Most animal salmonellosis occurred in cattle (64.7%) sheep (12%), pigs (10.9%), and bison (0.4%) with Salmonella Typhimurium (45.7%) as the predominant serotype; Salmonella Arizona (10.9%) and Dublin (10.5%) were host specific in sheep and cattle respectively. In humans, Salmonella Typhimurium (32.5%) and Salmonella Newport (11.2%) were predominant. Season influenced human (p = 0.027) and animal (p = 0.014) salmonellosis with cases peaking in the spring and summer for animals and humans, respectively. Salmonella Typhimurium case reports in humans were not seasonally related to domestic animals (p = 0.001) nor cattle (p = 0.001). Over time, case reports increased in humans but decreased in domestic animals. Most serotypes from domestic animals were multidrug resistant compared to human isolates. CONCLUSIONS AND APPLICATIONS: Many Salmonella serotypes (17) were involved in North Dakota human and animal salmonellosis with case reports closely related in fall and winter, but not during warmer months. Spatial clustering of human and animal cases was similar. Antimicrobial resistance was widespread but lower in human isolates. These data are helpful in determining future policy, research, and control strategies for salmonellosis in humans and domestic animals.

Streptococcus pyogenes is an important cause of throat infection that may be transmitted by food. Staphylococcus aureus is a major cause of food intoxication. Both organisms can be transferred to foods or food‐contact surfaces via food handlers. Because both S. pyogenes and S. aureus are hemolytic, the potential for their transfer in a foodservice setting could be assessed by sampling hands, hand‐contact surfaces and food‐contact surfaces for hemolytic bacteria. We performed such a survey at four foodservice facilities from December 2005 to March 2006. Of the 189 total samples, hands (50%), cart handle (40%), pan bottom (38%), door handle (25%) and utensil wrapper (25%) were most often contaminated with hemolytic bacteria. Hand‐contact surfaces were more often contaminated than food‐contact surfaces. S. pyogenes was not isolated but the potential pathogen Streptococcus agalacticae was isolated from one door handle. S. aureus was isolated from a cart handle sampled during the same shift.

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Food and nutrition services, along with the health care organizations they serve, are becoming increasingly complex. These complexities are driven by sometimes conflicting (if not polarizing) human, department, organization, and environment factors and will require that managers shift how they think about and approach productivity in the context of the greater good of the organization and, perhaps, even society. Traditional, single-factor approaches to productivity measurements, while still valuable in the context of departmental trend analysis, are of limited value when assessing departmental performance in the context of an organization's goals and values. As health care continues to change and new models of care are introduced, food and nutrition services managers will need to consider innovative approaches to improve productivity that are consistent with their individual health care organization's vision and mission. Use of process improvement tools such as Lean and Six Sigma as strategies for evaluating and improving food and nutrition services efficiency should be considered.

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