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"On March 29, 2018, at 3:40 p.m., a hospital in Montgomery County, Kansas telephoned the Kansas Department of Health and Environment's Infectious Disease Epidemiology and Response section (KDHE) to report an increase in salmonellosis. Five patients had tested positive for Salmonella at the hospital's laboratory on March 28 and 29; the patients' specimens had been collected between March 13 and March 27. KDHE initiated an outbreak investigation before 5 p.m. on March 29. KDHE's centralized interviewing team is responsible for salmonellosis investigations for Montgomery County residents, and was instructed to prioritize completing KDHE's standard hypothesis-generating questionnaire for each of these patients. On the following day, March 30, the Montgomery County Health Department (MCDH) was notified of the outbreak. Hospital staff attempted to determine if there was any common exposure among patients that were still hospitalized at the facility, but the patients did not report attending the same event, and no clear connection between the patients was identified."

"On January 19, 2016, at 3:08 p.m., the Kansas Department of Health and Environment's Infectious Disease Epidemiology and Response section (KDHE) was notified by the Centers for Disease Control and Prevention (CDC) that three Kansas residents with cases of salmonellosis were part of a multistate cluster of Salmonella Muenchen infections. The pulsed-field gel electrophoresis (PFGE) pattern of the three Kansas residents' Salmonella isolates was indistinguishable from eight isolates in three other states, suggesting a common source of infection."

"On June 3, 2015 at 11:55 a.m., an ill individual contacted the Lawrence-Douglas County Health Department (LDCHD), reporting that she and other members of her 12-person dining party became ill after eating at La Tropicana (434 Locust St, Lawrence, KS, 66044) on June 1 at 6:30 p.m. An anonymous individual from the same dining party also reported this information to the Kansas Department of Agriculture (KDA), who notified the Kansas Department of Health and Environment's Infectious Disease Epidemiology and Response section (KDHE) at 12:04 p.m. to report the possible outbreak. A restaurant inspection was conducted by KDA at 5:00 p.m. the same day, June 3, to implement prevention and control measures. The following morning at 8:00 a.m., after confirming LDCHD had a way to contact a member of the party that made the anonymous complaint, LDCHD and KDHE began an epidemiological investigation to determine the cause and scope of illness. On June 9, KDA was contacted by two individuals who reported illness after dining together at La Tropicana at 12:00 p.m. on June 2."

"On July 18, 2014, the Riley County Health Department (RCHD) notified the Kansas Department of Health and Environment's Infectious Disease Epidemiology and Response section (KDHE) of a possible outbreak of campylobacteriosis among workers at the Kansas State University Dairy Unit, which houses approximately 200 cows in addition to heifer calves. Two cases were identified through routine surveillance by RCHD. The first case was reported to public health on June 17th, and the second case was reported on July 10th. RCHD and KDHE initiated an outbreak investigation on July 18th to identify additional cases and to implement prevention and control measures."

"On Sunday, April 28, 2013, at 3:20 p.m., a Shawnee County hospital notified the Kansas Department of Health and Environment's Infectious Disease Epidemiology and Response section (KDHE) of a possible foodborne disease outbreak. The hospital reported that four patients from two different households sought care in the emergency department that afternoon after eating food from Carniceria Camecuaro, a restaurant and butcher shop located at 1016 SE 6th St., Topeka, Kansas. No other common exposures between the households were reported. KDHE immediately notified the Shawnee County Health Agency (SCHA) and the Kansas Department of Agriculture (KDA). KDHE recommended closing the restaurant, pending further investigation into the ill consumers. A KDA food inspector arrived at the restaurant at 4:30 p.m. A full inspection was not conducted, but the inspector checked temperatures of the food items being served: pork carnitas, pork al pastor, pico de gallo, tomato salsa, tomatillo salsa, and jalapeño and tomatillo salsa. The three salsas were all near 49°F, above the required cold holding temperature threshold of 41°F. Samples of these food items were collected. All three salsas on the make table in the front of the restaurant were discarded in a trash dumpster. The restaurant agreed to close voluntarily. The inspector instructed the establishment to close until a reopening inspection was conducted and to clean and sanitize all walls, fixtures, countertops, and food preparation equipment. The following day, Monday, April 29, at 3:56 p.m., a complaint was received by KDA regarding the same restaurant. The complainant stated that 25 pounds of pork carnitas were purchased on April 28, after the restaurant voluntarily closed. The pork carnitas were served at a private family event on the evening of April 28, along with rice, beans, and pasta salad prepared by family members. The complainant stated approximately 20 of 50 attendees became ill after eating at the event. In light of these additional illnesses caused by food sold after the restaurant voluntarily closed, KDA issued a temporary suspension order on April 30 to prohibit the restaurant from operating."

