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Patà Z, Faré PB, Lava SAG, Milani GP, Bianchetti MG, Janett S, Hunjan I, Kottanattu L. Nontyphoidal Salmonella Outbreaks Associated With Chocolate Consumption: A Systematic Review. Pediatr Infect Dis J 2024; 43:420-424. [PMID: 38285510 PMCID: PMC11003406 DOI: 10.1097/inf.0000000000004252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND A large, cross-border outbreak of nontyphoidal salmonellosis connected to chocolate product consumption was recently reported. This occurrence motivated us to conduct a comprehensive review of existing literature concerning outbreaks of nontyphoidal salmonellosis associated with chocolate consumption. METHODS We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42022369023) in 3 databases: U.S. National Library of Medicine, Web of Science and Excerpta Medica. Google Scholar and the bibliography of each identified report were also screened. Eligible were articles published after 1970, describing outbreaks of more than 10 patients with a nontyphoidal salmonellosis associated with chocolate consumption. RESULTS Twenty-three articles were included, which described 12 outbreaks involving a total of 3266 patients. All outbreaks occurred in high-income countries: 1 was limited to 1 city, 6 involved 1 country and the remaining 5 involved 2 or more countries. Six outbreaks peaked in winter, 3 in autumn, 2 in spring and 1 in summer. Children were mainly affected. No predominant serotype was identified. CONCLUSIONS Our data documents that chocolate is an optimal medium for the transmission of nontyphoidal salmonellosis. A connected worldwide reporting system including high-income, middle-income and low-income countries is crucial to detect infectious diseases outbreaks in an early phase and avoid their spread.
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Affiliation(s)
- Zacharie Patà
- From the Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera Italiana
| | - Pietro B. Faré
- Department of Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Department of infectious diseases, University Hospital Zurich, Zurich, Switzerland
| | - Sebastiano A. G. Lava
- Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
- ¶Clinical Pharmacology and Therapeutics Group, University College London, London, United Kingdom
| | - Gregorio P. Milani
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Mario G. Bianchetti
- From the Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera Italiana
| | - Simone Janett
- Sleep Center, Neurocenter of the Southern Switzerland, Ente Ospedaliero Cantonale
| | - Isabella Hunjan
- From the Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera Italiana
| | - Lisa Kottanattu
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
- Pediatric Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
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Human Salmonellosis Outbreak Linked to Salmonella Typhimurium Epidemic in Wild Songbirds, United States, 2020-2021. Pediatr Infect Dis J 2024; 43:270. [PMID: 38285512 DOI: 10.1097/INF.0000000000004246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
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Cardim Falcao R, Edwards MR, Hurst M, Fraser E, Otterstatter M. A Review on Microbiological Source Attribution Methods of Human Salmonellosis: From Subtyping to Whole-Genome Sequencing. Foodborne Pathog Dis 2024; 21:137-146. [PMID: 38032610 PMCID: PMC10924193 DOI: 10.1089/fpd.2023.0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Salmonella is one of the main causes of human foodborne illness. It is endemic worldwide, with different animals and animal-based food products as reservoirs and vehicles of infection. Identifying animal reservoirs and potential transmission pathways of Salmonella is essential for prevention and control. There are many approaches for source attribution, each using different statistical models and data streams. Some aim to identify the animal reservoir, while others aim to determine the point at which exposure occurred. With the advance of whole-genome sequencing (WGS) technologies, new source attribution models will greatly benefit from the discriminating power gained with WGS. This review discusses some key source attribution methods and their mathematical and statistical tools. We also highlight recent studies utilizing WGS for source attribution and discuss open questions and challenges in developing new WGS methods. We aim to provide a better understanding of the current state of these methodologies with application to Salmonella and other foodborne pathogens that are common sources of illness in the poultry and human sectors.
