Salmonella Outbreak at Costa Rica Hospital Sickens 66

Costa Rica's Ministry of Health has recorded 66 cases of Salmonella illness linked to Hospital CIMA in Escazú, with two cases confirmed by laboratory testing and two patients hospitalized. The U.S. Embassy in Costa Rica has issued a public alert in response.

Laboratory analysis identified Salmonella in the confirmed cases. Reported symptoms include diarrhea, abdominal pain, nausea, vomiting, fever, and general malaise, according to the embassy alert.

What is the source of the outbreak?

Investigators have not confirmed it. The Ministry of Health is working to identify common exposures among those affected and the mode of transmission. Reports describe illness among hospital workers. No specific food has been identified, and the source of contamination remains unconfirmed.

The embassy has advised its personnel to consider alternative locations for medical care until the outbreak is resolved. Its guidance to the public focuses on standard transmission controls:

• Consistent hand hygiene with soap and water, especially after using the restroom and before preparing or eating food
• Keeping raw and cooked foods separate
• Cooking eggs, poultry, and meat thoroughly
• Refrigerating perishable foods promptly
• Washing fruits and vegetables before consumption
• Avoiding unpasteurized dairy products
• Excluding anyone with gastrointestinal illness from preparing food for others while symptomatic

The last point carries particular weight in an institutional setting. Reports of illness among hospital workers mean that staff exclusion policies — keeping symptomatic food handlers and care workers off duty — are now a central containment question for the facility.

A second hospital outbreak in the region

The Costa Rica incident follows a larger outbreak in Mexico in early September. Health officials confirmed 135 people fell sick at the Hospital General de México Dr. Eduardo Liceaga in Mexico City.

That outbreak was linked to food provided by the hospital's outsourced catering service. Patients experienced abdominal pain, diarrhea, fever, and vomiting. In two cases, investigators also identified a coinfection with enterotoxigenic E. coli (ETEC).

The Mexican hospital suspended the outsourced dining service and opened an investigation to identify and monitor individuals who may have been exposed. An epidemiological and health investigation was started to determine the source of contamination and to establish additional prevention and control measures.

What does this change for hospital foodservice operators?

The two outbreaks, roughly a month apart and involving more than 200 combined cases, put outsourced and in-house hospital foodservice in Latin America under renewed scrutiny. In Mexico, the response was immediate and structural: the catering contract was suspended, not adjusted. That precedent signals to contract catering firms serving healthcare facilities that a single contamination event can end an account pending investigation.

For operators, the standard exposure controls now under attention are supplier verification, temperature management for eggs, poultry and meat, separation of raw and cooked product, and symptomatic-worker exclusion. Both investigations remain open, and neither has yet named a confirmed food vehicle or contamination point.