Description of a serious outbreak of salmonellosis in a nursery school

Salmonellosis is a disease of humans and animals (zoonosis) caused by microorganisms of the genus Salmonella belonging to the Enterobacteriaceae family. Not all serotypes are important in animal health, because some do not cause disease in animals, however, they are important in public health because they are the cause of one of the major food poisoning.

This article describes clinically and epidemiologically an outbreak of gastrointestinal infection by Salmonella enterica (serotype). Enteritidis in a day care center, which resulted in high morbidity and significant social alarm.

57 children (aged between 3 and 45 months) and 2 workers out of 92 attending the center presented symptoms compatible with salmonellosis, with diarrhea and fever being the main symptoms. Children younger than 12 months were the first to manifest symptoms, grouped in the first 6 days. Those older than 24 months started with symptoms 8 days after day 1.

74% of the patients were transferred to the hospital, and 37% were admitted (mean stay 3.3 days). Some of the factors for which they were admitted were dehydration, significant elevation of acute phase reactants and coagulopathy. Twelve of them received parenteral cefotaxime. There were 2 complications: 1 bacteremia and 1 readmission. The initial suspicion of the origin of the outbreak was food, but the analysis of the control samples was negative. Five workers were positive (2 symptomatic). It was concluded that the probable origin of the outbreak was an asymptomatic carrier and improper handling of diapers. The center was closed for 8 days and cleaning and disinfection measures, diaper changing instruction and carrier follow-up were carried out.

Immediate notification of an outbreak is essential for early control. Therefore, a rapid communication, as well as an adequate study of the outbreak, allows the identification of the pathogen and the establishment of control measures within a reasonable period of time. As the second most common foodborne zoonosis in the European Union and one of the most frequent worldwide, it is essential to maintain proper hygiene when handling food throughout the food chain on the farm, in the slaughterhouse, in the industry and, of course, at home or in establishments.

Rubio, Granza A. et al. (2022) “Descripción clínica y epidemiológica de un brote grave de salmonelosis en una escuela infantil urbana” Revista Española de Quimioterapia. PMCID:PMC9134884