An outbreak of Salmonella enteritidis infection at a fast-food restaurant: implications for foodhandler-associated transmission

An outbreak of Salmonella enteritidis infection occurred in patrons and employees of a fast-food restaurant. Transmission took place over a 9-day period. A single employee (employee A) was identified who had onset of gastrointestinal illness 1 day before the first reported patron exposures and had S. enteritidis isolated from stool. A case-control study of 37 ill and 20 healthy patrons who ate during shifts worked by employee A demonstrated that curly-fried potatoes and ice (odds ratio [OR], 6.8; 95% confidence interval [CI], 1.5-33.7; P = .007), both food items handled bare-handed by employee A, were associated with illness. Employees who worked two or more shifts with employee A were more likely to be infected than those who did not work with employee A (OR, 4.4; CI, 1.0-19.5; P = .03). Foodhandlers who subsequently became infected apparently contaminated multiple food items with additional transmission to patrons. This outbreak illustrates the potential for foodhandlers in a fast-food restaurant setting who are infected with Salmonella to be a source of transmission.