On May 27th the Wood County Health District learned of positive salmonella test results in residents of Heritage Corner Assisted Living facility. We immediately notified the Ohio Department of Health (ODH) and began working with the facility to initiate infection control measures and attempt to identify the source of the infection. We also were in contact with a Food Safety Specialist with the ODH Food Safety Program. In addition ODH’s Division of Quality Assurance worked closely with the facility to monitor infection control practices. As of today, there have been 18 positive cases but no new cases of symptoms have been reported since June 10th. Sadly, during the outbreak, we were notified that two residents who tested positive for salmonella had passed away. However, we cannot say whether this was related to the illness.
“Our hearts go out to the residents, employees and their families affected by this outbreak,” states Health Commissioner Ben Batey. “We truly appreciate all of the cooperation from the residents who have participated in the investigation during this difficult time in their lives.”
Everyone who has developed symptoms since May 27th has been tested but not everyone who has been tested has been positive and some test results are still pending. The normal incubation period for salmonella is 12-72 hours. With more than 6 days passing since the last new report of symptoms, the outbreak may be at its end.
According to Amy Jones, Director of Nursing, “Although we are still awaiting some test results, with the knowledge that there have been no new reports of symptoms, we are cautiously optimistic that the outbreak is done.”
Since learning of the outbreak, the health district has taken several steps to both try to identify the cause and prevent more cases. Sanitarians and an Ohio Department of Health Food Safety Specialist inspected the kitchen and spoke with the kitchen manager about food preparation practices and food sources. No major problems were identified.
The Health District and ODH recommended closing of common areas such as dining and activity rooms until the reports of new symptoms ceased. In addition the facility was encouraged to sanitize these areas and make hand sanitizer readily available throughout. The common areas were opened over the weekend after passing the 72 hour mark of the last report of new symptoms.
Several health district employees were in the facility last week and this week to provide information to residents and ask questions about food and activities in the last few weeks. The hope in these interviews is to try to identify an item or event that separates those that got sick and those that didn’t. “
Unfortunately, in many outbreaks we never find out the initial cause,” said Connor Rittwage, Epidemiologist. “There can be so many variables when you’re talking about what people eat and do over the potential exposure period, that it can be difficult to identify one single common link.”
But that doesn’t stop the Health District from trying. Information from interviews of the residents is still being analyzed and will take weeks to complete.
Batey states, “Even in these sorts of outbreaks where we may never know the exact cause, we aim to provide guidance and oversight to help quickly reduce the spread of the disease to others and their families. We remain committed to fully investigating all disease outbreaks in Wood County so that any insights found can be shared with individuals and facilities for future prevention measures.”
• Salmonella is an enteric bacterium, which means that it lives in the intestinal tracts of humans and other animals. Salmonella bacteria are usually transmitted to humans by eating foods contaminated with human or animal feces.
• Salmonella bacteria are often found in food, water, and on animals. Salmonellosis is typically a food-borne illness acquired from contaminated raw poultry, eggs, and unpasteurized milk and cheese products. Although poultry and eggs are primary culprits, Salmonella can be found in a variety of foods including ground meat, fruits, and vegetables—even processed foods such as frozen pot pies. Contaminated foods usually look and smell normal.
• Other sources of exposure include contact with infected animals/pets, especially turtles, iguanas, other reptiles, chicks, cattle and poultry.
• An infected food handler who neglects to wash his or her hands with soap and warm water after using the bathroom may also contaminate food.
• Most persons infected with salmonella develop symptoms including nausea, diarrhea, fever, and abdominal cramps; they typically start 12 to 72 hours after exposure.
• There is no real cure for Salmonella infection, except treatment of the symptoms. Persons with severe diarrhea may require rehydration, often with intravenous fluids.
• The illness usually lasts 4 to 7 days, and most persons recover without treatment. However, in some persons, the diarrhea may be so severe that the patient needs to be hospitalized.
• Most people recover on their own; still, anyone with symptoms like these should see a health care provider right away.
• Persons with diarrhea usually recover completely, although it may be several months before their bowel habits are entirely normal.
• Although anyone can get a Salmonella infection, older adults, infants, and people with impaired immune systems are at increased risk for serious illness. In these people, a relatively small number of Salmonella bacteria can cause severe illness.