Consequences in Georgia of a nationwide outbreak of Salmonella infections: What you don't know might hurt you

Objectives. This study assessed the impact in Georgia of a nationwide salmonellosis outbreak caused by ice cream products and the effectiveness of the subsequent warning against eating the implicated products. Methods. A telephone survey of 250 randomly selected Georgia customers of the ice cream producer was conducted 13 to 17 days after the warning. Results. Respondents from 179 households representing 628 persons were interviewed. The median date of first hearing the warning was 5 days after it was issued, and 16 respondents (9%) had not heard it. Among those who had heard the warning, 42 (26%) did not initially believe the products were unsafe. In 22 (31%) of the 72 households that had the implicated ice cream when the respondent heard the warning, someone subsequently ate the ice cream. Diarrhea was reported in 26% (121/463) of persons who had eaten the products but in only 5% (8/152) who had not (odds ratio [controlling for household clustering] = 3.8; 95% confidence interval = 2.0, 7.5). We estimate this outbreak caused 11 000 cases of diarrhea in Georgia, 1760 (16%) with exposure after the warning. Conclusions. A large outbreak occurred in Georgia, much of which might have been prevented by a more timely and convincing warning.