbenmeyer also oversees the hospital’s laboratory department, and according to him, “We actually have four units that this testing can be ran on. It was testing what we couldn’t have before.”

These testing units were installed in July and they were able to cut the wait on test results from multiple days to mere hours. According to Wibbenmeyer, the timing of the upgrades proved to be very lucky in light of the recent outbreak. Wibbenmeyer said, “It just so happens that us implementing this G.I. panel happened just shortly before this outbreak. It’s worked really well because it speeds up the diagnostic time by days. That’s beneficial to everyone. It has other testing capabilities–it’s not just a G.I. testing–and in all of those areas, we’ve reported significant reductions in the turnaround time for results that have improved the timeliness of getting appropriate medications to the patients. It’s proven its worth over and over again.”

Conclusion

While most salmonella infections don’t require hospitalization, many do, and it even has the ability to kill. Proper prevention techniques are vital in ensuring your own and your families health, especially in the case of foodborne illnesses. Should you encounter any of the common salmonella infection symptoms after coming into contact with common salmonella infection carriers, be sure to see your physician or healthcare provider in order to receive the appropriate diagnosis and help any investigation going on.

By: Abigail Ryan, Contributing Writer (Non-Lawyer)