An outbreak of Campylobacter jejuni enteritis in a school of Madrid, Spain

An outbreak of gastroenteritis caused by Campylobacter infection was identified in May 2003 in a school in Madrid, Spain. Eighty one cases were identified in a total of 253 people studied. A retrospective cohort study showed that a custard made with ultra high temperature (UHT) milk was associated with illness (RR: 3.15; 95% CI: 1.25-7.93). The custard was probably contaminated with Campylobacter jejuni from a raw chicken prepared a day previously in the same kitchen. Our recommendations were to periodically remind the school’s authorities how to act if an outbreak should be suspected, to include the monitoring of a food handler’s working day in each environmental investigation in order to detect any risk behaviour; to implement microbiological analysis from the surfaces and utensils of the collective kitchens and improve the sanitary education of food handlers.

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A foodborne norovirus outbreak among the film crew in the Autonomous Province of Vojvodina, Serbia

Medicinski pregled ◽

10.2298/mpns1908235s ◽

2019 ◽

Vol 72 (7-8) ◽

pp. 235-241

Author(s):

Mirjana Strbac ◽

Mioljub Ristic

Keyword(s):

Cohort Study ◽

Retrospective Cohort ◽

Clinical Manifestations ◽

Food Poisoning ◽

Medical Attention ◽

Microbiological Analysis ◽

Environmental Investigation ◽

Common Causes ◽

The World ◽

Autonomous Province

Introduction. Norovirus is one of the most common causes of acute gastroenteritis in the world. The aim of this study was to describe characteristics of an outbreak of norovirus infection and present all the steps of an outbreak investigation. Material and Methods. A retrospective cohort study was conducted among all individuals who ate food from the same restaurant. All the exposed persons filled out an adapted questionnaire that is routinely used in patients with food poisoning. Results. This paper presents a norovirus outbreak among film crew members and measures taken to control the epidemic. Gastroenteritis was diagnosed in 20 exposed persons. In most patients, symptoms lasted 1 - 3 days, and every third patient sought medical attention. The predominant clinical manifestations were vomiting and diarrhea. The food that probably caused the infection were sandwiches with ham, cheese and lettuce and microbiological analysis confirmed that the outbreak was caused by norovirus. Conclusion. Although the source of this outbreak remains unclear, the results of environmental investigation of the restaurant showed several irregularities in the kitchen that may have caused norovirus transmission.

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Campylobacterinfection associated with consumption of duck liver pâté: a retrospective cohort study in the setting of near universal exposure

Epidemiology and Infection ◽

10.1017/s0950268813001969 ◽

2013 ◽

Vol 142 (6) ◽

pp. 1269-1276 ◽

Cited By ~ 2

Author(s):

N. J. YOUNG ◽

J. DAY ◽

F. MONTSHO-HAMMOND ◽

N. Q. VERLANDER ◽

C. IRISH ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Univariate Analysis ◽

Case Definition ◽

Water Sampling ◽

Environmental Investigation ◽

Final Multivariable Model ◽

Clinical Case Definition

SUMMARYA retrospective cohort study was performed following several reported cases of gastrointestinal illness after a catered event. The attack rate was 45/77 (58·4%) by clinical case definition, with four individuals confirmed to haveCampylobacter. There was near universal exposure to most foodstuffs served; consumption of duck liver pâté [relative risk (RR) 2·53, 95% confidence interval (CI) 1·05–6·10], mixed leaf salad (RR 2·91, 95% CI 1·22–6·92) and table water (RR undefined,P < 0·01) were associated with illness in univariate analysis, with only the latter associated in the final multivariable model (P < 0·001). Samples of cooked duck liver pâté subsequently prepared using identical methods at the venue were contaminated withCampylobacter jejuniandC. coli; water sampling was negative. Making inferences about causation in the presence of near universal exposures in this study required consideration of the limitations of statistical analysis, with the most compelling evidence of the causal role of inadequately prepared duck liver pâté provided by environmental investigation.

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Onychomadesis outbreak linked to hand, foot, and mouth disease, Spain, July 2008

Eurosurveillance ◽

10.2807/ese.15.37.19663-en ◽

2010 ◽

Vol 15 (37) ◽

Author(s):

J Guimbao ◽

P Rodrigo ◽

M J Alberto ◽

M Omeñaca

Keyword(s):

