Outbreak of Salmonella serotype Hartford infections associated with unpasteurized orange juice.
1998
Context.—Acidic foods such as orange juice have been thought to be unlikely vehicles
of foodborne illness.Objective.—To investigate an outbreak of Salmonella enterica serotype Hartford (Salmonella Hartford) infections
among persons visiting a theme park in Orlando, Fla, in 1995.Design.—Review of surveillance data, matched case-control study, laboratory
investigation, and environmental studies.Setting.—General community.Participants.—The surveillance case definition was Salmonella
Hartford or Salmonella serogroup C1 infection
in a resident of or a visitor to Orlando in May or June 1995. In the case-control
study, case patients were limited to theme park hotel visitors and controls
were matched to case patients by age group and hotel check-in date.Main Outcome Measures.—Risk factors for infection and source of implicated food.Results.—Sixty-two case patients from 21 states were identified. Both Salmonella Hartford and Salmonella enterica
serotype Gaminara (Salmonella Gaminara) were isolated
from stool samples of 1 ill person. Thirty-two case patients and 83 controls
were enrolled in the case-control study. Ninety-seven percent of case patients
had drunk orange juice in the theme park vs 54% of controls (matched odds
ratio, undefined; 95% confidence interval, 5.2 to undefined). The orange juice
was unpasteurized and locally produced. Salmonella
Gaminara was isolated from 10 of 12 containers of orange juice produced during
May and July, indicating ongoing contamination of juice probably because of
inadequately sanitized processing equipment.Conclusions.—Unpasteurized orange juice caused an outbreak of salmonellosis in a
large Florida theme park. All orange juice was recalled and the processing
plant closed. Pasteurization or other equally effective risk-management strategies
should be used in the production of all juices.
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