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Tomatoes: Culprits of Salmonella outbreak

size and scope. "This outbreak is most likely due to tomatoes, and many cases were probably exposed through restaurants," he said.

According to Hedberg a major concern in restaurant-related outbreaks of salmonellosis is the role of infected food handlers in spreading the disease. He said that food service workers can become ill from eating the contaminated product and then expose customers to the disease when they are still shedding the organism and don't use proper hygiene practices.

Medus was the lead author of a study in the August issue of the Journal of Food Protection where the role of food service workers in restaurant-related Salmonella outbreaks in Minnesota between 1995 and 2004 was tracked. The researchers found that 129 of 1,033 food workers tested positive for Salmonella with about half of them reporting no recent gastrointestinal illness. Bacterial shedding lasted about 30 days in the workers who reported symptoms, but averaged only 3 days in those who didn't.

The authors of the report concluded that the duration of Salmonella outbreaks in restaurants suggests that there existed an ongoing contamination reservoir with infected food workers being a likely source of disease transmission.

Hedberg, a coauthor of the report, asserted that infected food workers, as secondary transmission sources, can increase the size and duration of the outbreaks. He said, "Restaurants should be stepping up surveillance for illnesses in their food workers," and also said that restaurants should make sure that food workers who have gastrointestinal illnesses are evaluated and treated.
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