Salmonella Litchfield outbreak associated with a hotel restaurant--Atlantic City, New Jersey, 2007

On July 10, 2007, the Pennsylvania Department of Health notified the New Jersey Department of Health and Senior Services (NJDHSS) of three culture-confirmed cases of Salmonella Litchfield infection with matching pulsed-field gel electrophoresis (PFGE) patterns. Data from PulseNet, the national molecular subtyping network for foodborne disease surveillance, confirmed 11 cases (including the three from Pennsylvania) of this rarely identified Salmonella serotype in five states during a 5-week period; seven of the 11 patients had reported recent travel history to Atlantic City, New Jersey. This report describes the subsequent investigation led by NJDHSS and the Atlantic City Health Department (ACHD), which associated the outbreak with a hotel restaurant in Atlantic City. In all, 30 confirmed or probable cases of illness with S. Litchfield infection were identified among persons from eight states who had eaten at the hotel restaurant, including 10 restaurant food handlers. Investigators concluded that the outbreak most likely was associated with fruit salad, particularly the honeydew melon component, and that contamination likely resulted from an ill food handler. This investigation illustrates the potential for recurring food contamination by ill and asymptomatic food handlers and underscores the utility of PulseNet to link illnesses that might appear unrelated.