The U.S. Embassy in Costa Rica has issued a health alert following a Salmonella outbreak under investigation at CIMA Hospital in Escazú Canton, San José Province, with about 66 suspected cases reported among hospital workers.

According to the Ministry of Public Health (MS), Salmonella, also known as salmonellosis, is a bacterial infection that can cause diarrhea, fever and stomach pain. People can contract the infection by consuming contaminated food and, in some cases, through contact with animals.

Symptoms include diarrhea, which may be bloody, fever, stomach pain or cramps, nausea, vomiting and headache. Symptoms can develop within hours or several days after exposure to the bacteria.

The embassy's alert follows a report from the MS about an investigation launched last week into the outbreak. Of the approximately 66 suspected cases affecting hospital workers, two have been confirmed by laboratory testing as Salmonella spp. Two additional people have tested positive for the bacteria and have been hospitalized.

“We continue to analyze epidemiological and laboratory data to identify a common exposure factor and determine the possible mechanism of transmission,” said Christian Valverde, director general of the Health Department. “These actions are essential for advancing the investigation and clarifying the origin of the outbreak.”

Health authorities said experts are working to identify a common source of exposure among those affected and determine how the bacteria spread. Investigators are examining the possibility of transmission through contaminated food or water.

As of Sunday, authorities had not identified a specific food linked to the outbreak or confirmed the source of contamination.

The U.S. Embassy has advised its personnel to consider alternative locations for medical care until the outbreak is resolved. The embassy's website provides a nonexhaustive list of hospitals and medical providers in Costa Rica.

The embassy also issued the following recommendations for U.S. citizens living in Costa Rica:

• Practice consistent hand hygiene with soap and water, especially after using the restroom and before preparing or eating food.

• Keep raw and cooked foods separate, cook eggs, poultry and meat thoroughly, and refrigerate perishable foods promptly.

• Wash fruits and vegetables before eating them, and avoid unpasteurized dairy products.

• If diarrhea, vomiting, abdominal pain or fever develops, maintain hydration by drinking fluids and contact a health care provider for guidance.

• Seek urgent medical evaluation for persistent vomiting or an inability to keep fluids down; signs of dehydration, including decreased urination, dizziness or dry mouth; bloody stools; a high or persistent fever; or symptoms lasting more than a few days. Infants, young children, older adults, pregnant individuals and immunocompromised people should seek evaluation earlier.

• People with gastrointestinal illness should not prepare food for others while experiencing symptoms.

• In a medical emergency, call 911.

In a press release, CIMA Hospital said it immediately activated the appropriate infection-control protocols after detecting the Salmonella outbreak. The hospital said the measures helped bring the situation under control at an early stage.

“We have worked in coordination with health authorities, providing all requested information and cooperating with inspections and reviews, while also implementing the necessary monitoring and containment measures that have enabled us to bring the situation under control at an early stage,” the hospital said.

Regarding the well-being of its employees, the hospital added that “our priority, from the very beginning, has been the health and recovery of our staff.”

The Ministry of Public Health (MS) oversees Costa Rica's public and private health care systems and is responsible for implementing and enforcing health regulations.

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