OUTBREAK OF SALMONELLA SEROTYPE HARTFORD INFECTIONS ASSOCIATED WITH UNPASTEURIZED ORANGE JUICE

Context.-Acidic foods such as orange juice have been thought to be unl ikely vehicles of foodborne illness. Objective.-To investigate an outb reak of Salmonella enterica serotype Hartford (Salmonella Hartford) in fections among persons visiting a theme park in Orlando, Fla, in 1995, Design.-Review of surveillance data, matched case-control study, labo ratory investigation, and environmental studies. Setting.-General comm unity, Participants.-The surveillance case definition was Salmonella H arfford or Salmonella serogroup C-1 infection in a resident of or a vi sitor to Orlando in May or June 1995. In the case-control study, case patients were limited to theme park hotel visitors and controls were m atched to case patients by age group and hotel check-in date. Main Out come Measures.-Risk factors for infection and source of implicated foo d. Results.-Sixty-two case patients from 21 states were identified, Bo th Salmonella Harfford and Salmonella enterica serotype Gaminara (Salm onella Gaminara) were isolated from stool samples of 1 ill person. Thi rty-two case patients and 83 controls were enrolled in the case-contro l study, Ninety-seven percent of case patients had drunk orange juice in the theme park vs 54% of controls (matched odds ratio, undefined; 9 5% confidence interval, 5.2 to undefined). The orange juice was unpast eurized and locally produced. Salmonella Gaminara was isolated from 10 of 12 containers of orange juice produced during May and July, indica ting ongoing contamination of juice probably because of inadequately s anitized processing equipment. Conclusions.-Unpasteurized orange juice caused an outbreak of salmonellosis in a large Florida theme park. Al l orange juice was recalled and the processing plant closed, Pasteuriz ation or other equally effective risk-management strategies should be used in the production of all juices.