Cluster of Salmonella Enteritidis in Sweden 2005-2006 – suspected source: almonds

Previous outbreaks of Salmonella Enteritidis in Canada and the United States have been associated with the consumption of almonds. From December 2005 to August 2006 a cluster of 15 cases of Salmonella Enteritidis NST 3+ was reported in Sweden. A case-control study was performed to identify the source of transmission. Three controls per case were randomly selected, matched on sex, age and place of residence. Cases and controls were interviewed by telephone and data were analysed with a conditional logistic model. The results showed that eating almonds was a risk factor for infection with Salmonella Enteritidis NST3+ (unmatched odds ratio 45.0, 95% confidence interval: 4.8-421.8). No Salmonella was isolated from almonds tested in the study. In conclusion, almonds could be the source of the outbreak and should be considered when investigating outbreaks as well as sporadic cases of Salmonella Enteritidis.

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An Outbreak of Cyclosporiasis in 1996 Associated with Consumption of Fresh Berries - Ontario

Canadian Journal of Infectious Diseases ◽

10.1155/2000/640405 ◽

2000 ◽

Vol 11 (2) ◽

pp. 86-92 ◽

Cited By ~ 10

Author(s):

DG Manuel ◽

S Neamatullah ◽

R Shahin ◽

D Reymond ◽

J Keystone ◽

...

Keyword(s):

Public Health ◽

Odds Ratio ◽

Case Control Study ◽

The United States ◽

Case Control ◽

Foodborne Outbreak ◽

Public Health Response ◽

The North ◽

Sporadic Cases ◽

Control Study

BACKGROUND: A large foodborne outbreak of cyclosporiasis occurred in North America in 1996. An index cluster of cases associated with a catered event on May 11, 1996, in Ontario sparked the recognition of this outbreak in Canada.OBJECTIVES: To describe the Ontario experience with the North American outbreak of cyclosporiasis in 1996.PATIENTS AND METHODS: Public health units investigated the index and subsequent event-associated clusters. Investigations included retrospective cohort studies of clusters, traceback of suspect foods and a case-control study of sporadic cases. These activities, coordinated with those in the United States, were part of an international investigation.RESULTS: In Ontario, 232 cases of cyclosporiasis (20 laboratory-confirmed and 72 clinically defined cases associated with seven events plus 140 additional laboratory-confirmed sporadic cases) were identified between May 1 and July 30, 1996. For the index cluster, a strawberry flan with raspberries and blueberries was the only significant exposure (relative risk 2.16, P=0.02). Fresh berries were served at all seven events associated with clusters of cases. Raspberries were definitely served at three events, possibly served at three events, and not served at one event. Only imported berries were available in Ontario in May 1996, when initial clusters and sporadic cases were identified. The raspberries served at the two events with well documented traceback data came from Guatemala. Univariate analyses of the matched case-control study demonstrated that illness was associated with consumption of raspberries (matched odds ratio 21.0, 95% CI 3.48 to 448) and strawberries (matched odds ratio 28.5, 95% CI 4.02 to 478). Further evidence amassed by the international investigation compellingly implicated Guatemalan raspberries as the vehicle of the outbreak.CONCLUSION: Cyclosporiasis may be acquired domestically from the consumption of contaminated produce. The scope and vehicle of this international foodborne outbreak were recognized through a coordinated public health response.

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Outbreak ofSalmonellaBraenderup infections associated with Roma tomatoes, northeastern United States, 2004: a useful method for subtyping exposures in field investigations

Epidemiology and Infection ◽

10.1017/s0950268807007911 ◽

2007 ◽

Vol 135 (7) ◽

pp. 1165-1173 ◽

Cited By ~ 61

Author(s):

S. K. GUPTA ◽

K. NALLUSWAMI ◽

C. SNIDER ◽

M. PERCH ◽

M. BALASEGARAM ◽

...

Keyword(s):

United States ◽

Odds Ratio ◽

Case Control Study ◽

The United States ◽

Field Investigation ◽

Case Control ◽

Northeastern United States ◽

Field Investigations ◽

Foodborne Outbreaks ◽

Control Study

SUMMARYSalmonellaBraenderup is an uncommon serotype in the United States. In July 2004, a multistate outbreak ofSalmonellaBraenderup diarrhoeal infections occurred, with 125 clinical isolates identified. To investigate, we conducted a case-control study, enrolling 32 cases and 63 matched controls. Cheese, lettuce and tomato eaten at restaurants all appeared to be associated with illness. To further define specific exposures, we conducted a second study and asked managers of restaurants patronized by patients and controls about cheese, lettuce and tomato varieties used in dishes their patrons reported consuming. This information was obtained for 27 cases and 29 controls. Roma tomatoes were the only exposure significantly associated with illness (odds ratio 4·3, 95% confidence interval 1·2–15·9). Roma tomatoes from two restaurants were traced back to a single tomato packing house. The methods used in this field investigation to define specific exposures may be useful for other foodborne outbreaks.

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