By: Heather Williams

The Chicago Department of Public Health (CDPH) has issued a news release identifying a Salmonella outbreak linked to a Morgan Park restaurant with 14 individuals affected so far and at least 6 have been hospitalized.  During CDPH investigations and interviews, Best BBQ at 1648 W. 115th Street has been identified as a source of the Salmonella outbreak.  Best BBQ has since closed their restaurant voluntarily and is cooperating with Public Health investigators.

The Chicago Department of Public Health urges residents who display symptoms and has recently eaten at the Best BBQ to see their medical care provider and to be sure to inform them of the possibility of Salmonella infection.  This will speed up the diagnostic process so that your health care professional can perform specific tests for Salmonella, as it is not something routinely expected.  The health department has already issued an alert to area physicians notifying them of the outbreak and provided medical guidance.

“This is a serious condition that is treatable,” said CDPH Commissioner Julie Morita, M.D. “Anyone who believes they may be symptomatic and ate at this restaurant should see their medical provider immediately. CDPH is taking every precaution as part of our robust response in order to limit the impact of this outbreak.”

Discovery of the Outbreak

The outbreak was discovered by CDPH official during ongoing review of health data surveillance.  The department reviews laboratory reports of patients who have been diagnosed with specific diseases for epidemiological purposes.  Salmonella is an agent that pops up on their radar as a public health concern.  Investigators identified an increase in a particular serotype (or family) of Salmonella.  After contacting those affected patients, interviews revealed that many of those affected had recently eaten at the Best BBQ restaurant.

The restaurant is working with food protection inspectors to address any possible contamination issue and investigating the sanitary and health conditions already in place.  The restaurant is also providing inspectors a list of suppliers to continue investigating any supply chain sources for the contamination.  Sometimes an outbreak occurs at a restaurant that originates from the food supply and at no fault of the restaurant.

Salmonella

Salmonella is an infectious bacterium that causes the illness salmonellosis.  The pathogen was discovered by an American Scientist named Dr. Salmon who named the bacteria after himself.  These bacteria have been known to cause illness for over 125 years.

The Center for Disease Control and Prevention (CDC) estimates 1.2 million people are infected with Salmonella in the United States each year.  An estimated 450 deaths occur from the non-typhoidal versions of Salmonella annually.  Infection is more common in the summer than in the winter.  Statistically young children (children under the age of 5) have higher rates of Salmonella infection compared to other age groups.

How is Salmonella Diagnosed?

When a patient sees a health care professional and presents symptoms consistent with that of salmonellosis and a health alert or patient interview indicates Salmonella may be the cause of the illness, a clinical specimen will be obtained and tested.  This is generally a stool sample, but depending on the symptoms presented may be a blood sample as well.  This sample is tested to distinguish it from other illnesses that present similar symptoms.  Many diarrheal illnesses cause diarrhea, fever, and abdominal cramps.  This is usually performed on a culture where growth medium specialized for Salmonella is provided.  A specialized technician analyzes what grows and determines if the cell type is consistent with Salmonella.  Once the Salmonella bacteria is identified, additional testing can be performed to further characterize the bacteria.  The sample is usually sent off to the public health laboratory for serotyping and DNA fingerprinting.  This information is logged into PulseNet.

PulseNet is an online program managed by the CDC that compares the DNA fingerprints of bacteria entered for patients.  This helps to identify clusters of diseases.  If several people who live in the same area start presenting the same serotype of a bacteria, an outbreak investigation is prompted.  PulseNet began in 1996 and has improved U.S. food safety systems with its ability to identify outbreaks very early.  This allows investigators to identify the source and alert the public sooner.  While PulseNet works with U.S. local and state public health laboratories, PulseNet International performs a similar role for foodborne illness on the international level.

Many serotypes for Salmonella exists, allowing investigators to more easily connect the dots for related cases.  Serotypes are the types of a bacteria.  Consider breeds of dog.  They are all dogs, but a Labrador Retriever is very different from a Chihuahua.  The same with Salmonella.  The symptoms of the illness is pretty much the same for each serotype, with the exception of a few very different versions, which may cause stronger symptoms; however knowing the serotype and DNA fingerprint allows information about the origin of the illness.

Symptoms of Salmonella Infection

General symptoms include diarrhea, fever, and abdominal cramps.  Symptoms begin to appear within 12 and 72 hours of infection.  The illness lasts between 4 to 7 days for most people, and most of the time those affected recover without medical treatment.  While symptoms of diarrheal Salmonella infection usually recover within 7 days, it may take several months before bowel habits return to completely normal.  In some severe cases diarrhea may be so severe that the patient must be hospitalized and treated for dehydration.  In some patients, the infection spreads beyond the intestines and enter the blood stream, allowing the infections to reach other areas of the body.  For these life-threatening cases, patients who are not treated promptly with antibiotics may not survive.  Most healthy individuals do not have this issue; however, the very young, the very old, and those with a compromised immune system are of higher risk for this severe illness.  For a very small number of people, Salmonella infection may develop into reactive arthritis.  This causes pain in the joints and may last for months or even years.  Reactive arthritis may lead to chronic arthritis, a difficult disease to treat.  The CDC explains that even if antibiotic treatment is given during the initial Salmonella infection, some people may still develop reactive arthritis.  Those who have developed reactive arthritis can also develop irritation of the eyes or even painful urination.

If you have eaten at Best BBQ recently and are experiencing the symptoms that indicate salmonellosis, seek medical attention or notify your local health department.  This will help investigators better identify the source of the illness that has reached 14 people so far.

 

Sources:

https://www.cityofchicago.org/city/en/depts/cdph/provdrs/inspections_and_permitting/news/2017/september/cdph-identifies-salmonella-outbreak-linked-to-morgan-park-restau.html

https://www.cdc.gov/salmonella/general/diagnosis.html

https://www.cdc.gov/salmonella/general/index.html

https://www.cdc.gov/pulsenet/

https://www.cdc.gov/pulsenet/about/index.html