Investigation

∙ Single cases of S. Paratyphi bioser Java infection should be followed up to ascertain exposures such as  overseas travel, sandpits (associated with outbreaks on the Northern beaches of Sydney), aqu ariums in  the home and imported seafood (both associated with multi-antibiotic resistant S. Paratyphi bioser Java  organisms).

∙ Single cases of S. Enteritidis need to be followed up to ascertain overseas travel during their exposure  period. If the case was unlikely to have been acquired overseas, the case should be interviewed with the  Salmonella Enteritidis questionnaire to ascertain a possible local source (see Useful links section). S.  Enteritidis is transmitted through consumption of contaminated eggs where transovarial transmission  has occurred. While S. Enteritidis is endemic in commercial poultry farms in most countries it is not  endemic in chicken flocks for egg-laying or meat production in Aus tralia. Understanding the  epidemiology of locally acquired S. Enteritidis infection in humans may assist in the detection of S.  Enteritidis in poultry.

∙ If the case has recently travelled overseas, determine what countries were visited during their exposure  period. An interview with the hypothesis generating questionnaire is not necessary for cases that were  most likely infected while overseas.

∙ Investigation into single cases of infections of other serotypes of Salmonella is dependent on local  epidemiology and at the discretion of the Public Health Unit Director. The identification of unusual or  emerging pathogens may prompt an investigation.

Education

The case or relevant care-giver should be informed about the nature of the infection and the mode of  transmission. Emphasise the importance of correct food handling and hygienic practices, particularly hand  washing before eating and preparing food and after going to the toilet. Casess of S. Enteritidis explained

Isolation and restriction

∙ Cases who are food handlers should not attend work until 48 hours have elapsed after symptoms  resolve. The case should be provided with information regarding hand washing and hygiene before  returning to work.

∙ Other people with Salmonella infection should not attend work while diarrhoea is present

∙ Cases who reside in an institution should be cohorted (separated from non-infected residents) if  possible. Contact precautions should be used when caring for infected residents

∙ Children in childcare should be excluded until 24 hours after diarrhoea ceases. It is not necessary for  them to be excluded if they have a positive stool sample but do not have symptoms.

Environmental evaluation

Where a food source is suspected on epidemiological grounds, immediately notify the NSW Food Authority to  conduct an environmental assessment and consider control measures.   APA