NEWS RELEASE
April 13, 2000

Michigan Department of Community Outbreak Investigation Leads to CDC Article on Salmonella

Michigan Department of Community Health Director James K. Haveman, Jr., today announced that the Centers for Disease Control and Prevention (CDC) has profiled a 1999 Salmonella outbreak investigation in the current edition of the Morbidity and Mortality Weekly Report (MMWR).

"Other states can learn from our experience in identifying the source of human salmonella cases," said Haveman. "I commend our scientists and physicians who work diligently to find the sources of illnesses such as Salmonella and am pleased the Centers for Disease Control and Prevention has profiled Michigan's efforts."

Handling chicks and ducklings poses a health risk, particularly for children. Such exposures may occur more commonly during the spring or Easter season. The risk posed by chicks and ducklings may be highest for children since Salmonella infections in children may be more severe, and children are often recipients of chicks or ducklings as pets.

"It is extremely important to carefully wash your hands with soap and water after handling these animals and anything that has come in contact with them," said Michigan Department of Community Health Chief Medical Executive Dr. David R. Johnson.

Salmonella is a common cause of foodborne illness, but can also be spread to people by direct contact with animals that carry the bacteria. "Close contact with the birds, such as cuddling them when young and bringing them inside the house when its cold outdoors, may play a role in illness," said Dr. Johnson. "Children may especially be at risk for these infections, as they are less likely to wash their hands after touching the birds and have more frequent hand-to-mouth contact than adults."

Safe poultry handling practices are important for every stage of contact with poultry, ranging from care of live birds all the way through to food preparation of poultry products such as meat and eggs. Some facts about Salmonella and what you can do to reduce risk of illness are:

• Symptoms of Salmonella infection usually begin 12-72 hours after exposure and include diarrhea, fever, and abdominal cramps. Illness usually lasts 4-7 days, and most people will recover without treatment. Infants, children, the elderly and immunocompromised persons are more likely to experience severe illness due to Salmonella that may require treatment and/or hospitalization.
• Avoid contact with feces from poultry. Carefully wash your hands and the hands of children with soap and water after handling these birds and after touching anything that had contact with them. Be sure to wash hands after contact with your bird's food or environment, including pens and equipment.
• Keep your poultry in an outdoor area designed for them. Cold weather in Michigan may present a problem and owners should be prepared to have a means of keeping poultry warm in their pens. Do not bring live poultry into your house and keep them out of any area where food is prepared.
• Do not nuzzle or kiss your poultry or birds. Discourage poultry as pets for children. Always have parents or adults supervise children if they are around chicks, ducklings or other poultry.
• Wash your hands, kitchen work surfaces and utensils with soap and water immediately after they have come in contact with raw meat, poultry or other foods of animal origin.
• Thoroughly cook poultry, ground beef, and eggs before eating.

The following is an excerpt from the April 14, 2000 MMWR report from the CDC:

In May 1999, the Michigan Department of Community Health (MDCH) was notified of an increase in Salmonella serotype Infantis infections with closely related pulsed-field gel electrophoresis (PFGE) patterns; 21 case-patients were reported with onset of illness during April 1--July 31, 1999. Ages of infected persons ranged from 8 days to 82 years (mean: 25 years); eight (38%) were aged <10 years. Twelve (57%) were female. Symptoms reported during patient interviews included diarrhea (81%), fever (57%), bloody diarrhea (24%), and vomiting (14%). Three patients were hospitalized. Overall, 17 (82%) patients reported direct and/or indirect contact with young fowl: eight (38%) with chicks, two (10%) with ducklings, one (5%) with pheasant, and six (29%) with multiple species, including chicks and ducklings. Of the young fowl that were traceable, 88% were shipped from a single hatchery.

MDCH conducted a case-control study to identify exposures associated with illness. Nineteen patients were enrolled and were matched by age and place of residence to 37 healthy controls using sequential-digit dialing. During the 5 days before illness onset, 14 (74%) of 19 patients had direct contact with young fowl or resided in a household that raised fowl (chicks, ducklings, goslings, pheasants, and/or turkeys) compared with six (16%) of 37 controls (matched odds ratio [MOR]=20; 95% confidence interval [CI]=3--378). In several households, young birds were kept inside the home. One child kept young birds in his bedroom and another carried chicks inside his jacket.

MDCH, with assistance from the Michigan Department of Agriculture (MDA), visited the implicated hatchery in September 1999. During the spring, the hatchery shipped approximately 100,000 birds per week by mail order directly to customers and to several feed and farm supply retail outlets across the state. Fowl were shipped in lots of 25 to 100 birds, and usually were raised for backyard use (i.e., meat and egg production for the family). S. Infantis with the outbreak PFGE pattern was recovered from three of 47 environmental samples and five of 33 bird samples taken at the hatchery. Other Salmonella serotypes also were isolated from the environmental samples, including serotypes Montevideo (seven), Chester (one), and Mbandaka (one).