Over the weekend, 40 residents and employees of a Pineville, Louisiana state hospital presented with gastrointestinal symptoms after eating in the facility’s cafeteria. Some of the victim’s symptoms were so severe that hospitalizations were required, and three patients died shortly after being sickened. State health officials and investigators publicly stated that foodborne illness was a suspect in the investigation and the culprit may be chicken salad. This revelation begins to narrow down the likely foodborne pathogenic culprits at hand in this poisoning.
Since chicken salad is typically served cold, it makes the food particularly susceptible to certain pathogens that thrive at the temperatures that a chicken salad is stored and served. Many of these foodborne microbes cause intense illness and are common to the institutional food service environment. If chicken salad is the suspect that proves to be the outbreak food source, a likely food poisoning suspect would be Staphylococcus aureus.
Staphylococcus aureus, or “Staph”, is sometimes referred to as the “cafeteria” illness because of its relationship with public food settings. Staph is a common bacterium found on human skin in nasal passages. When Staphylococcus aureus contaminates food it is not necessarily the bacteria that cause the foodborne illness, but rather a toxin produced from the bacteria.
Staphylococcus aureus poisoning can onset very quickly in comparison to other foodborne illnesses, with symptoms coming on in a matter of hours after ingestion of the toxin. The symptoms of Staphylococcus poisoning can be intense, but typically the Staphylococcus foodborne illness isn’t fatal for its victims. But foodborne illness has a way of attacking the most vulnerable of our citizens. All three of the deaths were patients at the Central Louisiana State Hospital, and these victims could have had preexisting conditions that would have made these individuals more susceptible to the powerful poisons that Staphylococcus can produce.
Norovirus is another likely foodborne pathogen suspect in the Central State Hospital outbreak. Norovirus gets passed from people who are infected with the virus and leave behind the microbe on surfaces they touch. Like Staphylococcus aureus, Norovirus is also associated with buffet or cafeteria type settings, often being reported as the foodborne pathogen responsible for cruise ship outbreaks.
Norovirus illness can onset quickly after exposure to the virus and the illness is often very intense. But norovirus illness is rarely lethal even for individuals with preexisting conditions or weakened immune systems, but that doesn’t mean that there aren’t deaths associated with norovirus or norovirus symptoms, like dehydration, that could lead to dangerous complications.
Salmonella has been associated with cold salads and foods made with chicken. If the chicken wasn’t properly cooked, or if the chicken salad was cross contaminated with another Salmonella contaminated product, it could easily become a breeding ground for the dangerous bacteria. Salmonella can be very dangerous, and it is responsible for hundreds of deaths every year. The usual onset time for Salmonella is not within the reported time frame of the Central State Hospital outbreak, but that doesn’t mean Salmonella is immediately ruled out. Salmonella food poisoning has been known to onset in a matter of hours dependent on the amount initially consumed.
There is the possibility that the poisoning occurred from an unlikely pathogen. E. coli O157, which is typically found in cow feces, has a way of getting into foods that it’s not supposed to get into. A year ago, people across America were sickened by at least two different strains of E. coli O157 found in Nestle cookie dough. E. coli O157 has also been discovered in leafy vegetables and fruits.
An E. coli similar to the O157 type is E. coli O145, which was recently discovered in a bag of romaine lettuce after investigations into a national outbreak of E. coli O145. The Louisiana Central State Hospital outbreak’s onset times and the foods involved don’t indicate E. coli as a culprit, but you can never be sure when dealing with E. coli. The same rings true for any number of foodborne illness culprits like Campylobacter or Shigella.
There is also the often overlooked form of food poisoning, actual poisons in the food. Poisons can end up in foods through both accidental and intentional means. Kitchens often contain industrial chemicals and other powerful cleansers used to sanitize floors, dishes, pots and pans and counters. These chemicals have found their way into foods especially when safety procedures are overlooked.
Whatever the source of the foodborne illness outbreak, the poisonings at Louisiana’s Central State Hospital highlight the unique dangers of food poisoning at hospital facilities. These cafeterias serve large numbers of individuals in a short amount of time, some of these people will have preexisting conditions, it is a hospital after all, and preexisting conditions and food poisoning can be a frighteningly dangerous combination.
Many of the illnesses I have discussed can be controlled with proper processing on the part of the food manufacturer, vigilant sanitation on the parts of kitchens and kitchen employees, and proper storage and handling of the food. When any of these protocols fail, the results are often tragic.
Richard J. Arsenault, 2010
