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BACKGROUND: We describe an investigation of a confirmed Salmonella I 4,5,12:i:- gastroenteritis outbreak in April–May 2013 at Firefly on Paradise restaurant in Las Vegas, Nevada, that affected at least 336 people, and suspected that the outbreak was likely due to cross-contamination in the restaurant’s kitchen.
METHODS: The outbreak response consisted of conducting a facility inspection, closing the restaurant, testing clinical and food specimens, performing a case-control study, and carrying out surveillance for additional illnesses.
RESULTS: During the restaurant inspection, we identified numerous conditions that could have fostered microbial growth and their cross-contamination among foods. Serotype Salmonella I 4,5,12:i:- was matched by pulsed field gel electrophoresis in 199 clinical stool specimens, and of these, 138 were confirmed to be associated with the restaurant. Univariate analysis implicated several food items served at the restaurant that were statistically significantly associated with illness. The outbreak strain of Salmonella was isolated from one food specimen (cooked chorizo), but this product likely became contaminated after the cooking process in the restaurant’s kitchen. The original source of Salmonella was not determined. Timing of the illness onset dates of 4 restaurant employees suggested that none was the source of the illness. Residents from 29 American states and 2 foreign countries were affected, and Nevadans comprised 60% of those who were ill. Among 3,414 restaurant patrons served by the restaurant, the observed attack rate was 10%. Over half (N=172; 51%) of case-patrons sought medical care and 50 (15%) of those affected were hospitalized. No deaths were reported.
CONCLUSIONS: To prevent such outbreaks, food service establishments should adhere to established food safety regulations, implement policies and practices that impede microbial proliferation, and eliminate opportunities for cross-contamination.