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Toronto Sees Sharp Increase in Salmonellosis

Over the past decade, Toronto has averaged about 70 cases of Salmonella infection during the first two months of the year.

This year, as of February 28, 114 cases of salmonellosis have been confirmed in the city. In a news release, Toronto Public Health (TPH) attributed much of the sharp increase to three known clusters of illness:

–  a large catered event February 11 in York Region that resulted in transmission of S. typhimurium to numerous attendees who continue to report illness

–  an outbreak, still under investigation by Public Health Ontario, of a less common species of Salmonella (S. heidelberg) across the region

–  an uptick of S. enteriditis (the most common strain of Salmonella reported in Toronto) linked to recent travel to Cuba

Because of this general increase in circulating Salmonella infection, TPH is warning that there is higher chance of person-to-person transmission.

TPH is also advising the following:

– Health-care providers should consider salmonellosis in the differential diagnosis of patients presenting with signs and symptoms of gastroenteritis. Salmonella infection is confirmed by culture and is reportable to the local Medical Officer of Health.

– Symptoms of Salmonella infection, which include diarrhea, nausea, vomiting, abdominal cramps and fever usually occur within 6 to 72 hours after exposure and may last 2 to 5 days.

– Infants, elderly and immunocompromised individuals are at higher risk of bacteremia. Extraintestinal focal infections (e.g., arthritis, meningitis, pneumonia) can occur in those with bacteremia.

 – Ill patients should be reminded of the potential for transmission to others and the importance of proper hand hygiene and safe food handling practices should be emphasized.

– TPH requires individuals infected with Salmonella who work in or attend high risk environments such as food premises and child care facilities to be excluded from these settings until symptom-free for 24 hours (or until cleared with two negative stool specimens if asymptomatic with poor hygiene practices).

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