Massive Outbreak of Antimicrobial-Resistant Salmonellosis Traced to Pasteurized Milk
- Caroline A. Ryan, MD;
- Mary K. Nickels, MS;
- Nancy T. Hargrett-Bean, PhD;
- Morris E. Potter, DVM;
- Tomy Endo, DrPH;
- Leonard Mayer, PhD;
- Carl W. Langkop, MSPH;
- Carol Gibson;
- Robert C. McDonald, MD;
- Richard T. Kenney, MD;
- Nancy D. Puhr;
- Paul J. McDonnell;
- Russell J. Martin, DVM, MPH;
- Mitchell L. Cohen, MD;
- Paul A. Blake, MD, MPH
- From the Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta (Drs Ryan, Hargrett-Bean, Potter, Mayer, McDonald, Kenney, Cohen, and Blake and Ms Puhr), and the Illinois Department of Public Health, Springfield, III (Mss Nickels and Gibson, Drs Endo and Martin, and Messrs Langkop and McDonnell).
Abstract
Two waves of antimicrobial-resistant Salmonella typhimurium infections in Illinois totaling over 16000 culture-confirmed cases were traced to two brands of pasteurized 2% milk produced by a single dairy plant. Salmonellosis was associated with taking antimicrobials before onset of illness. Two surveys to determine the number of persons who were actually affected yielded estimates of 168791 and 197581 persons, making this the largest outbreak of salmonellosis ever identified in the United States. The epidemic strain was easily identified because it had a rare antimicrobial resistance pattern and a highly unusual plasmid profile; study of stored isolates showed it had caused clusters of salmonellosis during the previous ten months that may have been related to the same plant, suggesting that the strain had persisted in the plant and repeatedly contaminated milk after pasteurization.
(JAMA 1987;258:3269-3274)
Footnotes
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Reprint requests to Enteric Diseases Branch 1-5428, Division of Bacterial Diseases, Centers for Disease Control, Atlanta, GA 30333 (Dr Ryan).