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Affiliation(s)
- Rebeca Cardim Falcao
- British Columbia Centre for Disease Control, Vancouver, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Megan R Edwards
- British Columbia Centre for Disease Control, Vancouver, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Matt Hurst
- Public Health Agency of Canada, Guelph, Canada
| | - Erin Fraser
- British Columbia Centre for Disease Control, Vancouver, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Michael Otterstatter
- British Columbia Centre for Disease Control, Vancouver, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
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Fischerström K, Dryselius R, Lindblad M, Kühlmann-Berenzon S, Karamehmedovic N, Börjesson S, Hashemi N, Gunn I, Gustavsson AM, Lindroos N, Nederby-Öhd J, Widerström M, Rimhanen-Finne R, Vainio A, Rehn M. Outbreak of Salmonella Typhimurium linked to Swedish pre-washed rocket salad, Sweden, September to November 2022. Euro Surveill 2024; 29:2300299. [PMID: 38456218 PMCID: PMC10986667 DOI: 10.2807/1560-7917.es.2024.29.10.2300299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/04/2023] [Indexed: 03/09/2024] Open
Abstract
In September 2022, the Public Health Agency of Sweden observed an increase in domestic Salmonella Typhimurium cases through the Swedish electronic notification system, and an outbreak strain was identified with whole genome sequencing. Overall, 109 cases with symptom onset between 17 September and 24 November 2022 were reported from 20 of 21 Swedish regions. The median age of cases was 52 years (range 4-87 years) and 62% were female. A case-control study found cases to be associated with consumption of rocket salad (adjusted odds ratio (aOR) = 4.9; 95% confidence interval (CI): 2.4-10, p value < 0.001) and bagged mixed salad (aOR = 4.0; 95% CI: 1.9-8.1, p value < 0.001). Trace-back, supported by Finnish authorities who identified the Swedish outbreak strain in a Finnish cluster during the same time period, identified rocket salad, cultivated, pre-washed and pre-packed in Sweden as the likely source of the outbreak. No microbiological analyses of rocket salad were performed. Our investigation indicates that bagged leafy greens such as rocket salad, regardless of pre-washing procedures in the production chain, may contain Salmonella and cause outbreaks, posing a health risk to consumers. We emphasise the need for primary producers of leafy greens to identify possible contamination points to prevent outbreaks.
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Affiliation(s)
- Karolina Fischerström
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Public Health Agency of Sweden (PHAS), Solna, Sweden
| | | | | | | | | | - Stefan Börjesson
- School of Health Science, Örebro University, Örebro, Sweden
- Public Health Agency of Sweden (PHAS), Solna, Sweden
| | | | - Ingrid Gunn
- Department of Infectious Disease Prevention and Control, Region Kalmar County, Kalmar, Sweden
| | - Ann-Mari Gustavsson
- Department of Infection Prevention and Control, County of Värmland, Karlstad, Sweden
| | - Nilla Lindroos
- Department of Infectious Disease Prevention and Control, Region Halland, Halmstad, Sweden
| | - Joanna Nederby-Öhd
- Department of Infectious Disease Prevention and Control, Stockholm Region, Stockholm, Sweden
| | | | - Ruska Rimhanen-Finne
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Anni Vainio
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Moa Rehn
- Public Health Agency of Sweden (PHAS), Solna, Sweden
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5
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Wang Z, Huang C, Liu Y, Chen J, Yin R, Jia C, Kang X, Zhou X, Liao S, Jin X, Feng M, Jiang Z, Song Y, Zhou H, Yao Y, Teng L, Wang B, Li Y, Yue M. Salmonellosis outbreak archive in China: data collection and assembly. Sci Data 2024; 11:244. [PMID: 38413596 PMCID: PMC10899168 DOI: 10.1038/s41597-024-03085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
Infectious disease outbreaks transcend the medical and public health realms, triggering widespread panic and impeding socio-economic development. Considering that self-limiting diarrhoea of sporadic cases is usually underreported, the Salmonella outbreak (SO) study offers a unique opportunity for source tracing, spatiotemporal correlation, and outbreak prediction. To summarize the pattern of SO and estimate observational epidemiological indicators, 1,134 qualitative reports screened from 1949 to 2023 were included in the systematic review dataset, which contained a 506-study meta-analysis dataset. In addition to the dataset comprising over 50 columns with a total of 46,494 entries eligible for inclusion in systematic reviews or input into prediction models, we also provide initial literature collection datasets and datasets containing socio-economic and climate information for relevant regions. This study has a broad impact on advancing knowledge regarding epidemic trends and prevention priorities in diverse salmonellosis outbreaks and guiding rational policy-making or predictive modeling to mitigate the infringement upon the right to life imposed by significant epidemics.
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Affiliation(s)
- Zining Wang
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Hainan Institute of Zhejiang University, Sanya, 572000, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Chenghu Huang
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Hainan Institute of Zhejiang University, Sanya, 572000, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Yuhao Liu
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Hainan Institute of Zhejiang University, Sanya, 572000, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Jiaqi Chen
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Rui Yin
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Chenghao Jia
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Xiamei Kang
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Xiao Zhou
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Sihao Liao
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Xiuyan Jin
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Mengyao Feng
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Zhijie Jiang
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Yan Song
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Haiyang Zhou
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Hainan Institute of Zhejiang University, Sanya, 572000, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Yicheng Yao
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Lin Teng
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Baikui Wang
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China
| | - Yan Li
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China
- Hainan Institute of Zhejiang University, Sanya, 572000, China
| | - Min Yue
- Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou, 310058, China.