"On Sunday, June 2, 2013 at 6:36 p.m., the Salina-Saline County Health Department (SSCHD) received a call from Salina Regional Health Center (SRHC). SRHC reported that a patient in the emergency department was ill with gastrointestinal symptoms, and the patient knew of several others ill with similar symptoms who presented to Abilene Memorial Hospital. All the ill individuals attended a rehearsal dinner at Martinelli's Little Italy Restaurant (158 S Santa Fe, Salina, KS, 67401) on May 31, 2013, and a wedding reception held at a different Salina location on June 1, 2013. SSCHD contacted the Kansas Department of Health and Environment's Infectious Disease Epidemiology and Response section (KDHE) at 7:29 p.m. to report the possible outbreak. The following morning, SSCHD, KDHE, and the Kansas Department of Agriculture (KDA) began an investigation to determine the cause and scope of illness, and to implement prevention and control measures."

"On September 23, 2013, the Leavenworth County Health Department notified the Kansas Department of Health and Environment's Infectious Disease Epidemiology and Response section (KDHE) of four laboratory-confirmed cases of pertussis within Pleasant Ridge Elementary in Easton, Kansas. The Leavenworth County Health Department (LCHD) and USD #449, along with KDHE, began an outbreak investigation to identify additional cases, exposed individuals, and to implement prevention and control measures. Further investigation revealed additional epidemiologically-linked cases among the elementary, middle, and high schools of Unified School District (USD) #449, which have a combined student enrollment of 575."

"On September 13, 2012, at 3:06 p.m., the Kansas Department of Agriculture (KDA) notified the Kansas Department of Health and Environment (KDHE) of a foodborne illness complaint. The complainant stated that approximately seven colleagues became ill with nausea and diarrhea following lunch at a Wyandotte County fast food restaurant. The Wyandotte County Public Health Department (WCPHD) was notified at approximately 4:30 p.m., and immediately began an investigation."

"On the morning of January 24, 2012, the Kansas Department of Agriculture (KDA) received a foodborne illness complaint. The complainant became ill with gastrointestinal symptoms after dining at Lupita's Mexican Restaurant (732 S Kansas Avenue, Topeka, Kansas) on January 20, and was aware of others who experienced symptoms after eating there. The Infectious Disease Epidemiology and Response (IDER) section at the Kansas Department of Health and Environment (KDHE) was notified of the complaint at 9:20 a.m. Shortly after this complaint was received, IDER was made aware of another group of employees who also reported illness after eating at the restaurant on January 20. IDER notified the Shawnee County Health Department of these circumstances, and chose to lead the investigation rather than the local health department. By 10:38 a.m., a questionnaire was emailed to the complainant and the affected group of employees."

"On February 21, 2012, at 11:37 a.m., the Kansas Department of Agriculture (KDA) notified the Kansas Department of Health and Environment (KDHE) of a foodborne illness complaint. The complainant stated that she and eight others became ill with gastrointestinal symptoms after eating takeout from a Sedgwick County fast food restaurant. KDHE notified the Sedgwick County Health Department (SCHD) at 11:39 a.m., and SCHD began the outbreak investigation within one hour by interviewing the complainant, who provided contact information for additional affected individuals. In response to this report, an outbreak investigation was also initiated immediately by staff from KDA and the Food Safety and Protection Division of the City of Wichita's Office of Environmental Health."

