Salmonella outbreak shuts down New Bolton Center

Kennett Square, Pa. -The George D. Widener Hospital for Large Animals at University of Pennsylvania's (UP) New Bolton Center is expected to reopen Aug. 4 following its closure due to an outbreak of Salmonella Newport .

The virulent salmonella strain, which cultured positive in 16 cases of horse deaths at the equine facility, is resistant to treatment via the usual variety of antibiotics, officials say. Cleanup costs and lost revenue is expected to exceed $2 million.

To control the disease's spread, the hospital shut down and depopulated but has since reopened the Georgia and Phillip Hofmann Research Center for Animal Reproduction. The building sits two miles away from the large animal hospital and was closed to eliminate traffic flow among the campus' 70-plus buildings, officials say.

The university has adopted all preventative measures as the strain can cause serious disease, says Dr. Bruce Rappoport, hospital director and associate dean.

"The strain's multi-drug resistant status makes this a very serious, sensitive issue," he says. "Although 16 horses tested positive for the virus at the time of death, that does not mean they died from Salmonella. We don't know to what extent Salmonella might have been a contributing factor."

At presstime, no human cases were reported.

Adopting barriers

The first Salmonella case cropped up in May. Since then, Salmonella organisms have been found primarily in the orthopedic and neonatal intensive care units on the 700-acre New Bolton Center campus. With the facility closed, student rotations have been canceled and rescheduled for next year.

Salmonella is not uncommon among large animal veterinary teaching facilities with sizeable caseloads. The hospital dealt with a small outbreak in the 1980s, but has never closed before now. While the university does not fecal culture every animal admitted, that could change, Rappoport says.

"When you look at our caseload of 6,500, 16 cases does not seem to be overwhelming, but it's certainly unacceptable," he says. "We spend a lot of time and money routinely doing a lot of environmental culturing, and it was a cluster of cases that led us to recognize this problem."

Decontaminating

With the hospital out of use, a team made up of 120 faculty and staff have been employed to decontaminate the facility.

To oversee their efforts, officials appointed epidemiology and public health lecturer Dr. Helen Aceto, now named director of biosecurity. It's her job to implement cleaning protocols that will guard against future outbreaks.

"We're basically using an incident command-type structure," she says. "We've cultured all areas, the facilities, dormitories, cafeterias, research labs and farm management buildings. Everything south of the hospital has cultured negative and is functioning as normal with restrictions on vehicle and people traffic."

Major remediation is in order, Aceto adds. Stalls are being poured concrete, traffic patterns have changed and feed storage has moved.

"We're also putting in a whole new set of monitoring and reviewing in place before we reopen," she says. "We're implementing multi-level barriers."

Setting an example

At presstime, owners of deceased horses found to be Salmonella positive were not publicly reacting to the outbreak by way of legal action.

The role Salmonella played in the deaths is difficult to determine, says Dr. Paul Morely, Colorado State University's director of biosecurity who brought hired by UP to consult as the case erupted. Although Morely suspects Salmonella might have played a role in one or two deaths, most of the cases were seriously compromised for other health reasons, he says.

Closing the facility was aggressive, but necessary, he adds.

"I feel like the university has been very responsible and should be looked to as an example of how to deal with these constant threats," Morely says. "People can react that this is bad press, but to me the message is to take the best action depending on the situation."

"It's becoming very clear the best way to manage this type of risk is to have a comprehensive program in place. It's become the standard of practice."