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A Michigan restaurant was originally a Salmonella epidemic that has lasted for more than a decade, according to a new report.
Finding the source of this protracted epidemic, which has infected some three dozen people over 11 years, has proven difficult, according to the report published Thursday, August 19 in the journal Center for Disease Control and Prevention (CDC). Morbidity and Mortality Weekly Report. Usually, health officials can trace an outbreak of foodborne illness to a single contaminated or improperly prepared food item. But in this case, officials determined the outbreak was due to a “complex association” between the restaurant and the employees who worked there. Specifically, the facility itself was found to be contaminated and some employees harbored the pathogen without showing symptoms, officials found.
The pathogen was so ingrained in the establishment that even a thorough cleaning and renovation of the kitchen failed to eliminate the organism, leading to the closure of the restaurant.
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Michigan officials first learned of the outbreak in 2012, when they identified several cases of Salmonella in Kalamazoo County, Michigan, which were caused by genetically similar strains, meaning the cases could be from the same source. These cases, which were caused by a strain of bacteria known as Salmonella Mbandaka, had arisen over the years since 2008.
From 2012 to 2014, authorities tried to figure out how people got sick. Believing that only one food was probably the culprit, officials asked people about the food they ate before they got sick and the types of restaurants they visited. In 2014, they noted that five of the cases reported eating at a single restaurant in Kalamazoo County. But there was still not enough evidence to firmly link the restaurant to the outbreak. In 2017, authorities began to regard the restaurant as the source, and in 2018, they began a full investigation into the establishment.
The investigation revealed that, from 2008 to 2019, 35 cases of Salmonella Mbandaka were attached to the restaurant.
Officials then took numerous samples from the restaurant environment (such as kitchen surfaces) and asked employees to provide stool samples for Salmonella trial. They found that nearly 50% of the environmental samples were positive for the Salmonella Mbandaka strain, including samples from areas used for cooking, preparation, dishes and storage, as well as the toilet area. Additionally, four of the restaurant’s 100 employees tested positive for Salmonella Mbandaka, even though they had no symptoms. Follow-up tests on these employees revealed that they continued to test positive for about 30 to 120 days. Employees couldn’t return to work until they tested negative for the bacteria twice.
Scientists knew that people can be carriers of another type of disease over the long term. Salmonella bacteria, Salmonella Typhi, which causes typhoid fever. Perhaps the most famous transporter of Salmonella Typhi was Mary Mallon, aka “Typhoid Mary,” a cook who likely infected dozens of people in New York City with typhoid fever in the early 1900s despite having no symptoms, according to The Washington Post.
But less is known about long-term carriers of “non-typhus” Salmonella, such as Salmonella Mbandaka, although some cases of this phenomenon have been reported before, the authors said.
Research also shows that outbreaks in restaurants in which environmental samples and workers are positive for Salmonella may last longer than outbreaks that are attributed to a single food source.
“The almost 11-year duration of this epidemic attests to the potential recalcitrance of Salmonella in restaurant environments, the importance of restaurant hygiene policies and practices, and the challenge of identifying the source when cases occur intermittently and without a clear foodborne vehicle, ”wrote the authors.
After two renovations and two deep cleanings of the restaurant in 2018, officials have again detected Salmonella in the restaurant. The establishment was therefore voluntarily closed at the end of 2018. “Food, dishes, storage, everyday consumer products, chairs and tables were destroyed”, and the “building was deemed ineligible for production or storage of food, ”according to the report.
The restaurant was not named in the report, but in December 2018, a Cracker Barrel restaurant in Kalamazoo County closed after being linked to an outbreak of Salmonella Mbandaka, according to a statement of the Kalamazoo County Government. “Despite extraordinary efforts to eradicate the presence of this strain from the store environment, we couldn’t be sure we could prevent a recurrence,” a statement from Cracker Barrel said at the time, according to local media. WWMT.
Originally posted on Live Science.
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