- Hainan Institute of Zhejiang University, Sanya, 572000, China.
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou, 310058, China.
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
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Bolzoni L, Conter M, Lamperti L, Scaltriti E, Morganti M, Poeta A, Vecchi M, Paglioli S, Rampini A, Ramoni P, De Vita D, Bacci C, Rega M, Andriani L, Pongolini S, Bonardi S. Salmonella in horses at slaughter and public health effects in Italy. Int J Food Microbiol 2024; 408:110429. [PMID: 37839149 DOI: 10.1016/j.ijfoodmicro.2023.110429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 10/17/2023]
Abstract
The study assessed the role of equids at slaughter as faecal carriers of Salmonella enterica and the occurrence of contaminated equid carcasses during the slaughter process in Northern Italy (Emilia-Romagna Region). From June to November 2021, 152 equids (146 horses, 5 donkeys and 1 mule) were tested for Salmonella both in caecal contents and through carcass swabs. Antimicrobial resistance (AMR) of recovered strains was tested against 15 antimicrobials. Salmonella was detected in 3/152 of the caecal contents (2.0 %), while all carcass samples were negative. S. enterica serovars Enteriditis, Typhimurium and Stanleyville were identified. The only AMR isolate was S. Typhimurium with AMR profile AmCStxT. Considering the consumption of raw horse meat (i.e., minced raw meat named "pesto di cavallo" and dried and smoked strips named "sfilacci di cavallo") in different areas of Northern Italy, we also investigated the possible link between horse meat eating and salmonellosis cases in the human population in the same area. Specifically, we compared the Salmonella strains collected during the study with those routinely processed in the laboratory surveillance system for human salmonellosis in Emilia-Romagna (a region with about 4.5 million inhabitants). The comparison was based on whole genome sequencing data through core genome multi-locus sequence typing (cgMLST) used in routine surveillance. A genomic match in cgMLST was found between the strain of S. enterica serovar Enteritidis isolated from a horse caecal content and an enduring outbreak of 17 human cases in Emilia-Romagna during the study period. The consequent epidemiological investigation highlighted that a number of cases with known food history reported the consumption of horse meat and traced different batches of the consumed meat, released weeks apart from each other, to the slaughter investigated in the study. The results of the epidemiological investigation suggested the role of horses in the S. enterica serovar Enteritidis outbreak affecting raw horse meat consumers. This study shows that, despite the low prevalence on equid carcasses, S. enterica in horse meat can represent a risk to consumers. From the perspective of the slaughter activities, this highlights the need to maintain a high level of hygiene during the entire process, starting from the hygiene at lairage up to the slaughtering phase and dressing of carcasses.
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Affiliation(s)
- Luca Bolzoni
- Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, Parma, Italy
| | - Mauro Conter
- Department of Veterinary Science, Unit of Inspection of Food of Animal Origin, University of Parma, Italy
| | - Luca Lamperti
- Department of Veterinary Science, Unit of Inspection of Food of Animal Origin, University of Parma, Italy
| | - Erika Scaltriti
- Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, Parma, Italy
| | - Marina Morganti
- Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, Parma, Italy
| | - Antonio Poeta
- Hygiene and Public Health Unit, Local Health Authority, Reggio Emilia, Italy
| | - Marco Vecchi
- Specialization School in Inspection of Food of Animal Origin, University of Parma, Italy
| | - Silvia Paglioli
- Hygiene and Public Health Unit, Local Health Authority, Parma, Italy
| | | | - Paolo Ramoni
- Hygiene and Public Health Unit, Local Health Authority, Piacenza, Italy
| | - Daniela De Vita
- Hygiene and Public Health Unit, Local Health Authority, Reggio Emilia, Italy
| | - Cristina Bacci
- Department of Veterinary Science, Unit of Inspection of Food of Animal Origin, University of Parma, Italy
| | - Martina Rega
- Department of Veterinary Science, Unit of Inspection of Food of Animal Origin, University of Parma, Italy
| | - Laura Andriani
- Department of Veterinary Science, Unit of Inspection of Food of Animal Origin, University of Parma, Italy
| | - Stefano Pongolini
- Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, Parma, Italy
| | - Silvia Bonardi
- Department of Veterinary Science, Unit of Inspection of Food of Animal Origin, University of Parma, Italy.
