Animal-Slaughter Markets, United

cause ≈1.2 million human illnesses an-nually in the United States (1). Infec-tions are primarily acquired through exposure to contaminated food or infected animals (1,2). Since 2007, state and local health departments and the Centers for Disease Control and Prevention have investigated mul-tiple salmonellosis outbreaks linked to meat purchased at live-bird mar-kets (LBMs) and live-animal markets (LAMs), where poultry and livestock are sold for onsite slaughter. These markets typically operate in large cit-ies and serve populations of diverse ethnic backgrounds (3). In 2007, an outbreak involving 62 case-patients infected with 1 of 3 S. enterica serotype Schwarzen-grund strains was investigated in Massachusetts; 61 % were children <5 years of age, including 14 (23%) infants <1 year of age, and 96 % were Asian (Table). A case-patient was defined as a person infected with S. enterica who had a pulsed-field gel electrophoresis XbaI restriction en-zyme pattern indistinguishable from the outbreak strain. Exposure to poultry purchased at LBMs was re-ported, and environmental sampling at an implicated LBM identified 6 S. enterica serotypes, including 1 out-break strain. Three subsequent investigations of S. enterica serotype Schwarzen-grund infections were conducted: a 2009 outbreak of 50 cases in New York, New York; a 2010–2011 multi-state outbreak of cases predominantl