SUMMARYWe describe the investigation of two temporally coincident illness clusters involving salmonella andStaphylococcus aureusin two states. Cases were defined as gastrointestinal illness following two meal events. Investigators interviewed ill persons. Stool, food and environmental samples underwent pathogen testing.Alabama: Eighty cases were identified. Median time from meal to illness was 5·8 h.SalmonellaHeidelberg was identified from 27 of 28 stool specimens tested, and coagulase-positiveS. aureuswas isolated from three of 16 ill persons. Environmental investigation indicated that food handling deficiencies occurred.Colorado: Seven cases were identified. Median time from meal to illness was 4·5 h. Five persons were hospitalised, four of whom were admitted to the intensive care unit.SalmonellaHeidelberg was identified in six of seven stool specimens and coagulase-positiveS. aureusin three of six tested. No single food item was implicated in either outbreak. These two outbreaks were linked to infection withSalmonellaHeidelberg, but additional factors, such as dual aetiology that includedS. aureusor the dose of salmonella ingested may have contributed to the short incubation periods and high illness severity. The outbreaks underscore the importance of measures to prevent foodborne illness through appropriate washing, handling, preparation and storage of food.
Pulse oximeter perfusion index for assessment of brachial plexus block: a holy grail or a design fail?