SALMONELLA OUTBREAK IN AN AMERICAN CHILD-DEVELOPMENT CENTER IN GERMANY

In July 1993, an outbreak of Salmonella occurred in a U.S. Army child care center in Heidelberg, Germany. Sixteen children and 4 staff membe rs had confirmed positive cultures; the center had an average census o f 135 children during the time of the outbreak. Rectal swabs were done on all the children in rooms with symptomatic children or staff or in rooms with confirmed cases. A total of 246 rectal swabs was done init ially, with 216 representing paired specimens. A case was defined as a staff member, child, or family member of an ill staff member or child who attended the center with diarrhea or abdominal pain with at least one of the following symptoms: diarrhea, fever, nausea, loss of appet ite, abdominal pain, vomiting, or lethargy. The attack rate for the ch ildren was 40 of 86 (47%), and the attack rate for staff was 15 of 47 (32%). No associations were found when looking at the attack rates in each of the 10 rooms in the center. Complete environmental investigati on revealed that the cook was preparing food 1 day before it was serve d. In addition, he was running the dishwasher without a sufficient amo unt of soap, Although food was not available for testing, the source o f the Salmonella outbreak appears to be uncooked or inadequately cooke d and prepared food with some person-to-person transmission.