"On November 20, 2012, at 1:30 p.m., the Harper County Health Department (HCHD) notified the Kansas Department of Health and Environment (KDHE) of a possible foodborne outbreak. HCHD had learned of approximately ten individuals who became ill with diarrhea and abdominal pain following a catered dinner on November 17, 2012. An estimated 100 individuals attended the event. KDHE and HCHD immediately began an outbreak investigation."

"On December 14, 2011, at approximately 4:30 p.m., the Kansas Department of Agriculture (KDA) received a foodborne illness complaint via telephone. The caller stated that she and her daughter became ill with gastrointestinal symptoms after dining together at Taco Grande, a fast food restaurant at 412 E 23rd Street, Hays, Kansas, and was aware of others who experienced symptoms after eating there. The Kansas Department of Health and Environment (KDHE) was notified of the complaint the following morning at 9:53 a.m., and notified the Ellis County Health Department (ECHD). ECHD began the outbreak investigation that afternoon by interviewing the complainant, who provided contact information for five additional individuals who ate at the same restaurant."

"On July 11, 2012, the Crawford County Health Department (CCHD) notified the Kansas Department of Health and Environment (KDHE) of two campylobacteriosis cases identified through routine surveillance who shared a meal at a private home. The home hosted approximately 70 individuals for an outdoor cookout on June 30. Some food was prepared at the home, and some was prepared and brought by guests, potluck-style. CCHD contacted the host to obtain a list of foods served, in addition to contact information for the attendees, so that each could be interviewed for an epidemiological investigation."

"At approximately 2:00 p.m. on April 18, 2011, the Kansas Department of Health and Environment Bureau of Epidemiology and Public Health Informatics (KDHE) was notified of two laboratory-confirmed cases of salmonellosis among a group who recently traveled to Negril, Jamaica to attend a destination wedding held at the Beaches Negril resort. Some guests arrived as early as March 27, 2011, and all departed on April 3, 2011. A spokesperson for the wedding group estimated four others became ill following the trip. KDHE began an investigation immediately, working to obtain names and contact information for the group, which included 31 individuals from 17 different households -- residents of Kansas, Missouri, Arizona, Arkansas, South Dakota, Virginia, New York, New Jersey, and Germany. Because of the multijurisdictional nature of this outbreak, KDHE distributed an alert on April 26 via the Epidemic Information Exchange (Epi-X), a communication network maintained by the Centers for Disease Control and Prevention (CDC) that allows state, local, and federal partners to exchange disease outbreak information. KDHE requested to be notified of additional cases of salmonellosis among travelers to Beaches Negril. A similar notification was distributed via CDC's foodborne outbreak listserv on April 27."

"On March 10, 2011, the Sedgwick County Health Department (SCHD) was notified of a possible outbreak of respiratory illness among residents of a 40-bed Long-Term Care Facility (LTCF) in Sedgwick County. The facility indicated that approximately 8 illnesses had occurred over the past four days. The primary symptoms included fever and cough. Laboratory tests had not yet been successful in identifying the causative agent. In response to this report, an outbreak investigation was initiated on March 10 by the Kansas Department of Health and Environment (KDHE) and SCHD. The purpose of the investigation was to quantify and characterize the illnesses, determine the cause of illness, and to prevent additional cases."

"On February 7, 2011, the Reno County Health Department (RCHD) was notified of a possible outbreak of respiratory illness among residents and staff of a 126-bed Long-Term Care Facility (LTCF) in Reno County. The facility indicated that approximately 30 illnesses had occurred over the past ten days, and five residents had been hospitalized. Symptoms included fever, fatigue, poor appetite, cough, crackles, and bronchitis. Laboratory tests had not yet been successful in identifying the causative agent. In response to this report, an outbreak investigation was initiated on February 7 by the Kansas Department of Health and Environment (KDHE) and RCHD. The purpose of the investigation was to quantify and characterize the illnesses, determine the cause of illness, and to prevent additional cases."

