Rural Missouri hospital reports Salmonella outbreak


Missouri’s Perry County Memorial Hospital (PCMH) is reporting at least 23 cases of Salmonella have been diagnosed since  August 6.    And more than 30 cases may be involved in the outbreak, according to the Perry County Health Department, which does not yet know the source of the infections.

Patient ages range from 2 to 68.  Cases have presented to the PCMH ER and through the local physician offices.  Of these cases, three have required acute hospital admission, two short-term hospital observation, and treatment, and one case has been transferred to a Cape hospital.  To date, the others are recovering with medication and hydration at home.

PCMH is located in Perryville, MO with a population of fewer than 9,000 people.

Upon identifying this influx of patients, the PCMH Laboratory Director reported the case information to local and state health officials per state law.  The Perry County Health Department began immediately preparing the investigation of this outbreak and will be handling the evidence that will hopefully determine the source and/or causation of the illnesses.  The State Laboratory will receive culture samples of the infected patients to conduct their epidemiological investigation.

The symptoms of Salmonella infection are high fever, diarrhea, bloody stools, fatigue, abdominal pain, nausea and vomiting, and severe dehydration.  Some patients may experience some, but not all of the symptoms, while others will experience all such symptoms.  The incubation period for the bacteria is approximately 12 to 72 hours.  If patients have these symptoms, they should seek medical care to obtain testing to confirm their diagnosis.  Knowledge of being infected and early treatment is crucial to preventing serious illness and the spread of the disease.  Patients experiencing symptoms of severe dehydration; such as dizziness, weakness, fainting, confusion, and difficulty breathing should seek emergency care.

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Salmonella is highly contagious and is generally contracted through the consumption of contaminated food. Person-to-person transmission can also occur through contamination of hands or objects with bacteria shed in the stool.  It is a bacteria that can survive on surfaces leading to extensive transmission over time.  The best way to avoid contracting and spreading the bacteria is by practicing good handwashing technique and avoid person to person contact with an infected individual.  Thorough cleaning of food preparation areas and bathroom surfaces is recommended with known contact with an infected individual.  Cleaning solutions containing bleach are found to be the most effective against Salmonella.   Diarrhea must subside for at least 24 hours without the use of an anti-diarrheal agent before one should return to work, daycare, or school.

Special concern should be given to the elderly, immunocompromised patients, and small children.  These individuals can become quickly dehydrated and succumb to other health risks if severely infected.

In July, PCMH Laboratory implemented a new, highly specialized Gastrointestinal (GI) test panel which has been very beneficial in these cases.  The GI panel rapidly detects 22 of the most common organisms that cause diarrhea. This panel provides information used in treating patients in 1 to 3 hours as compared to the traditional stool culture testing which typically takes 3 to 5 days. This test helps a physician to diagnose the cause of abdominal symptoms, most commonly diarrhea, more accurately and efficiently than traditional testing. Identifying the correct infectious agent quickly can ensure appropriate treatment, proper management of an ailment and thus can help to limit the spread within the community.

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