Clinical presentation and treatment of a Salmonella bredeney epidemic in Shelby County, Alabama

Background. Numerous residents of Shelby County, Alabama, were infected with Salmonella when a restaurant unknowingly served food tainted with the bacterium. Because of the similarity in symptoms caused by other gastrointestinal pathogens and the variability in time of presentation, an outbreak such as this could be confused with one of another pathogenic origin. The pathogen identified, Salmonella bredeney, is a particularly rare cause of food poisoning. It makes up only 0.1% of the Salmonella isolates identified by the Centers for Disease Control and Prevention (CDC) each year. Methods. We analyzed patient presentations through chart review and combined this information with that obtained from the state laboratories in Montgomery and the Shelby County Health Department. Results. Symptoms were mostly gastrointestinal and ranged greatly in severity. The total number of patients affected in this incident exceeded 170, making it the largest epidemic of its kind ill the recent history of Alabama. Conclusions. The outbreak in Shelby County was caused by an exceedingly rare species of Salmonella. At this time, it is the only outbreak of S bredeney reported in MEDLINE-accessible literature since 1983.