"On January 12, 2009, the Kansas Department of Agriculture (KDA) was notified of a possible outbreak of gastrointestinal illness among individuals who shared a meal from the Coyote Canyon restaurant, 1251 S W Ashworth Place, Topeka, KS, 66604. The preliminary complaint indicated that a party of twelve ate the evening of January 9, and seven became ill the following day with diarrhea; two individuals sought care at a hospital. In response to this report, an outbreak investigation was initiated by the Kansas Department of Health and Environment (KDHE) and the Shawnee County Health Agency (SCHA)."

"On June 22, 2009, the Kansas Department of Agriculture (KDA) was notified of a possible outbreak of gastrointestinal illness among individuals who shared a meal from Buzzard's Pizza, 401 E Franklin, Pomona, KS, 66076. The preliminary complaint indicated that a party of 23 ate at noon, June 20, and 16 individuals later became ill with diarrhea and vomiting. In response to this report, an outbreak investigation was initiated by the Kansas Department of Health and Environment (KDHE) and the Franklin County Health Department (FCHD)."

"On March 3, 2008, the Kansas Department of Health and Environment's Bureau of Consumer Health (KDHE-BCH) notified KDHE's Office of Surveillance and Epidemiology (KDHE-OSE) of a possible foodborne illness outbreak. The complainant, an individual employed in Shawnee County, stated that 15 coworkers experienced gastrointestinal illness after eating sandwiches catered by Jersey Mike's Subs (2121 SW Wanamaker Rd, Suite 115, Topeka, KS) on February 27. KDHE-OSE and the Shawnee County Health Agency initiated an outbreak investigation to determine the source of the illness and to ensure appropriate control and prevention measures were implemented."

"On April 21, 2008, the Kansas Department of Health and Environment's Bureau of Consumer Health (KDHE-BCH) notified KDHE's Office of Surveillance and Epidemiology (KDHE-OSE) of a possible waterborne illness outbreak. The complainants, four Riley County families, stated that eight children experienced gastrointestinal illness after swimming in a Days Inn hotel pool (2300 East Kansas Avenue, McPherson, KS) on April 19. KDHE and the Riley County Health Department (RCHD) initiated an outbreak investigation to determine the source of the illness and to ensure appropriate control and prevention measures were implemented."

"On November 9, 2007, a Butler County health care provider reported a case of campylobacteriosis to the Office of Surveillance and Epidemiology (OSE) at the Kansas Department of Health and Environment (KDHE). The health care provider listed unpasteurized milk as the likely cause of illness, and reported the milk had been shared among several families. The Butler County Health Department (BCHD) and OSE began a joint outbreak investigation immediately. The purpose of the investigation was to identify the source of exposure, determine the extent of the outbreak, and to implement appropriate prevention and control measures. The campylobacteriosis case's family reported purchasing unpasteurized milk from a dairy in Reno County. After some difficulty in pinpointing its address, the dairy was identified by the Reno County Health Department (RCHD) and the Kansas Department of Agriculture (KDA). The dairy had been previously implicated as the source of a Reno County resident's August 2007 Campylobacter infection."

"On August 3 2006, the Lawrence-Douglas County Health Department (LDCHD) received a report of cryptosporidiosis. The case was an enrollee at Daycare Facility X, located in the city of Lawrence. Further investigation revealed a cluster of diarrheal illness at the daycare; in addition to the laboratory-confirmed case, three other enrollees and two staff members were also symptomatic. The daycare's total enrollment was 140; it employed 30 staff members. LDCHD distributed stool kits to test the symptomatic individuals. By August 11, both Giardia and Cryptosporidium were detected in enrollees. LDCHD notified the Epidemiologic Services Section (ESS) at the Kansas Department of Health and Environment (KDHE) of the outbreak. An outbreak investigation was begun. The purpose of the investigation was to determine the extent of the outbreak and to implement appropriate prevention and control measures."

