health issue

profileangieb1979
salmonella.docx

Running Head: Salmonella in the Caribbean 1

Salmonella in the Caribbean 4

Angela Brown

Salmonella in the Caribbean

Southern New Hampshire University

The two articles that I have choose to write about is outbreak of multidrug- resistant salmonella infections link to pork – Washington 2015 and outbreak of salmonella Heidelberg infections linked to a single poultry producer- 13 states 2012-2013. After reading about the outbreak of multidrug- resistant salmonella infections link to pork I learned that on the basis of cases investigated before August 2015, a supplemental questionnaire that went into more detail in addressing meat and livestock exposures was developed. Among 80 patients (42% of all confirmed cases) who were interviewed, 59 (74%) reported eating pork during the 7 days preceding illness. This was significantly higher than the most recently published (2007) Foodborne Diseases Active Surveillance Network (FoodNet) population survey of healthy persons, in which 43% reported eating pork in the week before they were interviewed. After reading the outbreak of salmonella Heidelberg infections linked to a single poultry producer I have learned that initial state-based interviews found that chicken was commonly consumed by the persons with infections. A structured questionnaire was developed to collect detailed information on chicken and other exposures noted during initial interviews, and exposures commonly linked to Salmonella Heidelberg, such as eggs. Of 70 patients who responded, 55 (79%) reported consuming chicken in the week before illness onset, a percentage significantly higher than the 64.9% reported in the 2006–2007 foodborne diseases active surveillance network (FoodNet) Population Survey of healthy persons. These resources will be helpful. Plasmids are mobile genetic elements that can be gained or lost relatively easily, which might explain the variable resistance profiles. Resistance to third-generation cephalosporins (e.g., ceftriaxone) is clinically important because extended-spectrum cephalosporins are commonly used for treatment of severe salmonellosis in children. WADOH and PHSKC investigation into the source of pork traced the pork consumed by 35 (59%) of the 59 interviewed patients who reported eating pork back to a U.S. Department of Agriculture’s Food Safety and Inspection Service–inspected pork slaughter establishment in Graham, Washington. This was the largest Salmonella outbreak in Washington in recent history, and highlights that pork is an important source for human Salmonella infections. Best practices in all parts of the pork production industry, from farm to processing plant, can help reduce the risk for future outbreaks. In addition, prevention strategies that include rigorous Salmonella control in pork slaughter establishments in conjunction with food handling education at the wholesaler and restaurant level should be strengthened.

Reference

CDC. Foodborne Diseases Active Surveillance Network (FoodNet) population survey atlas of exposure, 2006–2007. Atlanta, GA: US Department of Health and Human Services, CDC; 2008. http://www.cdc.gov/foodnet/surveys/foodnetexposureatlas0607_508.pdf

US Department of Agriculture Food Safety and Inspection Service. Class I recall—news release: Kapowsin meats recalls pork product due to possible Salmonella contamination. Washington, DC: US Department of Agriculture, Food Safety and Inspection Service; 2015. http://goo.gl/osPJOl

CDC. National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS): human isolates final report, 2013. Atlanta, GA: US Department of Health and Human Services, CDC; 2015.

Varma JK, Molbak K, Barrett TJ, et al. Antimicrobial-resistant nontyphoidal Salmonella is associated with excess bloodstream infections and hospitalizations. J Infect Dis 2005;191:554–61. CrossRef PubMed

CDC. Foodborne outbreak online database. Atlanta, GA: US Department of Health and Human Services, CDC; 2015. http://wwwn.cdc.gov/foodborneoutbreaks

Dickson JS, Hurd HS, Rostagno MH. Salmonella in the pork production chain. Report no. 03558-3/13. Des Moines, IA: National Pork Board (US); 2013. http://www.pork.org/wp-content/uploads/2010/05/salmonellaproductnchn.pdf