Salmonella Causes Outbreak

By Linda Cicoira — About 150 people in eight states who attended the 18th Annual Chili Chowder Cook Off and Car Show on Chincoteague on Sept. 30, have come down with an infection of salmonella bacteria, Dr. David Matson of the Eastern Shore Health Department said Wednesday in a telephone interview.

The director continues to urge those who went to the event to answer questions via an online survey found at https://redcap.vdh.virginia.gov/redcap/surveys/?s=RPPDH7DWDF  These answers will help the department narrow down the cause so there will not be an issue at a future event. Everyone is also asked to share the survey link.

“We have a very nice unique and secure survey tool that … keeps it as confidential as anything can be on computers these days,” Matson said. The survey takes between five and 10 minutes to complete. 

All attendees are asked to fill out the form — not just those who became ill. About 2,000 people attended the cook off with 350 of those completing the survey. In regard to the event’s sponsors and participants, “We’ve had very good cooperation. There hasn’t been the slightest resistance. They are working with us to solve the problem.”

Matson said the first 50 to 60 people who reported illness, alerted the health department by telephone and were then asked to go to the website to answer the survey. “We’re in the process of eliminating duplicates,” he explained.

The director also noted that about half of those who have been sick have gotten medical care with some hospitalizations. A prepared message released by the state health department noted, “If you are experiencing gastrointestinal illness (abdominal cramps, nausea, diarrhea, etc.) please seek medical care. Contact the Eastern Shore Health District at (757) 302-4268 with any questions.”

“Riverside Shore Memorial Hospital has treated three patients for possible food poisoning over the past two weeks,” Peter Glagola, a spokesperson for the health system said Wednesday.

People from Virginia, Maryland, Delaware, New Jersey, New York, Pennsylvania, West Virginia and North Carolina reported getting sick. The source has not been narrowed down to a particular entree at this time. 

“The great majority of people who are going to become ill with salmonella in this type of situation become ill within a couple of days of their exposure,” Matson said. “Most were sick the day after the event. It’s really a two-week risk period. Some people become sick later. Not everyone who is sick and exposed, will (appear) sick.” He explained that some “might have one or no loose stools” but “later in the second week, become ill with different symptoms” through blood flow. Those “late cases” will be the ones who will need antibiotics for joint, bone, and other body part infections. In those cases, “The doctor has to be much more attuned to the possibility that this could have happened.”

The ones who have early symptoms should not receive antibiotics, Matson said. “It’s paradoxical — against what most people would think to be reasonable. In Salmonella, if you try to kill it, you prolong the time the person has it in the intestine and increase the chance of it … in the blood. Those who have infections of the blood stream or joint focus, should absolutely be treated. This is where the art of medicine shows up.”

In finding the source of the bacteria, “What makes this more difficult, we know that a good number of different kitchens were involved and many food handlers were involved at the cookout,” Matson said. “We have to be able to … say with confidence and with precision and accuracy … to intervene to reduce chances that this happens again. This is as complex as it gets,” he added.

Matson said two types of samples are in testing. More than 20 stool samples were taken from those who got sick. Samples of foods and ingredients are also being tested, he said. The samples were sent to “our state lab” so comparisons could be made.

“We know only that it is salmonella from a specimen that came from an ill person,” Matson said. 

“It’s a bacteria of the intestines, common cause of illness in the U.S. Many, many, many, … serotypes, over 3,000 types in salmonella … eight different vehicles by which persons can be exposed … usually happens when something in common is taken by mouth by a group of persons. The information we have points against beverages.”

“We know that it is Salmonella javiana,” Matson said, acknowledging that will not mean much to most people. “It just means that’s the level of particular detail that we’ve reached. For us it’s helpful.”

The centers for disease control list javiana as “the fourth most common serotype associated with food-borne illness. A report on salmonella serotypes from the Food Safety and Inspection Service, the food safety arm of the U. S. Department of Agriculture, indicate this strain is not often associated with products regulated by the agency. This serotype is associated with exposure to amphibians in the Southeast U.S. It has also been linked to contaminated mozzarella cheese, watermelon, bass, poultry, lettuce and tomatoes.”

The local health department is not anticipating any action against the source. “We have some permitting authority,” Matson said. “We have not heard yet of any behavior or actions … from the vendor side … hosts of this event, that would lead us in our thinking about penalties or restrictions or anything like that.”

Salmonella was identified late Monday by the Division of Consolidated Laboratory Services (state laboratory) in Richmond.

Matson ruled out papaya from Mexico that has caused an outbreak across the Eastern U.S. “No fruit dish was offered at this event. No one mentioned it in the ‘other’ type box” on the survey. “Papayas are off the list,” he said. Still he urged readers to wash fruit, remove the stems and especially wash when the stem enters the fruit.

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