ABSTRACT
Children under the age of 5 years experience a disproportionately high rate of bacterial enteric infections. Research has shown a relationship between inadequate child-care center sanitation and illnesses in children. This cross-sectional study assessed the sanitation levels of foodservice surfaces in a sample of 36 Texas child-care centers via recovery and identification of selected enteric gram-negative bacteria. The centers in this study had the capacity to care for 50 to 332 children and represented diverse socioeconomic and racial profiles. Forty-one percent (68 of 167) of total swab samples collected tested positive for bacteria. Twenty-seven different types of bacteria were identified from positive swab samples. Most of the bacteria found are considered opportunistic pathogens, which can pose serious health risks to those with compromised immune systems, such as young children. Two types of bacteria recovered, Salmonella paratyphi A and Klebsiella pneumonia, are considered nonopportunistic and can infect healthy individuals. The most common areas of bacterial contamination were the sink drain area of the dishwashing sink, the hand-washing sink faucet handles, the handle of the garbage can lid, and cutting boards. It is vital for child-care staff to wash their hands often and disinfect all surfaces, because even surfaces that appear clean can harbor microorganisms.
Subject(s)
Child Day Care Centers , Equipment Contamination , Food Microbiology , Food Services/standards , Sanitation/standards , Child, Preschool , Consumer Product Safety , Cross-Sectional Studies , Enterobacter/isolation & purification , Environmental Microbiology , Female , Food Contamination/analysis , Food Contamination/prevention & control , Foodborne Diseases/prevention & control , Humans , Klebsiella pneumoniae/isolation & purification , Male , Salmonella paratyphi A/isolation & purificationABSTRACT
Foodborne botulism is caused by potent neurotoxins of Clostridium botulinum. We investigated a large outbreak of foodborne botulism among church supper attendees in Texas. We conducted a cohort study of attendees and investigated the salvage store that sold the implicated foods. We identified 15 cases of botulism (40%) among 38 church supper attendees. Nine patients (60%) had botulinum toxin type A detected in stool specimens. The diagnosis was delayed in 3 cases. Fifteen (63%) of 24 attendees who ate a chili dish developed botulism (relative risk, undefined; P<.001). The chili dish was prepared with "brand X" or "brand Y" frozen chili, "brand Z" canned chili, and hot dogs. An unopened container of brand X chili yielded type A toxin. Brand X chili was purchased at a salvage store where perishable foods were inadequately refrigerated. Our investigation highlights the need to improve clinicians' awareness of botulism. More rigorous and more unannounced inspections may be necessary to detect food mishandling at salvage stores.
