{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:43:52Z","timestamp":1777898632099,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T00:00:00Z","timestamp":1597276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The Virginia Department of Health (VDH) identified an outbreak of Salmonella serotype Javiana infections in Virginia after a chili and chowder cook-off with 11 competitors and about 2500 attendees on September 30, 2017. The objectives of this study were to assess the extent of the outbreak and identify the most likely source of exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To identify people with suspected Salmonella infection, VDH used press releases and social media posts to recruit event attendees to take an online survey about foods eaten at the cook-off and any gastrointestinal (GI) symptoms experienced. VDH defined a case as reported GI illness that occurred within 1 week after eating food from the cook-off. Confirmed cases required a clinical specimen culture positive for Salmonella. Probable cases reported diarrhea or related clinical symptoms. \u201cNot ill\u201d people did not report GI illness. Investigators calculated unadjusted relative risks of illness and performed stratified analysis to address potential confounding. Available food samples were tested for Salmonella. Environmental health specialists interviewed food handlers and inspected restaurants where 3 competitors had prepared food.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 438 survey responses, 171 (39%) met the case definition. Of all chilies and chowders consumed, Chowder A was associated with the highest relative risk of illness (8.9; 95% CI, 5.7-13.7). A Chowder A sample tested positive for Salmonella serotype Javiana. The environmental investigation did not identify an original contamination source but did find deficiencies in maintaining safe cooking temperatures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Epidemiologic and laboratory findings indicated that Chowder A was the most likely cause of outbreak. Recommendations to prevent future outbreaks include preparation of all food on-site to ensure safe temperatures during food preparation and service.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0033354920944861","type":"journal-article","created":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T19:45:56Z","timestamp":1597347956000},"page":"668-675","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Salmonellosis Outbreak After a Large-Scale Food Event in Virginia, 2017"],"prefix":"10.1177","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2964-8946","authenticated-orcid":false,"given":"Kelly A.","family":"Shaw","sequence":"first","affiliation":[{"name":"Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, GA, USA"},{"name":"Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"Wright","sequence":"additional","affiliation":[{"name":"Eastern Shore Health District, Virginia Department of Health, Accomac, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Privett","sequence":"additional","affiliation":[{"name":"Eastern Shore Health District, Virginia Department of Health, Accomac, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelsey","family":"Holloman","sequence":"additional","affiliation":[{"name":"Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth","family":"Levine","sequence":"additional","affiliation":[{"name":"Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"McCombs","sequence":"additional","affiliation":[{"name":"Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Turner","sequence":"additional","affiliation":[{"name":"Division of Consolidated Laboratory Services, Virginia Department of General Services, Richmond, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Holsinger","sequence":"additional","affiliation":[{"name":"Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane","family":"Woolard","sequence":"additional","affiliation":[{"name":"Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,8,13]]},"reference":[{"key":"bibr1-0033354920944861","unstructured":"Virginia Department of Health. Virginia monthly morbidity surveillance report\u2014surveillance and investigation. Accessed June 4, 2020. https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/virginia-reportable-disease-surveillance-data\/virginia-monthly-morbidity-surveillance-report-2018"},{"key":"bibr2-0033354920944861","unstructured":"Centers for Disease Control and Prevention.\n                      Salmonella\n                      . 2020. Accessed January 18, 2020. https:\/\/www.cdc.gov\/salmonella\/index.html"},{"key":"bibr3-0033354920944861","doi-asserted-by":"publisher","DOI":"10.3201\/eid1701.P11101"},{"key":"bibr4-0033354920944861","unstructured":"Centers for Disease Control and Prevention. EHS-Net resources. 2019. Accessed June 4, 2020. https:\/\/www.cdc.gov\/nceh\/ehs\/ehsnet\/resources\/index.htm"},{"key":"bibr5-0033354920944861","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"bibr6-0033354920944861","unstructured":"Facebook. Eastern Shore Health District. 2017. Accessed June 4, 2020. https:\/\/www.facebook.com\/EasternShoreHealthDistrict\/"},{"key":"bibr7-0033354920944861","unstructured":"Aragon TJ. epitools: Epidemiology Tools. 2017. Accessed June 4, 2020. https:\/\/CRAN.R-project.org\/package=epitools"},{"key":"bibr8-0033354920944861","doi-asserted-by":"publisher","DOI":"10.1089\/fpd.2006.3.59"},{"key":"bibr9-0033354920944861","volume-title":"Bacteriological Analytical Manual","author":"Andrews WH.","year":"1998","edition":"8"},{"key":"bibr10-0033354920944861","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2017.00375"},{"key":"bibr11-0033354920944861","doi-asserted-by":"publisher","DOI":"10.3201\/eid1908.121511"},{"key":"bibr12-0033354920944861","doi-asserted-by":"publisher","DOI":"10.4315\/0362-028X-63.5.579"},{"key":"bibr13-0033354920944861","unstructured":"Matthews J., Venkat H., Sunenshine R et al. Investigation of a local outbreak of\n                      Salmonella Javiana\n                      involving a seafood restaurant receiving imported product. 2017. 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