A skilled nursing and rehabilitation center in Blue Hill, Nebraska is ground zero for an outbreak of Salmonella Newport, a potentially drug-resistant strain of bacteria that in this case has caused 17 confirmed illnesses and 2 additional probable cases among residents, visitors and staff. The Nebraska Department of Health and Human Services expects to have results on the isolates regarding susceptibility of the Salmonella Newport serotype later this week, according to spokeswoman Leah Bucco-White. Four residents of the Blue Hill Care Center were hospitalized for a short time after showing symptoms, and one visitor remains in the hospital. Blue Hill is located in Webster County about 175 miles south and west of Omaha. The outbreak is being investigated by the state and local South Heartland District Health Department, and health officials said the “Blue Hill Care Center is cooperating fully with the investigation to help identity the source and eradicate the issue.” Salmonella Newport causes significant clinical disease in humans, livestock, particularly cattle, and in other animal species. Multiple antimicrobial-resistant strains of S. Newport have been recorded in the U.S. and Canada, according to Purdue University. All of these strains are resistant to ampicillin, chloramphenicol, streptomycin, sulphonamides and tetracycline. In addition, many of these strains show intermediate or full resistance to third-generation cephalosporins, kanamycin, potentiated sulphonamides and gentamicin. Salmonellosis is caused by an infection with bacteria called Salmonella, which live in the intestinal tracts of humans and other animals, including birds. It is usually spread to humans when they eat food contaminated with animal feces, such as beef, poultry, milk, or eggs. Non-animal products such as vegetables can also become contaminated. Thorough cooking kills Salmonella. Salmonella can also be spread through contact with pets and pet feces, including birds and reptiles. People should always wash their hands immediately after handling an animal or touching its environment, even if the animal appears healthy. It is not yet clear whether the Salmonella Newport bacteria that caused this outbreak originated in a food or water source Symptoms of Salmonellosis include fever, diarrhea and intestinal cramps. Symptoms usually appear 12 to 72 hours after a person has been infected and the illness and last 4 to 7 days. While most people recover without treatment, severe symptoms or spread of infection to the blood stream can lead to hospitalization.