Epidemic Salmonellosis in Hospitals and Institutions

Abstract

During the period 1963–1967 the Salmonella Surveillance Report recorded 40 epidemics of salmonellosis in hospitals and institutions, involving 3025 patients and 43 deaths. Epidemics occurred in newborn nurseries, pediatric wards, general-hospital wards, nursing homes and mental institutions. Epidemics involving children were smaller and associated with higher case fatality ratios and more often spread by cross-infection than outbreaks affecting adults. Common-vehicle outbreaks were usually limited to adults and were most frequently due to eggs or egg products. Early detection of outbreaks requires an alert hospital surveillance system. In common-vehicle outbreaks, the contaminated vehicle must be identified and removed. In cross-infection outbreaks, a search for human excreters and contaminated environmental objects must be made. Cross-infection outbreaks are difficult to halt and require vigorous enforcement of hygienic technics, isolation of salmonella excreters and patients admitted with diarrhea (pending stool-culture results) and early discharge of infected patients.