AN OUTBREAK OF SHIGELLA-DYSENTERIAE TYPE-2 AMONG LABORATORY WORKERS DUE TO INTENTIONAL FOOD CONTAMINATION

Context.-Shigella dysenteriae type 2 is rare in the United States, and outbreaks associated with this pathogen are uncommon. Objective.-To d etermine the magnitude and source of an outbreak of S dysenteriae type 2. Design.-Retrospective cohort. Setting.-Laboratory of a large medic al center. Patients.-Case patients were identified as laboratory worke rs who had diarrhea on or after October 28 and a positive stool cultur e or temperature greater than 37.8 degrees C. Laboratory workers with diarrhea only were probable case patients. Main Outcome Measures.-We i nterviewed laboratory staff and performed identification, serotyping, and pulsed-field gel electrophoresis on isolates from case patients, i mplicated food, and laboratory stock culture. Results.-From October 29 through November 1, a total of 12 (27%) of 45 laboratory staff develo ped severe, acute diarrheal illness; 8 had S dysenteriae isolated from stool and 4 were hospitalized. All case patients reported having eate n muffins or doughnuts placed in the staff break room on October 29. P ulsed-field gel electrophoresis showed stool isolates from 9 case pati ents were indistinguishable from S dysenteriae type 2 recovered from a n uneaten muffin and from the laboratory's stock strain, a portion of which was missing. Conclusions.-The source of the outbreak was most li kely the laboratory's stock culture, which was used to contaminate the pastries. Results of this investigation underscore the need for adequ ate precautions to prevent inadvertent or intentional contamination fr om highly pathogenic laboratory specimens.