San Diego Cases Identified in Multistate, Multidrug-resistant Salmonella Heidelberg Outbreak
October 11, 2013
The Centers for Disease Control and Prevention (CDC), United States Department of Agriculture (USDA), California Department of Public Health (CDPH), and other state and local health departments are investigating an outbreak of multidrug-resistant Salmonella Heidelberg infections. Epidemiologic, laboratory, and traceback investigations have identified consumption of Foster Farms brand chicken as the likely outbreak source. USDA issued a public health alert warning consumers of these illnesses and their association with three Foster Farm facilities in California.
As of October 7, 2013, a total of 278 cases with 7 outbreak strains have been reported from 17 states. Among cases nationwide, 77% have been reported from California. In San Diego County, 22 outbreak-associated cases have been identified. Symptom onset dates among local cases range from March 9 to September 1, 2013. Eight of the 22 (36%) cases with known clinical information have been hospitalized, and no deaths have been reported. Local cases range in age from 3 months to 61 years (median: 9 years) and 59% are male.
CDC laboratory analysis of Salmonella Heidelberg outbreak strains indicates potential drug resistance to one or more commonly prescribed antibiotics: ampicillin, chloramphenicol, gentamicin, kanamycin, streptomycin, sulfisoxazole, and tetracycline. This antibiotic resistance may be associated with an increased risk of hospitalization or treatment failure.
A recent CDPH press release noted that there has been no recall of Foster Farms chicken because, with proper handling and preparation, the products are safe for consumption. Salmonella bacteria are well known potential contaminants of raw chicken and eggs. Salmonellosis has been reported in 363 San Diego residents so far this year; average number of cases over the last 3 years is 324.
Case Reporting and Specimen Submission Requested
Infection with Salmonella may cause fever, abdominal cramps, and diarrhea, which may be bloody. Symptoms usually resolve within 1 week, but children under 5 years, older adults, and immune compromised persons are at risk for more severe disease and hospitalization.
With local outbreak-related cases reported, clinicians should be alert for suspect cases. Stool cultures should be requested in suspect cases, especially when patients are hospitalized. When treating salmonellosis, providers should be aware of the potential drug resistance seen in this outbreak.
Laboratories and clinicians should promptly report confirmed cases, as Salmonella may require work exclusion and / or public health clearance for persons in sensitive occupations or settings. Reporting can be completed by faxing a Confidential Morbidity Report to (858) 715-6458 or by calling (619) 692-8499 (Monday–Friday, 8am–5pm) or (858) 565-5255 (after hours). Salmonella isolates should be sent to the San Diego County Public Health Laboratory for further testing.
Updated information on this multistate outbreak at may be found at CDC websites for providers and consumers. General resources on prevention, diagnosis, and treatment of salmonellosis are available from CDC and foodsafety.gov.
County of San Diego, Health & Human Services Agency Epidemiology and Immunization Services Branch:
- Phone: (619) 692-8499
- Fax: (858) 715-6458
- Urgent Phone for PM / Weekends / Holidays: (858) 565-5255
- Email: firstname.lastname@example.org