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Outbreak of Human Salmonella Typhimurium Infections Linked to Contact With Baby Poultry From a Single Agricultural Feed Store Chain and Mail-order Hatchery, 2009

Loharikar, Anagha MD*; Vawter, Shannon DVM, MS; Warren, Kim MPH; Deasy, Marshall III§; Moll, Maria MD§; Sandt, Carol PhD; Gilhousen, Renee MSN, CRNP§; Villamil, Elizabeth MPH; Rhorer, Andrew MS**; Briere, Elizabeth MD*; Schwensohn, Colin MPH††; Trees, Eija PhD, DVM‡‡; Lafon, Patricia MS‡‡; Adams, Jennifer Kincaid BS‡‡; Le, Brenda ScD, MSPH§§; Behravesh, Casey Barton MS, DVM, DrPH††

The Pediatric Infectious Disease Journal: January 2013 - Volume 32 - Issue 1 - p 8–12
doi: 10.1097/INF.0b013e3182755e28
Original Studies

Background: Over 30 outbreaks of human salmonellosis linked to contact with live poultry from mail-order hatcheries were reported to Centers for Disease Control and Prevention between 1990 and 2010. In May 2009, we investigated an outbreak of human Salmonella Typhimurium infections, primarily affecting children.

Methods: A case was defined as a person with the outbreak strain of Salmonella Typhimurium, as determined by pulsed-field gel electrophoresis and multiple-locus variable-number tandem repeat analysis, in a Pennsylvania or New York resident with illness onset between May 1 and September 1, 2009. We conducted a case-control study to examine the relationship between illness and live poultry contact. Controls were age-matched and geographically-matched. Traceback and environmental investigations were conducted.

Results: We identified 36 case-patients in Pennsylvania and New York; 36% were children aged ≤5 years. Case-patients were more likely than controls to report live baby poultry contact (matched odds ratio [mOR]: 17.0; 95% confidence interval [CI]: 2.7–710.5), contact with chicks (mOR: 14.0; 95% CI: 2.1–592.0), ducklings (mOR: 8.0; 95% CI: 1.1–355.0) and visiting agricultural feed stores (mOR: 6.0; 95% CI: 1.3–55.2). Most (83%) visited agricultural Feed Store Chain Y, a national agricultural feed store chain, which received poultry from Hatchery C, which is supplied by multiple egg sources. Salmonella Typhimurium was isolated from a source duck flock, but had a different pulsed-field gel electrophoresis pattern than the outbreak strain.

Conclusions: Live baby poultry remain an important source of human salmonellosis, particularly among children. Preventing these infections requires comprehensive interventions at hatcheries and agricultural feed stores; pediatricians should inform patients of risks associated with live poultry contact.

From the *Epidemic Intelligence Service; Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA; Pennsylvania Department of Health, Northeast District Office, Wilkes-Barre; §Pennsylvania Department of Health, Harrisburg; Pennsylvania Department of Health, Exton, PA; New York State Department of Health, Albany, NY; **United States Department of Agriculture Animal and Plant Health Inspection, Service National Poultry Improvement Plan; ††Outbreak Response and Prevention Branch; ‡‡Enteric Diseases Laboratory Branch; and §§Biostatistics Office, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA.

Accepted for publication August 21, 2012.

Results of this investigation were presented in part in April 2010 at the 2010 Epidemic Intelligence Service Conference, Atlanta, GA, in October 2010 at the 2010 Infectious Disease Society of America Conference, Vancouver, Canada and in July 2011 at the American Veterinary Medical Association Annual Convention in St. Louis, MO.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

This investigation was conducted by employees of federal and state public health agencies, as part of their duties of employment. There was no other source of funding outside of employment. The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Anagha Loharikar, MD, Centers for Disease Control and Prevention, 1600 Clifton Road NE Mailstop A38, Atlanta, GA 30333. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.