Salmonellosis Salmonellosis Is a Bacterial Illness Cases

Selected Reportable Communicable Disease Summary: 2008–2009

Salmonellosis Salmonellosis is a bacterial illness cases. The incidence of infection is highest in characterized by acute abdominal pain, infants and young children. diarrhea, and often fever that begins 12 hours to five days after infection. In cases of Of approximately 2,500 known serotypes, only enterocolitis, fecal excretion usually persists for about 200 are detected in the United States in several days or weeks beyond the acute phase any given year. In Oregon, S. Typhimurium of illness. Antibiotics generally have no effect and S. Enteritidis are the two most commonly on the illness and, in fact, may increase the reported serotypes. duration of organism excretion. In 2008, 396 cases of Salmonella were A wide range of domestic and wild animals confirmed and 33 cases were identified are carriers of Salmonella, including poultry, as presumptive. Twelve outbreaks of swine, cattle, rodents, iguanas, tortoises, turtles, salmonellosis with > 70 people affected young poultry, dogs and cats. The majority of were investigated in Oregon. Of those, nine human infections are thought to result from the were foodborne, and in three the source of ingestion of fecally contaminated food or water. Salmonella could not be determined. In 2009, Raw or undercooked produce and products 416 cases of Salmonella were confirmed, 25 of animal origin, such as eggs, milk, meat and cases were identified as presumptive. During poultry, have been implicated as common the same year, 18 outbreaks of Salmonella sources of animal and human salmonellosis. were investigated with 160 people reported Though uncommon, person-to-person spread ill. In six (33%) the source of the outbreak can occur in humans via patients, convalescent could not be determined. carriers and, especially, mild and unrecognized

Salmonellosis by year: Oregon, 1988–2009

600

500

400 s e

s 300 a C

200

100

0 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 8 8 9 9 9 9 9 9 9 9 9 9 0 0 0 0 0 0 0 0 0 0 9 9 9 9 9 9 9 9 9 9 9 9 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2

61 Selected Reportable Communicable Disease Summary: 2008–2009

Incidence of salmonellosis: Oregon vs. nationwide, 1988–2009 Incidence of Salmonellosis, Oregon vs. nationwide: 1988–2009 25 Oregon US 20

0 15 0 0 , 0 0 1 / s e

s 10 a C

0 8 0 2 4 6 8 0 2 4 6 8 8 9 9 9 9 9 0 0 0 0 0 9 9 9 9 9 9 0 0 0 0 0 1 1 1 1 1 1 2 2 2 2 2

Incidence of salmonellosis by county of residence: Oregon, 2000–2009

Clatsop Columbia

Umatilla Tillamook Hood Wallowa Washington Multnomah River Morrow Union Clackamas Sherman Yamhill Gilliam Wasco Polk Marion Baker Lincoln Wheeler Jefferson Linn Grant Benton

Crook Lane Deschutes Rate per 100,000 rate per 100,000 0.0–3.8 Malheur 0.0 - 3.8 3.9–7.9 3.9 - 7.9 Coos Harney Douglas 8.0–10.4 Lake 8.0 - 10.4 10.5–13.9 10.5 - 13.9 14.0–26.0 14.0 - 26.0 Curry Klamath Josephine Jackson

63 Selected Reportable Communicable Disease Summary: 2008–2009

Salmonellosis by onset month: Oregon, 2009 Salmonella 70 2009 Median 2004–2008 60

40 s e s a C 30

0 Jan Feb March April May June July August Sept Oct Nov Dec

Incidence of salmonellosis by age and sex: Oregon, 2009 Incidence of salmonella by age and sex, Oregon 2000–2009 40 Male Female 35

25 0 0 0 , 0

0 20 1 / s e s a

C 15

0 0–4 5–9 10–19 20–29 30–39 40–49 50–59 60–69 70–79 80+ Age

62 Selected Reportable Communicable Disease Summary: 2008–2009

Selected* Salmonella by serotype, Oregon, 2000–2009

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Enteritidis 45 34 43 78 64 86 74 54 76 61

Heidelberg 10 26 27 12 42 51 19 26 23 44

Montevideo 20 13 17 16 15 15 13 12 15 22

Muenchen 6 8 10 5 7 8 8 9 9 10

Newport 9 16 31 38 14 17 16 17 15 15

Oranienburg 7 10 12 13 6 8 5 8 8 6 Paratyphi B var. 6 9 8 7 17 20 7 11 7 3 Java

Saintpaul 12 4 18 36 16 7 10 3 23 10

Typhimurium 72 86 67 83 86 84 90 52 65 81

*Selected because at least one case was reported in 2009 and it is a more common serotype.

Shigellosis Shigellosis is an acute bacterial infection Outbreaks in daycare centers are common, characterized by (sometimes bloody) diarrhea, mainly due to the poor hygienic practices vomiting, abdominal cramps and, often, of small children. Hand washing is the most fever. Humans are the only known reservoir. important means of prevention. Treatment Shigellosis is transmitted from person to person, reduces duration of illness, but the organism and just a few organisms can cause illness. has become resistant to many antibiotics used for empiric therapy. Testing for antibiotic It is important to track the incidence of this susceptibility is important for treatment. disease to see trends and to detect outbreaks. The rate is higher among children 1–4 years In 2008 there were 94 cases, five which of age. The incidence of shigellosis usually were outbreak-related and 34 household increases in late summer and fall. A large transmissions. The number of cases in 2009 community-wide outbreak in 1991 resulted decreased to 56, a historic all-time low for in hundreds of cases in multiple Portland Oregon. There were no outbreaks, 39 metropolitan area daycare centers from April cases were reported as sporadic and 17 onward. At the tail end of that summer, in household transmission. August, additional cases were associated with a dual pathogen outbreak (E. coli and Shigella) at Blue Lake Park in Fairview.