Real-time PCR detection of salmonella in suspect foods from a gastroenteritis outbreak in kerr county, Texas.
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In June 2001, an outbreak of acute gastroenteritis among 109 attendees of a church picnic in Kerr County, Texas, was reported. A 5'-nuclease PCR assay was used to screen for Salmonella in nine food items from the buffet line. Barbeque chicken B tested positive for Salmonella, and no amplification was detected in the remaining food items. These PCR findings were consistent with culture results and were confirmed by direct nucleotide sequencing. Salmonella enterica serotype Panama was cultured from both food and patient stool samples. (+info)
Human salmonellosis associated with young poultry from a contaminated hatchery in Michigan and the resulting public health interventions, 1999 and 2000.
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Although approximately 95% of disease caused by nontyphoidal salmonella is transmitted by foodborne vehicles, four documented salmonella outbreaks in the 1990s have been traced to contact with young poultry. No environmental studies of source hatcheries were completed. This case-control study was performed by comparing culture-confirmed Salmonella Infantis in Michigan residents, identified between May and July 1999, with two age- and neighbourhood-matched controls. Eighty environmental and bird tissue samples were collected from an implicated hatchery; all salmonella isolates underwent pulsed-field gel electrophoresis (PFGE) analysis. The study included 19 case-patients sharing the same PFGE subtype and 37 matched controls. Within 5 days before illness onset, 74% of case-patients resided in households raising young poultry compared with 16% of controls (matched OR 19.5; 95% CI 2.9, 378.1). Eight hatchery samples yielded Salmonella Infantis with PFGE subtypes matching the patients' isolates. This investigation identified birds from a single hatchery as the source of human illness and confirmed the link by matching PFGE patterns from humans, birds and the hatchery environment. Subsequent public health interventions reduced, but did not eliminate, transmission of poultry-associated salmonellosis. Five additional PFGE-linked cases were identified in Spring 2000, necessitating quarantine of the hatchery for depopulation, cleaning and disinfection. (+info)
An outbreak of Salmonella enteritidis phage type 34a infection in primary school children: the use of visual aids and food preferences to overcome recall bias in a case control study.
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Outbreaks of infectious intestinal disease are common in schools. Case control studies are useful in the investigation of infectious disease outbreaks but the time interval between illness and investigation can lead to recall bias, particularly in young children. We describe an outbreak of Salmonella enteritidis phage type 34a infection involving 54 clinical cases in two adjacent schools, and a novel approach to overcome recall bias. The likely dates of infection were identified from the epidemic curve. We created a visual display of the menu from those days and asked 9 cases and 18 matched controls to identify their food preferences from this display. Preference for chocolate mouse was significantly associated with illness (P = 0.006). The results of the case control study agreed with the findings of the environmental investigation. We believe our approach could be used in other circumstances, where subjects are young children or recall bias is a concern. (+info)
Outbreak of Salmonella serotype Javiana infections--Orlando, Florida, June 2002.
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On July 16, 2002, the Minnesota Department of Health identified two cases of Salmonella serotype Javiana infections among persons who had attended the 2002 U.S. Transplant Games held at theme park A in Orlando, Florida, during June 25-29. Isolates from both patients were indistinguishable by pulsed field gel electrophoresis (PFGE). The U.S. Transplant Games is a 4-day athletic competition among recipients of solid organ transplants (i.e., heart, liver, kidney, lung, and pancreas) and bone marrow transplants. Approximately 6,000 persons from the United States and five other countries, including 1,500 transplant-recipient athletes, participated in the games. This report summarizes the results of an ongoing epidemiologic and laboratory investigation that has identified 141 ill persons in 32 states who attended the games. (+info)
Risk factors for sporadic infection with Salmonella enteritidis, Denmark, 1997-1999.
