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Large outbreak of Salmonella Enteritidis PT8 in Portsmouth, UK, associated with a restaurant

  • E. SEVERI (a1), L. BOOTH (a2), S. JOHNSON (a1), P. CLEARY (a3), M. RIMINGTON (a4), D. SAUNDERS (a5), P. COCKCROFT (a6) and C. IHEKWEAZU (a1)...

Summary

Seventy-five individuals with Salmonella infection were identified in the Portsmouth area during August and September 2009, predominantly Salmonella Enteritidis phage type 8. Five patients were admitted to hospital. A case-case comparison study showed that a local restaurant was the most likely source of the infection with a risk of illness among its customers 25-fold higher than that of those who did not attend the restaurant. A case-control study conducted to investigate specific risk factors for infection at the restaurant showed that eating salad was associated with a threefold increase in probability of illness. Changing from using ready washed lettuces to lettuces requiring washing and not adhering strictly to the 48 hours exclusion policy for food handlers with diarrhoea were likely to have contributed to the initiation and propagation of this outbreak. Possibilities for cross-contamination and environmental contamination were identified in the restaurant.

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Copyright

Corresponding author

*Author for correspondence: Mr E. Severi, Health Protection Agency, 151 Buckingham Palace Road, London SW1W 9SZ, UK. (Email: ettore.severi@hpa.org.uk)

References

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1. Ahmed, R, et al. Epidemiologic typing of Salmonella enterica serotype enteritidis in a Canada-wide outbreak of gastroenteritis due to contaminated cheese. Journal of Clinical Microbiology 2000; 38: 24032406.
2. O'Brien, S, Ward, L. Salmonella Enteritidis in England and Wales: increases in unusual phage types in 2002. Eurosurveillance 2002; 6: pii=1958.
3. Gillespie, I, Elson, R. Successful reduction of human Salmonella Enteritidis infection in England and Wales. Eurosurveillance 2005; 10: pii=2834.
4. de Jong, B, Ekdahl, K. The comparative burden of salmonellosis in the European Union member states, associated and candidate countries. BioMed Central Public Health 2006; 6: 4.
5. Majtanova, L. Occurrence of Salmonella enterica serotype Enteritidis phage types in the Slovak Republic. European Journal of Epidemiology 1997; 13: 243245.
6. van Duijkeren, E, et al. Serotype and phage type distribution of salmonella strains isolated from humans, cattle, pigs, and chickens in the Netherlands from 1984 to 2001. Journal of Clinical Microbiology 2002; 40: 39803985.
7. Beatty, ME, et al. Large Salmonella Enteritidis outbreak with prolonged transmission attributed to an infected food handler, Texas, 2002. Epidemiology and Infection 2009; 137: 417427.
8. Romani, C, et al. Reinterpreting a community outbreak of Salmonella enterica serotype Enteritidis in the light of molecular typing. BioMed Central Public Health 2007; 7: 237.
9. Chongsuvivatwong, V.Epidemiological calculator. R package version 2.11.1.0 (http://CRAN.R-project.org/package=epicalc). Accessed 20 August 2010.
10. R Development Core Team. R: a language and environment for statistical computing. Vienna, Austria, 2010 (http://www.R-project.org). Accessed 20 August 2010.
11. Wheeler, JG, et al. Study of infectious intestinal disease in England: rates in the community, presenting to general practice, and reported to national surveillance. The Infectious Intestinal Disease Study Executive. British Medical Journal 1999; 318: 10461050.
12. Currie, A, et al. Frozen chicken nuggets and strips and eggs are leading risk factors for Salmonella Heidelberg infections in Canada. Epidemiology and Infection 2005; 133: 809816.
13. Parry, SM, et al. Risk factors for salmonella food poisoning in the domestic kitchen – a case-control study. Epidemiology and Infection 2002; 129: 277285.
14. Wilson, IG. Salmonella and campylobacter contamination of raw retail chickens from different producers: a six year survey. Epidemiology and Infection 2002; 129: 635645.
15. Marcus, R, et al. Re-assessment of risk factors for sporadic Salmonella serotype Enteritidis infections: a case-control study in five FoodNet Sites, 2002–2003. Epidemiology and Infection 2007; 135: 8492.
16. Scientific Committee on Food. Risk profile on the microbiological contamination of fruits and vegetables eaten raw. European Commission, Directorate-General HCP, 2002.
17. Little, CL, Gillespie, IA. Prepared salads and public health. Journal of Applied Microbiology 2008; 105: 17291743.
18. Berger, CN, et al. Interaction of Salmonella enterica with basil and other salad leaves. International Society for Microbial Ecology Journal 2009; 3: 261265.
19. Working Group of the former PHLS Advisory Committee on Gastrointestinal Infections. Preventing person to person spread following gastrointestinal infection – guidelines for public health physicians and environmental health officers. Communicable Disease and Public Health 2004; 7: 362384.
20. Food Standards Agency. Food handlers fitness to work – regulatory guidance and best practice advice for food business operators. Food Standards Agency, 2009.
21. Hedican, E, et al. Restaurant Salmonella Enteritidis outbreak associated with an asymptomatic infected food worker. Journal of Food Protection 2009; 72: 23322336.
22. Hedican, E, et al. Salmonellosis outbreak due to chicken contact leading to a foodborne outbreak associated with infected delicatessen workers. Foodborne Pathogens and Disease 2010; 7: 995997.
23. Todd, EC, et al. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 5. Sources of contamination and pathogen excretion from infected persons. Journal of Food Protection 2008; 71: 25822595.
24. Greig, JD, et al. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 1. Description of the problem, methods, and agents involved. Journal of Food Protection 2007; 70: 17521761.
25. Medus, C, et al. Salmonella outbreaks in restaurants in Minnesota, 1995 through 2003: evaluation of the role of infected foodworkers. Journal of Food Protection 2006; 69: 18701878.
26. American Public Health Association. Salmonellosis. In: Heymann, DL, ed. Control of Communicable Diseases Manual , an official report of the American Public Health Association. Washington, DC, 2008, pp. 534540.
27. Center for Disease Control and Prevention. Diagnosis and management of foodborne illnesses: a primer for physicians and other health care professionals. Morbidity and Mortality Weekly Report. Recommendations Report 2004; 53: 133.
28. McCarthy, N, Giesecke, J. Case-case comparisons to study causation of common infectious diseases. International Journal of Epidemiology 1999; 28: 764768.

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