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Moore HL, Aabye M, Hoban A, Rosner B, Lefevre SK, Litrup E, Müller L, Ethelberg S, Simon S, Balasegaram S, Larkin L, Jernberg C, Takkinen J. Multinational collaboration in solving a European Salmonella Braenderup outbreak linked to imported melons, 2021. Euro Surveill 2024; 29:2300273. [PMID: 38179625 PMCID: PMC10905663 DOI: 10.2807/1560-7917.es.2024.29.1.2300273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/23/2023] [Indexed: 01/06/2024] Open
Abstract
A genomic cluster of Salmonella Braenderup ST22, a serovar of Salmonella enterica subsp. enterica which causes symptoms of gastrointestinal illness, was notified by Danish authorities to the European Centre for Disease Prevention and Control (ECDC) on 3 May 2021. By 6 July 2021, S. Braenderup outbreak cases (n = 348) had been reported from 12 countries in the European Union/European Economic Area (EU/EEA) and the United Kingdom (UK), including 68 hospitalised cases. With support from affected EU/EEA countries, and in partnership with the European Food Safety Authority (EFSA), ECDC established an international outbreak investigation team to rapidly identify the source and prevent outbreak spread. Consumption information was shared with affected countries through a standard line list, revealing that 124 of 197 cases (63%) reported having eaten (any) melons within 7 days prior to disease onset. The speed and completeness of the investigation, which identified the outbreak vehicle as galia melons imported from Honduras in June 2021, was a direct result of extensive collaboration and information sharing between countries' national food safety and public health authorities. This article describes the outbreak and the benefits, successes, and challenges of multi-country collaboration for consideration in future large foodborne outbreaks across Europe.
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Affiliation(s)
- Hannah L Moore
- UK Field Epidemiology Training Program (UK FETP), UK Health Security Agency, London, United Kingdom
- UK Health Security Agency, London, United Kingdom
| | - Martine Aabye
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden
- Statens Serum Institut, Copenhagen, Denmark
- The Danish Health Authority, Copenhagen, Denmark
| | - Ann Hoban
- UK Health Security Agency, London, United Kingdom
| | | | | | - Eva Litrup
- Statens Serum Institut, Copenhagen, Denmark
| | - Luise Müller
- UK Health Security Agency, London, United Kingdom
| | - Steen Ethelberg
- Statens Serum Institut, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | - Cecilia Jernberg
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Johanna Takkinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Nemechek K, Sean Stapleton G, Waltenburg MA, Low M, Gollarza L, Adams J, Peralta V, Lopez K, Morrison A, Schnitzler H, Kline KE, McGinnis S, Nichols M. Multistate outbreak of turtle-associated salmonellosis highlights ongoing challenges with the illegal sale and distribution of small turtles. Zoonoses Public Health 2023; 70:684-691. [PMID: 37772367 PMCID: PMC10878351 DOI: 10.1111/zph.13080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/07/2023] [Accepted: 09/17/2023] [Indexed: 09/30/2023]
Abstract
The sale and distribution of small turtles (shell length <4 inches) as pets has been banned in the United States since 1975 because of the risk of Salmonella transmission, especially to children. Despite this 48-year-old ban, salmonellosis outbreaks continue to be linked to contact with small turtles. During investigations of turtle-associated outbreaks, information regarding the turtle farm of origin is difficult to obtain because turtles are commonly sold by transient vendors. During 2020-2021, public health officials investigated a multistate illness outbreak caused by Salmonella enterica serotype Typhimurium linked to pet small turtles. Cases were defined as a laboratory-confirmed Salmonella Typhimurium infection highly related (within 0-6 allele differences) to the outbreak strain based on whole-genome sequencing analysis by core-genome multilocus sequence typing with illness onset occurring during 27 August 2020-14 May 2021. Forty-three patients were identified from 12 states; of these, 35% (15/43) were children <5 years old. Among patients with available information, 37% (14/38) were hospitalized, and one death was reported. Seventy-four percent (25/34) of patients reported turtle exposure in the week before illness onset, and 84% (16/19) specified exposure to small turtles. The outbreak strain was isolated from samples collected from a Pennsylvania patient's small turtle tank. Two patients reported purchasing their small turtles from pet stores. Salmonella Braenderup was isolated from samples collected from small turtles and their habitat at one of these stores; however, at that time, this strain was not associated with any human illnesses. This investigation was notable because of the documented sale of small turtles from several pet stores combined with the identification of a single small turtle supplier to these pet stores. The high proportion of children involved in this outbreak highlights the continued need to educate the pet industry as well as parents and caregivers about the risk of turtle-associated salmonellosis especially in children. Understanding and addressing the persisting challenges related to the illegal sale and distribution of small turtles could reduce the burden of turtle-associated salmonellosis.
