Hospital outbreak of Salmonella virchow possibly associated with a food handler

A foodborne outbreak of salmonella infection at a private hospital in Londo n in 1994 was found to be associated with eating turkey sandwiches prepared by a food handler. One patient, nine staff, and a foodhandler's baby were confirmed to have Salmonella enterica serotype virchow, phage type 26 infec tion. The attack rate was estimated to be 5% among the approximately 200 pa tients and staff at risk. A food handler reportedly became ill days after, but her baby days before, the first hospital case. Although it appeared to be a single outbreak, antibiogram analysis, supplemented by plasmid profile typing, demonstrated that there were two strains of S. virchow involved, o ne with resistance to sulphonamides and trimethoprim and a second sensitive to these antimicrobial drugs. Mother and child had different strains. The investigation demonstrated the importance of full phenotypic characterizati on of putative outbreak strains including antimicrobial susceptibility test ing. Outbreaks of foodborne infection in hospitals are preventable and are assoc iated with high attack rates and disruption of services. There is a need fo r good infection control policies and training of all staff involved in pat ient care as well as in catering services. Consultants in Communicable Dise ase (CCDCs) should include private hospitals in their outbreak control plan s. Good working relations between Infection Control Doctors (ICDs) in the p rivate health sector and their local CCDCs are important if outbreaks are t o be properly investigated. (C) 2000 The Hospital Infection Society.