Holiday meals: Salmonella outbreaks in hospitals and prisons

The incidence of foodborne Salmonella infection is typically high in summer months and often linked to food and water contamination. A number of environmental and social factors substantially contribute to the high rate of foodborne outbreaks, including ambient temperature, food storage practices, poor hygiene, travel, centralized meal preparation in large quantity, and consumption related to social events. In order to design better targeted prevention programs, it is exceedingly important to determine the time periods of high risk for salmonellosis in vulnerable subpopulations. We examine temporal variations in salmonellosis using a compiled database of all investigated foodborne outbreaks in the United States from 1990 to 2006 to conduct a systematic meta-analysis. The dataset, acquired from the CDC, contains information on 1754 outbreaks (56,000+ people affected) with data on the primary pathogen, month and year of the event, affected states, number of ill and hospitalized, contaminated foods and circumstances associated with each outbreak. Compared to a national average of 32±5 persons per outbreak, a disproportionally high intensity of outbreaks was observed in hospital setting and prisons (43±57 and 100±119, respectively). In prisons, the risk of outbreaks due to eggs, poultry and raw food consumption was 5.8 (95%CI:5.10-6.57) times higher than national average. In addition, a disproportionally high rate of outbreaks was detected in summer months and around the holiday season (November/December). Although regulatory agencies aggressively act to prevent foodborne illness, raising food quality control and hygiene practices in establishments that are federally and state regulated is imperative to control exposure and contamination.