[Tone] [National Library of Medicine, HF 1865] This transfer made: 01/16/06, Length: 00:13:18] [Music] [The U.S. Department of Health, Education, and Welfare Public Health Service presents] [A Communicable Disease Center Production] [Food Sanitation Series: An Outbreak of Salmonella Infection] [The U.S. Air Force, as a contribution to the control of communicable disease, made facilities and personnel available for this demonstration of a type of food-borne infection which could occur in any food-service establishment.] [Narrator:] This is Captain Kimberly, our Medical Officer. And these are some of our men eating their evening meal, as usual, at the end of another routine day. Yes, everything seems to be going well, just another day. But believe me, what followed turned out to be anything but routine. This meal is the beginning of our story, a story that developed during the night and continued for several days. During the early part of the night, we all went about our duties as usual. Everything was nice and smooth and quiet, the way we like to see things run. [Music] At midnight, about 40 of us in the duty section got a light meal. It was just about this time that things were beginning to happen. It began like this. At first a few of the men who weren't in the duty section got sick. More followed suit. And just before dawn, most of the men who had the midnight meal joined their ranks. You never saw such a sick bunch of men in your life. And it got steadily worse: vomiting, abdominal pains, and diarrhea. It was hard to tell which caused the most trouble. One thing is sure, the boys were well taken care of, some of them at the base infirmary, and others at a private hospital in town. [Music] For a while all we had time to do was bring in the sick-- and some of them were plenty sick-- get them in bed, and leave them to Captain Kimberly and his assistants. [Music] It was pretty rough going for a while. Vomiting, diarrhea, cramps, headache, sweating, prostration, fever, and dehydration. Yes, salmonella can make you plenty sick. [Music] Just as soon as we got the chance to let up and breathe a little, we got down to the business of finding the cause of all the trouble. Naturally, we had suspected some kind of food poisoning. And so it was. Look here, this is what we found. These are salmonella organisms of the species typhimurium, which were isolated from a patient's stool specimen. From the lapse of time between our patient's last meal and the outbreak of illness, it was pretty evident that the evening meals were responsible for the presence of the salmonella organisms in the stool specimen. In the meantime, our laboratory was working on samples of food eaten that night. [Music] Sampling, incubating, plating, transfer, and then more incubating. Laboratory examinations require time, and it may take several days to identify the organisms. Our results show that the other foods were okay. But the samples of leftover chicken and the gravy reveal the same bacteria as the stool specimens of the patients. For these, too, were thoroughly contaminated with salmonella typhimurium. How and when did the chicken and the gravy become contaminated with the organisms? Well, here's one thing we'll have to assume, but it's a pretty safe assumption, one or more of these chickens were contaminated by the salmonella organisms on the outside, and very likely inside. And of course the liver and gizzard are prime suspects. During the cleaning operation, this cutting board was undoubtedly contaminated. [Music] After the chickens were put in the oven, the giblets were cooked separately on top of the stove, and the cutting board was cleaned. But what a cleaning it got. Maybe we should just say that the salmonella organisms were more completely distributed over its surface and embedded in the cracks. [Music] While the giblets were cooking, a white gravy was prepared, and then the giblets were taken from the stove. Thorough cooking had killed the salmonella organisms, but this good clean food was recontaminated on the cutting board as it was chopped. [Music] Then these recontaminated giblets were put into the gravy. [Music] This contaminated gravy was not reheated, it was prepared for serving, and on the steam table, there wasn't enough heat to kill the organisms. In fact, there's a good chance they began to grow. [Music] The story was much the same with the chicken. Heat killed the salmonella organisms in the oven, but again the unclean cutting board contaminated the safe chicken meat as it was carved for serving. [Music] There wasn't much delay in getting the chicken served. [Music] And between the gravy and the chicken, we can account for the men who were sick around midnight or soon after. Those acute cases that occurred later form another chapter in our story. Here's how the next chapter goes. Food left over from the evening meal was saved for the midnight meal, and here in this lukewarm steam table, the salmonella organisms continued to grow. And to make matters worse, the cutting board contributed a new bunch of organisms as the leftover chicken was prepared for serving. [Music] So that by the time the midnight meal was served, the chicken a la king was supporting large numbers of salmonella organisms, enough to make the men on the night watch so violently ill. What could have prevented this sickness and suffering? We couldn't know that the chickens were infected. Look here. This is a detergent. This is hot water. This is a brush. These are hands. Put them together. Use them and get a clean cutting board, with all the troublemakers washed off. A good scrubbing immediately after the raw chicken was prepared would have gotten rid of the salmonella organisms. Of course this applies to our hands and anything else that might be contaminated by contact with the fowl. We made some other mistakes too. The leftover chicken should have been put into the refrigerator as soon as possible. And the gravy. It was cooked before the contaminated giblets were added. Thorough cooking after they were added would have killed the salmonella organisms. The air base mess hall accommodated the men in three shifts of approximately 150 at a time. Out of some 450 regular personnel, 173 became infected with salmonellosis, of which 84 were seriously ill enough to be hospitalized. All effected complete recovery and were back on duty within several days to about two weeks. [Music] [The End, M148a]