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Affiliation(s)
- Kaylea Nemechek
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - G. Sean Stapleton
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Michelle A. Waltenburg
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mabel Low
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lauren Gollarza
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Adams
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Association of Public Health Laboratories, Silver Spring, Maryland, USA
| | - Vi Peralta
- California Department of Public Health, Richmond, California, USA
| | - Karen Lopez
- Delaware Department of Agriculture, Dover, Delaware, USA
| | - Atisha Morrison
- Texas Department of State Health Services, Austin, Texas, USA
| | | | - Kelly E. Kline
- Pennsylvania Department of Health, Bureau of Epidemiology, Harrisburg, Pennsylvania, USA
| | - Shannon McGinnis
- Pennsylvania Department of Health, Bureau of Epidemiology, Harrisburg, Pennsylvania, USA
| | - Megin Nichols
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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9
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Rodríguez A, Sacristán C, Iglesias I, de la Torre A. Salmonella assessment along the Spanish food chain: Likelihood of Salmonella occurrence in poultry and pig products is maintained across the food chain stages. Zoonoses Public Health 2023; 70:665-673. [PMID: 37612884 DOI: 10.1111/zph.13076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/29/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
Salmonellosis is one of the most important foodborne diseases worldwide, including the European Union. Despite the One Health approach measures for risk assessment and risk management implemented by the European Union, the occurrence of disease and disease outbreaks remains high (e.g. 694 outbreaks were reported in 2020), highlighting the need of new assessment methods. Herein we applied machine learning using the random forests method to evaluate and identify key points regarding the occurrence of Salmonella sp. along the Spanish food chain during 2015-2020, using data provided by the Spanish Agency for Food Safety and Nutrition. We compared the role of the three categorical variables [product (20 categories), region (18 categories) and stage (11 categories)]. Salmonella presence was influenced by the three explanatory variables considered: first by product, followed by region and stage. The most determinant product for Salmonella probability was 'meat', while the most important stage was 'slaughterhouse'. Specifically, the highest values were found in pig and poultry meats. In these products, the Salmonella probability was high at the early and final stages of the food chain, although not at intermediate stages. The presence of Salmonella in the final stages (retail) of the food chain is of concern, as it can cause human cases of salmonellosis, including outbreaks. This study demonstrates the utility of the random forest method to identify key points and evaluate the control efforts. We recommend improving the surveillance and control measures, especially in the product and stages pointed out by our analysis, and enhancing the data collection harmonization among the different autonomous communities.
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Affiliation(s)
- Antonio Rodríguez
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, Spain
- Université Clermont Auvergne, INRAE, VetAgro Sup, UREP, Clermont-Ferrand, France
| | - Carlos Sacristán
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, Spain
| | - Irene Iglesias
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, Spain
| | - Ana de la Torre
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, Spain
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10
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Adamson JP, Sawyer C, Hobson G, Clark E, Fina L, Orife O, Smith R, Williams C, Hughes H, Jones A, Swaysland S, Somoye O, Phillips R, Iqbal J, Mohammed I, Karani G, Thomas DR. An outbreak of Salmonella Typhimurium associated with the consumption of raw liver at an Eid al-Adha celebration in Wales (UK), July 2021. Epidemiol Infect 2023; 152:e6. [PMID: 38031438 PMCID: PMC10789983 DOI: 10.1017/s0950268823001887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 11/01/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023] Open
Abstract
In July 2021, Public Health Wales received two notifications of salmonella gastroenteritis. Both cases has attended the same barbecue to celebrate Eid al-Adha, two days earlier. Additional cases attending the same barbecue were found and an outbreak investigation was initiated. The barbecue was attended by a North African community's social network. On same day, smaller lunches were held in three homes in the social network. Many people attended both a lunch and the barbecue. Cases were defined as someone with an epidemiological link to the barbecue and/or lunches with diarrhoea and/or vomiting with date of onset following these events. We undertook a cohort study of 36 people attending the barbecue and/or lunch, and a nested case-control study using Firth logistic regression. A communication campaign, sensitive towards different cultural practices, was developed in collaboration with the affected community. Consumption of a traditional raw liver dish, 'marrara', at the barbecue was the likely vehicle for infection (Firth logistic regression, aOR: 49.99, 95%CI 1.71-1461.54, p = 0.02). Meat and offal came from two local butchers (same supplier) and samples yielded identical whole genome sequences as cases. Future outbreak investigations should be relevant to the community affected by considering dishes beyond those found in routine questionnaires.