"On Friday, April 13, 2007, the Butler County Health Department (BCHD) notified the Kansas Department of Health and Environment (KDHE) of widespread illness among students at Augusta Middle School. Approximately 150 students--about 30% of the total student body--were absent Thursday, April 12. Vomiting, diarrhea, and abdominal cramps were reported among the absent students; some of the school staff were also reported to be ill. Over 100 students were out of school again on Friday, April 13. The illness seemed to be limited to one school; no other district school had reported extensive illnesses, and BCHD was unaware of similar outbreaks in the community. Staff at KDHE and BCHD initiated an outbreak investigation to determine the source of illness and implement appropriate control and prevention measures."

"On October 17, 2007, the Southeast Kansas Multi County Health Department (SEKMCHD) received a report of gastrointestinal illnesses among eleven enrollees at Daycare Facility X, located in Iola. The daycare's total enrollment was 13; it employed 3 staff members. SEK distributed two stool kits to test symptomatic individuals, and notified the Office of Surveillance and Epidemiology (OSE) at the Kansas Department of Health and Environment (KDHE) of the outbreak. An outbreak investigation was initiated. The purpose of the investigation was to determine the cause of the outbreak and to implement appropriate prevention and control measures."

"On Wednesday, February 15, 2006, a food protection investigator at the Southeast District office of the Kansas Department of Health and Environment (KDHE) received approximately five phone calls from individuals who reported illness after eating at a Miami County restaurant the previous evening, February 14th. Two complainants provided their contact information. The food protection investigator notified the Epidemiology Services Section (ESS) of KDHE about the possible foodborne outbreak. ESS the Miami County Health Department (MCHD) initiated an outbreak investigation to determine the source of illness and to implement appropriate control and prevention measures. The restaurant owner mentioned to ESS that some of her teenage employees had called in sick, and that there was some illness circulating in their high school."

"On July 11, 2006, the Harvey County Health Department (HCHD) notified the Epidemiology Services Section (ESS) at the Kansas Department of Health and Environment (KDHE) about an ongoing outbreak of shigellosis at Daycare Facility X in Harvey County, Kansas. As of July 11, eight children and one staff member had tested positive for Shigella sonnei. The daycare's total enrollment was 135; it employed 30 staff members. The HCHD and ESS began a joint outbreak investigation on July 12, 2006. The purpose of the investigation was to determine the extent of the outbreak and to implement appropriate prevention and control measures."

"On Thursday, December 28, 2005, a Kansas Department of Health and Environment (KDHE) Food Protection Investigator notified the KDHE Division of Epidemiology Services of a foodborne illness complaint. The complainant, a citizen from Franklin County, stated five individuals from two households experienced vomiting and/or diarrhea after eating at a Franklin County restaurant. Each individual ate dinner at approximately 7:00 p.m. December 22, 2005; they denied any other common meals. KDHE and the Franklin County Health Department (FCHD) initiated an outbreak investigation to determine the source of illness and implement appropriate control and prevention measures."

"On Wednesday, March 30, 2005, the Osage County Health Department (OCHD) notified the Kansas Department of Health and Environment (KDHE) of gastrointestinal illnesses among half the students and the teacher in one classroom. The school nurse also reported that several baby chicks had been kept in the affected classroom for an unknown number of days."

"On Tuesday, July 5, 2005, a Marion County citizen reported a possible foodborne outbreak to the Kansas Department of Health and Environment (KDHE). The caller stated 96 individuals from nine states (KS, AZ, CA, CO, FL, NE, OK, TX, WY) visited Marion County for a family reunion July 3. 31 attendees had since experienced vomiting or diarrhea. Nearly all attendees ate a catered lunch at approximately 12:30 p.m. July 3. Foods were served buffet-style and included cubed pork, cole slaw, macaroni salad, potato salad, dinner rolls, and baked beans. Homemade desserts, iced tea, water, and lemonade were also served. Some attendees also shared other meals, including a July 3rd dinner where leftovers were served. KDHE and the Marion County Health Department (MCHD) initiated an outbreak investigation to determine the source of illness and implement appropriate control and prevention measures.", "A cohort study was conducted to determine the cause of illness. MCHD and the Oklahoma State Department of Health assisted KDHE with interviewing reunion attendees. Each agency administered a uniform questionnaire to gather each individual's symptoms, food history, and travel history"--Page 2