Protracted, Intermittent Outbreak of Salmonella Mbandaka Linked to a Restaurant

Michigan, 2008-2019

William D. Nettleton, MD; Bethany Reimink, MPH; Katherine D. Arends, MPH; Douglas Potter, MBA; Justin J. Henderson, MPH; Stephen Dietrich, MS; Mary Franks, MPH


Morbidity and Mortality Weekly Report. 2021;70(33):1109-1113. 

In This Article

Public Health Response

In addition to routine inspections and administrative hearings in 2012 and 2014, iterative facility environmental assessments and administrative hearings during 2017–2018 addressed cleanliness, lack of active managerial control, and other foodborne illness risk factors cited at restaurant A. In addition to employee stool screening for Salmonella and exclusion of asymptomatic employees with Salmonella stool positive results, employees were also required to submit stool specimens for Salmonella testing if new onset of gastrointestinal symptoms occurred during the 2018 public health response. Seven employees reported symptoms, but all had negative Salmonella test results. Before the initial environmental Salmonella sampling event in spring 2018, the facility temporarily closed for renovations of the kitchen, flooring, walls, and major equipment. The restaurant was required to clean all facility and food contact surfaces to norovirus cleaning standards* and underwent follow-up environmental Salmonella sampling. In fall 2018, the facility temporarily closed for additional floor and equipment renovations with the intent of eradicating Salmonella from the facility. The facility again had a full norovirus standard cleaning performed before reopening. Despite kitchen renovation and environmental hygiene interventions, Salmonella Mbandaka continued to be detected in restaurant A. Therefore, the restaurant voluntarily and permanently closed in late 2018, and food, dishes, storage, soft goods, chairs, and tables were destroyed. The metal food production equipment was extensively cleaned, quarantined, and resampled for Salmonella before being redeployed. The building was deemed ineligible for food production or storage relicensure. One case of the outbreak subtype was isolated in urine 8 months after closure of the restaurant; the patient reported chronic, intermittent diarrhea after eating at restaurant A 3 weeks before it closed.