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Affiliation(s)
- James P. Adamson
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
- UK Field Epidemiology Training Programme, UK Health Security Agency, London, UK
| | - Clare Sawyer
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
- UK Field Epidemiology Training Programme, UK Health Security Agency, London, UK
| | - Gemma Hobson
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | - Emily Clark
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | - Laia Fina
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | - Oghogho Orife
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | - Robert Smith
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | - Chris Williams
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | | | - Allyson Jones
- Communicable Disease, Health and Safety Team for Shared Regulatory Services for Bridgend, Cardiff & Vale of Glamorgan Councils, Cardiff, UK
| | - Sarah Swaysland
- Communicable Disease, Health and Safety Team for Shared Regulatory Services for Bridgend, Cardiff & Vale of Glamorgan Councils, Cardiff, UK
| | - Oluwaseun Somoye
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | - Ryan Phillips
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | - Junaid Iqbal
- Lead for Service User Experience, Public Health Wales, Cardiff, UK
| | - Israa Mohammed
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | - George Karani
- School of Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Daniel Rhys Thomas
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
- School of Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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11
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Patel K, Stapleton GS, Trevejo RT, Tellier WT, Higa J, Adams JK, Hernandez SM, Sanchez S, Nemeth NM, Debess EE, Rogers KH, Mete A, Watson KD, Foss L, Low MSF, Gollarza L, Nichols M. Human Salmonellosis Outbreak Linked to Salmonella Typhimurium Epidemic in Wild Songbirds, United States, 2020-2021. Emerg Infect Dis 2023; 29:2298-2306. [PMID: 37877570 PMCID: PMC10617330 DOI: 10.3201/eid2911.230332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Salmonella infection causes epidemic death in wild songbirds, with potential to spread to humans. In February 2021, public health officials in Oregon and Washington, USA, isolated a strain of Salmonella enterica serovar Typhimurium from humans and a wild songbird. Investigation by public health partners ultimately identified 30 illnesses in 12 states linked to an epidemic of Salmonella Typhimurium in songbirds. We report a multistate outbreak of human salmonellosis associated with songbirds, resulting from direct handling of sick and dead birds or indirect contact with contaminated birdfeeders. Companion animals might have contributed to the spread of Salmonella between songbirds and patients; the outbreak strain was detected in 1 ill dog, and a cat became ill after contact with a wild bird. This outbreak highlights a One Health issue where actions like regular cleaning of birdfeeders might reduce the health risk to wildlife, companion animals, and humans.
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12
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Stancill LB, Ponder MG, Kinlaw AC, Teal L, Sickbert-Bennett EE, Weber DJ, DiBiase LM. Methodologic challenges and lessons learned through conducting a hospital-based Salmonella Javiana case-control study. Am J Infect Control 2023; 51:1132-1138. [PMID: 36965777 DOI: 10.1016/j.ajic.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVE Determine the food(s) most likely contaminated by Salmonella Javiana associated with a salmonellosis outbreak involving 2 hospitals in North Carolina that were within 50 miles of each other in November 2021. METHODS A 2:1 matched case-control study was conducted. Food histories were obtained from hospital food orders and potential confounder covariates were collected from patient medical records. Attack rates and conditional logistic regression odds ratios (OR) were estimated at the 80% confidence interval (CI) for each food exposure and salmonellosis. RESULTS There were 21 cases and 42 controls included. Fruit cups had the strongest association with salmonellosis (matched and adjusted OR = 7.9 80% CI: 2.7, 23.6). Hospital-specific ORs varied for several food items, but attack rates analyses provided additional evidence that fruit cups were a likely common source. CONCLUSION Our analyses implicated fruit cups in an outbreak of salmonellosis in 2 hospitals. Other methodologic challenges included selection of controls among sick patients, heterogeneity of food exposures, reliance on food orders rather than foods consumed, and retention of food history records. Understanding and anticipating these challenges through changes to policies and operational procedures is critical for conducting efficient and effective case-control studies in the hospital setting.
