In late September 2011, the Los Angeles County Department of Public Health received the first reports of salmonellosis-like illnesses. On September 28, 2011, District Public Health Nursing (DPHN) notified the Acute Communicable Disease Control Program (ACDC) of a cluster of illnesses associated with a film festival event, the Intelligent Use of Water Film Competition, hosted by Rainbird and catered by TRÈS LA. The film festival was held at a media center in Beverly Hills, California on September 20, 2011.
The first reported case of illness was by the mother whose eleven-year old daughter became ill after eating a catered box meal at the event. The mother believed the box meal to be the cause of her daughter’s illness because four employees from her husband’s business, a public relations firm contributing to the organization of the event, also fell ill but did not seek medical care. On September 30, 2011, the girl’s stool tested positive for Salmonella Heidelberg; PFGE pattern, Xba1 Pattern JF6X01.045. All four employees that fell ill and the eleven-year old girl, reported attendance at the event and consumption of some portion of the catered box meal. All five individuals reported the consumption of the oven-roasted turkey sandwich.
DPHN and ACDC interviewed cases in this cluster to obtain food histories and other risk factors related to salmonellosis. All known symptomatic persons who attended the event were asked to submit stool specimens for culture. ACDC requested DPHN ask all salmonellosis cases reported after September 28, 2011 about exposure to any event held in Beverly Hills. Additionally, ACDC created a Foodborne Illness Complaint Report on September 20, 2011.
The Environmental Health Food and Milk Program (F&M) inspected the caterer for the film festival on September 29, 2011. ACDC also contacted a second group that used the same caterer on September 18, 2011 to assess for illness. Confirmation and serotyping of all Salmonella isolates was performed by the Public Health Laboratory of California. Ultimately, six ill persons were identified in the cluster. All six cases reported eating some portion of a turkey sandwich.
The inspection of the caterer, TRÈS LA, did not reveal any major health code violations and no ill food handlers were identified at the time of inspection. There were 30-45 lbs. of turkey prepared by the caterer on September 17, 2011 for the film festival on September 20, 2011, where the outbreak occurred, and for another unrelated event held on September 18, 2011.
Three of the six outbreak cases, including the eleven-year old girl, had Salmonella positive stool cultures. All three positive isolates were serotyped S. Heidelberg and had the same PFGE pattern (Xba1 Pattern JF6X01.0045). Two of the three laboratory confirmed cases were associated with the PR firm that assisted with the organization of the catered film event. Of the four PR firm employees that did not seek medical care, one stool culture tested positive for Salmonella.
In their initial report, the Los Angeles County Department of Public Health was unable to conclusively rule contaminated food served at the catered film event as the cause for the illness cluster. Specifically, the initial report’s conclusion was: “A common source of outbreak of S. Heidelberg occurred among persons associated with a PR firm that organized and attended a catered event on 9/20/11. Although all cases attended the event and ate food prepared by a caterer, other exposures such as animal contact or sources either at the event or otherwise could not be ruled out.”
However, this initial conclusion was amended on January 31, 2012. On December 6, 2011, the California Department of Public Health notified the Acute Communicable Disease Control (ACDC) in Los Angeles County of an Oregon resident with the same as the PFGE pattern from an outbreak previously investigated by ACDC.
ACDC interviewed our client Michael Bishop and a second Oregon resident who attended the film event and also became ill. Tthese two new cases brought the total number of cases associated with the film event to eight; four of which were laboratory confirmed with the same PFGE pattern. Moreover, seven of the eight cases recalled eating the turkey sandwich that was catered at the event.
As a result, the two newly identified cases from Oregon, who were independent of the PR firm, lead the ACDC and Los Angeles County Department of Public Health to confirm that the source of the outbreak was the catered event, with turkey sandwiches as a possible vehicle.
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