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In a prospective case-control study of sporadic Salmonella Enteritidis infection in Denmark (1997-1999), foreign travel was reported by 25% of 455 case patients and 8% of 507 controls (odds ratio (OR) = 3.7, 95% confidence interval (CI): 2.4, 5.5). Among nontravelers, 80% of 335 cases and 81% of 467 controls had consumed eggs or dishes containing raw or undercooked eggs during the week before disease onset or interview, while 35% of cases and 19% of controls had incurred this exposure the day before onset or interview (OR = 2.2, 95% CI: 1.5, 3.1). Specific exposures included consumption of buttermilk dessert (OR = 11.7), homemade ice cream (OR = 4.3), raw eggs (OR = 3.4), and eggs fried "sunny side up" (OR = 2.5). Among persons who had used eggs in the week before disease onset or interview, eggs from battery laying hens were associated with disease (white eggs: OR = 2.4, brown eggs: OR = 1.9), whereas consumption of pasteurized eggs tended to be protective (OR = 0.3). The study confirmed that eggs are the principal source of S. Enteritidis in Denmark. This conclusion was reached through the use of an exposure time window that corresponds to the most relevant incubation period rather than the maximum incubation period. The authors recommend this method in studies that have the objective of determining risk associated with common exposures. (+info)
Relationship between home food-handling practices and sporadic salmonellosis in adults in Louisiana, United States.
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Salmonellosis is the leading cause of death caused by foodborne bacterial pathogens in the United States. Approximately 90% of salmonella infections are sporadic, but most of what is known about salmonellosis has come from outbreak investigations. We studied the risk for sporadic salmonellosis among 115 persons aged > or = 15 years reported to the Louisiana Office of Public Health during May 1998-April 1999, compared with 115 age-matched controls. Significantly more case-patients than controls had chronic underlying medical conditions [adjusted odds ratio (aOR) = 4.3; 95% confidence interval (CI) = 2.2-8.7]. Although reported consumption of specific food items likely to contain salmonella was not associated with illness, inconsistent handwashing between preparation of meat and non-meat items was associated with illness (aOR = 8.3; CI = 1.1-61.8). Enhanced measures to provide a consistently safe food supply and promote safer food preparation in households will depend on prevention of sporadic salmonellosis. (+info)
Risk factors for salmonella food poisoning in the domestic kitchen--a case control study.
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Domestic kitchen food handling risk factors for sporadic salmonella food poisoning are largely unknown. We compared food consumption and food handling practices, opportunities for cross contamination and refrigerator temperature control, in 99 households in South East Wales in 1997/8 with a case of salmonella food poisoning, and control households matched for electoral ward. On univariate analyses, cases were significantly more likely than control respondents to have purchased free-range eggs in the preceding week, and more likely than control households to have handled frozen whole chicken in the previous week, and to handle raw chicken portions at least weekly. In multivariate analysis, only consumption of raw eggs and handling free-range eggs were significant risk factors, independent of the age structure of the family and of the season. (+info)
The use of sequential studies in a salmonellosis outbreak linked to continental custard cakes.
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We investigated an outbreak of 54 cases of Salmonella Typhimurium phage type 9 (STM9) with a specific antibiotic resistance pattern. We used sequential analytic studies: two retrospective cohort studies, a case-control study, and a modified case-control study. An outbreak of salmonellosis due to Salmonella Typhimurium PT9 SSu (resistant to streptomycin and sulphafurazole) was identified. Fifty-four cases had illness onset from November 1998 to March 1999. Notifications commenced following a restaurant birthday party in December 1998. An initial cohort and case control study found no association with consumption of custard cake. However, case follow-up identified another cohort of people who had attended a birthday party in February at which 8/27 people who consumed a continental custard cake were ill compared to 0/10 who did not (P = 0.07). A revised case control study found illness was strongly associated with consumption of a particular continental custard cake (Mantel-Haenszel matched OR infinity, P = 0.00004). This report highlights the epidemiological value of using sequential study types, and persisting with the investigation of apparently sporadic food-borne outbreaks. (+info)