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Affiliation(s)
- Lisa B Stancill
- Department of Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
| | - Madison G Ponder
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alan C Kinlaw
- Division of Pharmaceutical Outcomes and Policy, University of North Carolina School of Pharmacy, Chapel Hill, NC; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Lisa Teal
- Department of Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
| | - Emily E Sickbert-Bennett
- Department of Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC; Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - David J Weber
- Department of Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
| | - Lauren M DiBiase
- Department of Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
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13
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Paradis A, Beaudet MF, Boisvert Moreau M, Huot C. Investigation of a Salmonella Montevideo Outbreak Related to the Environmental Contamination of a Restaurant Kitchen Drainage System, Québec, Canada, 2020-2021. J Food Prot 2023; 86:100131. [PMID: 37474022 DOI: 10.1016/j.jfp.2023.100131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023]
Abstract
In May 2020, the Direction de santé publique du CIUSSS de la Capitale-Nationale (DSPu) received a report from the Laboratoire de santé publique du Québec of a cluster of three cases of Salmonella enterica enterica, serogroup C1, serotype Montevideo. The epidemiological investigation identified a total of 67 cases between January 1, 2020, and August 13, 2021, 66% of which were directly linked to a restaurant in the area. The Salmonella strains from most of these cases were found to be identical by whole-genome sequencing (cluster code 2005MontWGS-1QC). The initial inspection of the restaurant by the competent authorities (Ministère de l'agriculture, des pêcheries et de l'alimentation du Québec) - including the evaluation of hygiene and food safety, the search for cases of illness among workers and food sampling - was unable to establish the source of the outbreak. Environmental samples showed that the restaurant's kitchen drains were contaminated with the same strain of Salmonella Montevideo as the cases in the outbreak. Several cleaning and disinfection methods were used repeatedly. When environmental sampling at the restaurant sites was repeatedly and consecutively negative, cases in the community stopped. The prior occurrence of a fire in the kitchen may have played a role in the contamination of the restaurant drains. In conclusion, public health professionals should consider drainage systems (plumbing) and possible aerosolization of bacteria as a potential source of a restaurant-related salmonellosis outbreak.
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Affiliation(s)
- André Paradis
- Infectious Diseases, Direction de Santé Publique, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, 2400 Av. D'Estimauville, Québec, QC G1E 7G9, Canada.
| | - Marie-France Beaudet
- Infectious Diseases, Direction de Santé Publique, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, 2400 Av. D'Estimauville, Québec, QC G1E 7G9, Canada
| | - Marianne Boisvert Moreau
- Public Health and Preventive Medicine Resident, Université Laval, 1600 Av. des Sciences-de-la-Vie, Québec, QC G1V 5C3, Canada
| | - Caroline Huot
- Unité Évaluation et Soutien à la Gestion des Risques, Direction de la Santé Environnementale, au Travail et de la Toxicologie, Institut National de Santé Publique du Québec, 945 Av. Wolfe, Québec, QC G1V 5B3, Canada
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14
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Raut R, Maharjan P, Fouladkhah AC. Practical Preventive Considerations for Reducing the Public Health Burden of Poultry-Related Salmonellosis. Int J Environ Res Public Health 2023; 20:6654. [PMID: 37681794 PMCID: PMC10487474 DOI: 10.3390/ijerph20176654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/20/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023]
Abstract
With poultry products as one of the leading reservoirs for the pathogen, in a typical year in the United States, it is estimated that over one million individuals contract non-typhoidal Salmonella infections. Foodborne outbreaks associated with Salmonella infections in poultry, thus, continue to remain a significant risk to public health. Moreover, the further emergence of antimicrobial resistance among various serovars of Salmonella is an additional public health concern. Feeding-based strategies (such as use of prebiotics, probiotics, and/or phytobiotics as well as essential oils), non-feeding-based strategies (such as use of bacteriophages, vaccinations, and in ovo strategies), omics tools and surveillance for identifying antibiotic-resistance genes, post-harvest application of antimicrobials, and biosecurity measures at poultry facilities are practical interventions that could reduce the public health burden of salmonellosis and antibiotic resistance associated with poultry products. With the escalating consumption of poultry products around the globe, the fate, prevalence, and transmission of Salmonella in agricultural settings and various poultry-processing facilities are major public health challenges demanding integrated control measures throughout the food chain. Implementation of practical preventive measures discussed in the current study could appreciably reduce the public health burden of foodborne salmonellosis associated with poultry products.
