Deschutes County Health Services, working with the Oregon Health Authority and other partners, has issued a Health Alert Network advisory telling health care providers in Deschutes County and the surrounding Central Oregon communities that it is investigating a multistate outbreak of Salmonella Enteritidis infections.
The advisory does not name a source, a case count, or the other states involved. What it does do is ask clinicians to keep a sharp eye out for patients with gastrointestinal illness consistent with salmonellosis, and to collect the information investigators need to tie cases together and find a common exposure.
Providers are asked to get a food-exposure history covering the five days before illness onset, with particular attention to:
- Eggs and egg-containing foods, including fresh or locally sourced eggs;
- Raw, unpasteurized milk;
- Contact with animals such as chickens and baby chicks, lizards, snakes, and turtles; and
- Specific restaurant names, locations, and meal dates.
The county is also asking providers to consider stool testing for patients with diarrhea (sometimes bloody), fever, and abdominal cramps. Where a culture-independent test such as PCR comes back positive for Salmonella, the advisory stresses that a reflex culture or specimen submission must follow so public health labs can characterize the isolate. That step matters: without an isolate, there is no whole genome sequencing, and without sequencing, a sick person in Bend may never be linked to sick people in other states.
Suspected or confirmed cases should be reported to Deschutes County at 541-322-7418, Crook County at 541-447-5165, Jefferson County at 541-475-4456 (business hours) or 541-475-2201 (after hours), or the Oregon Health Authority at 971-673-1111.
A sidelight from Oregon history
Oregon has seen a Salmonella outbreak with a far darker origin. In September and October 1984, followers of Bhagwan Shree Rajneesh, whose commune of Rajneeshpuram sat in Wasco County, deliberately contaminated salad bars and salad dressing at ten restaurants in The Dalles with Salmonella Typhimurium. The goal was to make enough local voters sick to swing the November county election. The salad bars were reportedly a trial run for contaminating the town’s water supply.
The attack sickened 751 people and hospitalized 45. It was the largest foodborne outbreak in the country that year and is still considered the largest bioterrorism attack in U.S. history. At first, investigators blamed ill food handlers. Only after a federal investigation and a raid on the commune, where vials of a matching strain were found in its lab, did the truth come out. Commune leaders eventually entered no contest pleas. The CDC’s full epidemiologic account was not published in JAMA until 1997. Food Safety News revisited the story on its 25th anniversary.
It is a useful reminder of why the restaurant names and meal dates that Deschutes County is now asking doctors to record matter so much. Careful exposure histories are how investigators find a common source, however that source came to be contaminated.
Salmonella: Marler Clark, The Food Safety Law Firm
Symptoms of Salmonella infection typically begin six hours to six days after exposure and include diarrhea, fever, and stomach cramps; nausea, vomiting, and headache can also occur. Most people recover in four to seven days, but young children, adults 65 and older, pregnant people, and those with weakened immune systems are more likely to develop severe illness requiring hospitalization. Some people develop lasting complications, including reactive arthritis and irritable bowel syndrome. More information is available from the CDC.
The Marler Clark law firm has decades of experience representing victims of Salmonella and other foodborne illness outbreaks. If you or a family member became ill with a Salmonella infection after eating food and you’re interested in pursuing a legal claim, contact the Marler Clark Salmonella attorneys for a free case evaluation.