On April 26, 2013, the Southern Nevada Health District (SNHD), Office of Epidemiology (OOE) received reports of Salmonella gastrointestinal illness from eight independent groups of patrons of Firefly on Paradise or the adjacent affiliated restaurant Dragonfly on Paradise (Firefly) located at 3900 Paradise Road, Las Vegas, NV 89109. All patrons from these groups ate at the restaurant during April 21-24, 2013. Ill patrons reported symptoms of diarrhea and/or vomiting after they consumed food from Firefly restaurant, and many sought medical care for their illness. In response to these illness reports, the SNHD initiated an investigation.

On April 26, 2013, the SNHD performed an investigative inspection and closed Firefly and Dragonfly restaurants to minimize ongoing risk of illness. The SNHD OOE, Environmental Health (EH) and Southern Nevada Public Health Laboratory (SNPHL) have been collaborating on the investigation and response to this outbreak. The Nevada State Health Division was also apprised of the outbreak investigation.

CONCLUSIONS

At least 86 patrons and 3 employees who consumed food and/or drinks at Firefly during April 21-25, 2013 may have contracted Salmonella infection.

FUTURE ACTIONS

1. Firefly should rectify faulty food storage equipment and practices to ensure that food will be maintained at proper temperatures.

2. The SNHD OOE staff will continue to collect information about customers who ate at Firefly during April 21-26, 2013 to establish illness occurrences among restaurant patrons, and to conduct a case-control study to identify specific food item(s), if any, were associated with illness.

3. The SNHD EH staff will continue to review Firefly’s food preparation methods to identify possible lapses in food safety procedures, and to require restaurant management to provide and implement a comprehensive food safety plan.

4. The SNHD OOE staff will continue to monitor the foodborne illness database for additional complaints of illness to determine whether the outbreak is limited to this establishment or has spread to the general community.

5. The SNPHL will perform pulsed field gel electrophoresis on the submitted specimens that were positive for Salmonella to determine if illnesses among patrons from the different groups were linked.

RECOMMENDATIONS

1. Food-service workers who test positive for Salmonella must be excluded or restricted from work per the FDA Food Code, and will require approval from the SNHD to return to work.

2. Restaurant employees should also be cautioned about how Salmonella is transmitted and be made aware of the heightened importance of hand hygiene through washing with soap and water. Information about salmonellosis can be found at the SNHD website http://www.southernnevadahealthdistrict.org/health-topics/salmonellosis.php

3. Food service workers should also be educated to the ways to clean and sanitize food preparation surfaces. Types of acceptable sanitizer solutions for use in a food establishment are located at the SNHD website http://www.southernnevadahealthdistrict.org/ferl/sanitizer-fact-sheet.php

4. The restaurants are advised to cook all potentially hazardous foods thoroughly. Menu items intended not to be cooked to the recommended temperatures should be noted on menus, with an appropriate warning to consumers about the potential health hazards of eating undercooked foods.

5. All suspected cases of Salmonella infection related to this outbreak should be reported to the health authority. Illness clusters (e.g. restaurants, schools, hotels) are reportable under Nevada Administrative Code sections 441A.525 and the SNHD Regulations Governing the Reporting of Diseases, Exposures, and Sentinel Health Events section 4.9. Reports should be made to the SNHD Office of Epidemiology at (702) 759-1300, option 3, and can be made 24 hours a day, seven days a week.

Full Report

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