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Affiliation(s)
- Rabin Raut
- Cooperative Extension Program, Tennessee State University, Nashville, TN 37209, USA;
- Public Health Microbiology Laboratory, Tennessee State University, Nashville, TN 37209, USA
| | - Pramir Maharjan
- Cooperative Extension Program, Tennessee State University, Nashville, TN 37209, USA;
| | - Aliyar Cyrus Fouladkhah
- Public Health Microbiology Laboratory, Tennessee State University, Nashville, TN 37209, USA
- Public Health Microbiology FoundationSM, Nashville, TN 37209, USA
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15
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Osasah V, Whitfield Y, Adams J, Danish A, Mather R, Aloosh M. An Outbreak of Salmonella Typhimurium Infections Linked to Ready-To-Eat Tofu in Multiple Health Districts - Ontario, Canada, May-July 2021. MMWR Morb Mortal Wkly Rep 2023; 72:855-858. [PMID: 37561672 PMCID: PMC10415003 DOI: 10.15585/mmwr.mm7232a1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
From May to mid-August 2021, the Ontario, Canada provincial public health agency, Public Health Ontario, in collaboration with local public health authorities and federal food safety partners, investigated a spatiotemporal cluster of 38 patients with Salmonella Typhimurium infections across multiple public health districts in Ontario. Five (13%) patients were hospitalized; no deaths were reported. The outbreak was linked to consumption of ready-to-eat seasoned tofu from one manufacturer that was distributed to multiple Ontario restaurants. Isolates from the seasoned tofu were within one or fewer allele differences to the outbreak strain by whole genome sequencing. Evidence from food safety investigations conducted by local public health authorities and the Canadian Food Inspection Agency (CFIA) revealed that unsanitary conditions could have led to cross-contamination of the tofu, and insufficient heating of the tofu at the production level likely resulted in failure to eliminate the pathogen. The CFIA issued a food recall for the tofu at hotel, restaurant, and institution levels. Tofu was identified as a novel outbreak-associated food vehicle for S. Typhimurium in this outbreak. Interventions that target the production level and all parts of the supply chain and include additional safeguarding steps that minimize microbial growth are important.
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16
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Rathnayake IU, Graham RMA, Bayliss J, Staples M, Micalizzi G, Ariotti L, Cover L, Heron B, Graham T, Stafford R, Rubenach S, D'Addona A, Jennison AV. Implementation of routine genomic surveillance provided insights into a locally acquired outbreak caused by a rare clade of Salmonella enterica serovar Enteritidis in Queensland, Australia. Microb Genom 2023; 9:mgen001059. [PMID: 37459172 PMCID: PMC10438802 DOI: 10.1099/mgen.0.001059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/08/2023] [Indexed: 07/20/2023] Open
Abstract
Salmonellosis is a significant public health problem globally. In Australia, Salmonella enterica serovar Enteritidis is one of the main causes of salmonellosis. This study reports how the implementation of routine genetic surveillance of isolates from human S. Enteritidis cases enabled identification of the likely source of an outbreak that occurred in a remote town in Far North Queensland, Australia. This study included patient, food and water samples collected during an outbreak investigation. S. Enteritidis of the novel sequence type 5438 was isolated from all seven patient samples and one bore water sample but not any of the food samples. Both whole-genome single nucleotide polymorphism (SNP) and core-genome multilocus sequence typing analysis revealed that S. Enteritidis isolated from outbreak-related patient samples and the bore water isolates clustered together with fewer than five SNP differences and ten allelic differences. This genetic relatedness informed the outbreak response team around public health interventions and no further cases were identified post-treatment of the bore water. This disease cluster was identified through the routine sequencing of S. Enteritidis performed by the state public health laboratory in an actionable time frame. Additionally, genomic surveillance captured a case with unknown epidemiological links to the affected community, ruled out a simultaneous outbreak in an adjacent state as the source and provided evidence for the likely source preventing further transmission. Therefore, this report provides compelling support for the implementation of whole-genome sequencing based genotyping methods in public health microbiology laboratories for better outbreak detection and management.
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Affiliation(s)
- Irani U. Rathnayake
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Rikki M. A. Graham
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Jo Bayliss
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Megan Staples
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Gino Micalizzi
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Lawrence Ariotti
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Leonie Cover
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Brett Heron
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Trudy Graham
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Russell Stafford
- OzFoodNet, Communicable Diseases Branch, Queensland Public Health and Scientific Services, Queensland Department of Health, Butterfield Street, Herston, Brisbane, Queensland, Australia
| | - Sally Rubenach
- Health Surveillance, Tropical Public Health Services Cairns, Cairns and Hinterland Hospital and Health Service, Queensland Department of Health, Cairns, Queensland, Australia
| | - