Salmonellosis Outbreak Traced to Playground Sand, Australia, 2007–2009

Michael Staff

, Jennie Musto, Geoff Hogg, Monika Janssen, and Karrie Rose

Author affiliations: New South Wales Health, Sydney, New South Wales, Australia (M. Staff, J. Musto); Public Health Laboratory, Melbourne, Victoria, Australia (G. Hogg); and Taronga Conservation Society Australia, Sydney (M. Janssen, K. Rose)

Abstract

A community outbreak of gastroenteritis in Australia during 2007–2009 was caused by ingestion of playground sand contaminated with Salmonella enterica Paratyphi B, variant Java. The bacterium was also isolated from local wildlife. Findings support consideration of nonfood sources during salmonellosis outbreak investigations and indicate transmission through the animal–human interface.

Variants of Salmonella enterica serovar Paratyphi B that use d-tartrate as a carbon source (known as S. enterica var. Java) primarily cause gastroenteritis. In contrast to experience in other countries (1–4), in Australia, S. enterica var. Java outbreaks have not been linked to food sources; the only outbreaks reported before 2007 were associated with imported ornamental fish (5). Sand in recreational sandboxes has been identified as a risk factor for infection of children with S. enterica serovar Typhimurium (6), and given the popular nature of this activity, there is a potential for sandboxes to pose a substantial public health hazard unless managed appropriately. We describe a protracted localized community outbreak associated with playground sand during 2007–2009, and highlight the need to consider nonfood sources when investigating salmonellosis outbreaks.