Cohort Study ◽

Retrospective Cohort ◽

Strong Association ◽

Foot And Mouth Disease ◽

Descriptive Study ◽

Epidemiological Studies ◽

Case Definition ◽

Mouth Disease ◽

Microbiological Analysis ◽

Foot And Mouth

In July 2008 an onychomadesis outbreak in a nursery setting was reported in Saragossa (Spain). Some of the cases had previously suffered from hand, foot and mouth disease (HFMD). In order to study the outbreak and to determine the relation between the two diseases, two epidemiological studies were conducted: a descriptive study focused on cases and a retrospective cohort study. Samples from stool, pharynx and nails were obtained from cases for microbiological analysis. During the study period, 27 children fulfilled the case definition. The average age was 1.8 years. A case shed on average four nails (minimum one maximum twelve). Twenty-four of the 27 cases had previously presented with HFMD which started an average of 40 days before the onset of onychomadesis (relative risk: 14). Unidentified non-polio enterovirus (n=10), coxsackie B1 (n=4) and coxsackie B2 virus (n=3) were isolated in 28 specimens obtained from 14 cases. The analysis showed a strong association between HMFD and onychomadesis. Microbiological results have not been conclusive; consequently more studies are necessary to determine the causal agent of infectious onychomadesis.

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Norovirus foodborne outbreaks associated with the consumption of oysters from the Etang de Thau, France, December 2002

Eurosurveillance ◽

10.2807/esm.09.03.00451-en ◽

2004 ◽

Vol 9 (3) ◽

pp. 24-26 ◽

Cited By ~ 38

Author(s):

A Doyle ◽

D Barataud ◽

A Gallay ◽

J M Thiolet ◽

S Le Guyaguer ◽

...

Keyword(s):

Retrospective Cohort ◽

Heavy Rainfall ◽

Descriptive Analysis ◽

Family Meals ◽

Microbiological Analysis ◽

Number Of Clusters ◽

Faecal Contamination ◽

Environmental Investigation ◽

Foodborne Outbreaks ◽

Stool Samples

In January 2003, the Institut de Veille Sanitaire received notification of clusters of gastroenteritis (GE) thought to be associated with consumption of oysters harvested from Etang de Thau in the south of France. At the same time Italy reported an outbreak (200+ cases) associated with oysters from the Etang de Thau. An investigation was carried out to determine the source and vehicle of the outbreaks. Descriptive analysis of reported clusters in France, microbiological analysis of stool and oyster samples, genotyping of noroviruses and an environmental investigation of the Etang de Thau were carried out. A retrospective cohort study was also undertaken among those attending a number of family meals in Paris. Thirteen family clusters in four districts of France (69 cases) could be attributed to the consumption of Thau oysters based on descriptive evidence. Oysters distributed at an office in Paris and consumed at fourteen family meals between 19 and 24 December led to a further outbreak. In this outbreak the attack rate was 21/36 (58%) for Thau oyster consumers and 0/22 for non-consumers (p=0.00002). Noroviruses (genogroups I and II) were found in stool samples from four clusters and oysters from three clusters (including Paris). Environmental investigations revealed heavy rainfall, an overflow of a water purification station and faecal contamination of the Etang de Thau in December. Oysters from the Etang de Thau were responsible for a number of clusters of norovirus GE in winter 2002 in France and also in Italy. High Escherichia Coli levels in Thau water and shellfish led to an official request, mid-December, for oyster purification before distribution. This was not possible, due to lack of purification facilities. This investigation has contributed to a change in the way that shellfish harvesting areas are classified in France.

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A waterborne outbreak of small round structured virus, campylobacter and shigella co-infections in La Neuveville, Switzerland, 1998

Epidemiology and Infection ◽

10.1017/s0950268899004495 ◽

2000 ◽

Vol 125 (2) ◽

pp. 325-332 ◽

Cited By ~ 50

Author(s):

A. M. MAURER ◽

D. STÜRCHLER

Keyword(s):

Drinking Water ◽

Cohort Study ◽

Point Source ◽

Campylobacter Jejuni ◽

Retrospective Cohort ◽

Pump Failure ◽

Human Faeces ◽

Waterborne Outbreak ◽

Epidemic Curve ◽

Faecal Samples

An outbreak of gastro-enteritis occurred in La Neuveville, township with 3358 inhabitants. A retrospective cohort study of 1915 participants showed that 1607 (84%) had been ill. Campylobacter jejuni was isolated from 28 patient faecal samples, Shigella sonnei from 21 patients and small round structured viruses (SRSV) from 6 patients. More than one pathogen was identified in eight persons. The epidemic curve was characteristic of a point-source outbreak. The risk for illness was significantly higher among persons who had drank unboiled drinking water than among those who had not (1290 [80·3%] of 1607 vs. 86 [27·9%] of 308; RR = 2·87; 95% CI 2·40–3·45). Risk increased significantly with the quantity of water consumed (P < 0·00 × 10−6). An SRSV isolate from water and one human faeces had an identical DNA sequence. The outbreak was due to a pump failure producing a spill of sewage into the groundwater. We conclude that transmission was waterborne and that measures including early warning, basic hygiene and sanitation improvements controlled this epidemic.

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