The outbreak of intestinal illness among people who attended a church supper in St. Mary's County is a sobering reminder of the risk posed by salmonella -- the leading cause of foodborne sickness in the United States.
And the death of an elderly woman -- who was among the 143 people who reportedly got sick after the dinner -- illustrates the fact that the aged are particularly at risk for serious and even fatal complications of the bacterial infection.
Health officials in St. Mary's County do not know what caused the disease, but are leaning toward turkey as a possible culprit.
Salmonella is carried by a large variety of foods, but disease outbreaks are usually traced to poultry -- including eggs and the meat of turkey and chicken. Over the past decade or so, the bacteria has spread relentlessly through the nation's poultry flocks, infecting birds in the East before heading West and reaching California in the past few years.
"Seventy percent of [foodborne illness] outbreaks are linked to salmonella," said Dr. Cindy Sears, an infectious disease specialist at the Johns Hopkins School of Medicine. "Most of that is thought to be related to eggs, but I would not rule out turkey as a vehicle."
A government survey in the early 1990s found that half the turkey slaughterhouses in the United States had at least one bird infected with salmonella. "It commonly contaminates the fowl that you buy on the supermarket shelf," said Dr. Karen Kotloff, an associate professor of pediatrics at the University of Maryland School of Medicine.
Because the organism is so widespread, experts believe that the only sure way to protect oneself against disease is to cook poultry thoroughly. This means cooking eggs until the yolks are solid and meat until there is no trace of pink.
"The long, slow overnight cooking of turkey is discouraged," Sears said. When turkey is slow-cooked, oven temperatures may not be hot enough to kill all the organisms. Or worse, an oven that is merely warm might actually promote the growth of salmonella.
Stuffings are particularly risky because they absorb drippings that may be rich in bacteria -- and because the cavity is often the coolest part of the bird. People who fail to wash their hands and countertops after handling raw poultry or eggs can inadvertently contaminate other foods.
When ingested, salmonella multiplies in the small intestines, where it causes symptoms that start with nausea and abdominal cramps, followed by diarrhea, fever and vomiting.
The illness is usually mild, lasting one to four days. But it can be much more serious among people whose immune systems are poorly equipped to fight infection. These include the elderly, the very young and people with AIDS, cancer and other chronic illnesses.
In severe cases, it can cause life-threatening dehydration or blood poisoning.
In 1992, the last year for which records are available, the U.S. Centers for Disease Control and Prevention received reports of 80 salmonella outbreaks involving 2,834 separate cases. Four people died in those outbreaks.
But experts believe the disease is vastly underreported.
Pub Date: 11/06/97