Stopping a Salmonella Outbreak among Infants in a Nursery

In a quaint town along the South Carolina coast, an otherwise healthy 5 month old girl began to show signs of getting sick. After a few days of diarrhea, her condition worsened, and she started having blood in her stools. Her parents immediately took her to their pediatrician, where a stool sample revealed a Salmonella infection.

Around the same time, an 8 month old boy from a neighboring town fell ill with vomiting, fever, and diarrhea. His mom took him to the doctor to find out what was going on. Turns out, this little boy was also sick with a Salmonella infection.

The laboratory results from the little girl and boy were reported to the State of South Carolina. In the course of interviewing the cases, an investigator from South Carolina’s FoodCORE Team discovered that they both attended the same nursery. She worked quickly to determine if any other infants from that nursery were ill. The investigator found three more infants from the same classroom were sick. Additional laboratory testing by the South Carolina Bureau of Labs using pulsed field gel electrophoresis, or “DNA fingerprinting” confirmed that the original cases were related because they had an identical strain of Salmonella bacteria.

The FoodCORE investigator collaborated with a multidisciplinary team, including a regional epidemiologist and an environmental health inspector, who jointly visited the nursery. The visit included a review of formula preparation, diaper changing and handwashing procedures. Despite this combined approach, the source of the Salmonella infection was not ultimately found. However, recommendations were made and are now being followed to improve overall hygiene practices. Such recommendations included carefully washing hands with soap and water between diaper changes.

Thanks to the disease detectives’ swift investigative collaboration with local and state partners, the outbreak was stopped quickly. Fortunately, all five of the sick infants recovered from their illnesses and are now healthy.

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