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    Highly Contagious Salmonella Infections Seen in Nursing Homes


    This super-salmonella strain was brought to the U.S. by a patient who suffered a stroke while traveling in the Philippines in 1995. Angulo says the patient was probably infected during his three-month treatment at the hospital in the Philippines. The patient was then sent to a nursing home in Oregon and while there infected eight other patients. One of those patients was briefly transferred from the nursing home to a hospital, and while hospitalized infected another elderly patient.

    The most likely scenario is that both patients were bathed in the same tub, a tub that wasn't adequately cleaned between baths, Angulo says. The patient infected in the hospital was subsequently discharged to a different nursing home, where the infection spread to a roommate.

    In all, 11 people, two nursing homes, and two hospitals were involved in an outbreak that continued over a four-year period, says Angulo.

    "Salmonella in a nursing home is an absolute disaster," says Morris. Although healthy adults can weather a salmonella infection with a few days of discomfort, among the very young and the very old -- who have poorer immune systems to fight infections -- the bacteria can be a killer because the infection can spread to the blood, causing a life-threatening condition know as bacteremia. The patients in the Oregon outbreak were aged 64 to 90.

    And salmonella is a pesky and persistent bacteria that many people excrete in their stool for up to two years after the acute illness is passed, says Morris. This process can be disastrous as the infection continues to be passed to more and more patients.

    "You keep repeating this cycle of transmission," he says. "It can be very difficult to break this without draconian measures, such as isolating patients, and no nursing home is going to do that."

    Scientists think that in the future, hospitals and nursing homes are likely to see more rather than less of this super salmonella. Hope for warding it off involves following good infection-control measures, including use of antibacterial cleaning solutions that can kill salmonella on surfaces like doorknobs and telephones, along with good old-fashioned -- but often-neglected -- hand washing.

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