A Food-Borne Outbreak Caused by Salmonella Enteritidis

Tansel, Ozlem;Ekuklu, Galip;Otkun, Metin; Muserref Tatman-Otkun;Akata, Filiz;Tugrul, Murat

  • Published : 20030400

Abstract

This study was designed to define the epidemiology of a food-borne outbreak caused by Salmonella enteritidis that affected only one squadron of a military battalion located in the vicinity of the city of Edirne in Turkey. The outbreak was analyzed by a standard surveillance form of the Centers for Disease Control and Prevention. The relationship between the eaten foods and cases was analyzed by Fisher's exact chi-square test, and odds ratios were calculated by a case-control study. The outbreak affected 60 of 168 soldiers in the squadron, 16 of whom were hospitalized. S.enteritidis was cultured in stools from 13 of the hospitalized soldiers and from 3 soldiers who had prepared the food. All strains were completely susceptible to antibiotics; their plasmid profiles were also identical. The highest attack rate detected was 55.7% in an omelet eaten 24 hours before (p < 0.001). Furthermore, it was the riskiest food according to the case-control study (OR=7.88; 95% CI=3.68-16.89). The food samples were unobtainable because they had been discarded. All of the hospitalized cases recovered, and none of the control cultures of stools yielded the pathogen after three weeks. In conclusion, although our results didn't indicate the exact source of the outbreak microbiologically, the omelet was considered to be the source based on the epidemiological proofs.

Keywords

References

  1. Food-borne disease. In: Mandell, Douglas and Bennetts's principles and practice of infectious diseases Tauxe, R.V.;Swerdlow, D.L.;Hughes, J.M.;Mandell, G.L.(ed.);Bennett, J.E.(ed.);Dolin, R.(ed.)
  2. MMWR v.30 Case definitions for public health surveillance Wharton, M.;Chorba, T.L.;Vogt, R.L.;Morse, D.L.;Buehler, J.W.
  3. MMWR v.49 Surveillance for food-borne diseases outbreaks- United States, 1993-1997 Olsen, S.J.;MacKinnon, L.C.;Goulding, J.S.;Bean, N.H.;Slutsker, L.
  4. Escherichia, Salmonella, Shigella and Yersinia. In: Manual of Clinical Microbiology Grayb, L.D.;Murrayb, P.R.(ed.);Baron, J.E.(ed.);Pfaller, M.A.(ed.);Tenover, F.C.(ed.);Yolken, R.H.(ed.)
  5. Performance standards for antimicrobial susceptibility testing; 9th International Supplement. NCCLS Document M100-S9 National Committee for Clinical Laboratory Standards
  6. J Bacteriol v.145 Rapid procedure for detection and isolation of large and small plasmids Kado, C.I.;Liu, S.T.
  7. Salmonella species, including Salmonella typhi;Mandell, Douglas and Bennetts's principles and practice of infectious diseases Miller, S.I.;Pegues, D.A.;Mandell, G.L.(ed.);Bennett, J.E.(ed.);Dolin, R.(ed.)
  8. J Clin Microbiol v.37 Salmonella enteritidis phage types 1 and 4: pheno- and genotypic epidemiology of recent outbreaks in Finland Lukinmaa, S.;Schildt, R.;Rinttila, T.;Siitonen, A.
  9. Infeksiyon Dergisi v.12 1995-1997 y1llar1nda disk1dan izole edilen Salmonella serotiplerinin daglhml ve antibiyotik $duyarl_1l_1klar_1$ Tatman-Otkun, M.;Ozkan, E.;Ozturk, D.;Dundar, V.;Tugrul, M.
  10. Scand J Infect Dis v.29 Impact of infecting dose on severity of disease in an outbreak of food-borne Salmonella enteritidis Rejnmark, L.;Stoustrup, O.;Christensen, I.;Hansen, A.
  11. Eur J Clin Microbiol Infect Dis v.20 Antibiotic resistance patterns and plasmid profiles of Salmonella typhimurium isolates in Turkey Otkun, M.;Erdem, B.;Akata, F.;Tatman-Otkun, M.;Gerceker, D.;Yagci, S.(et al.)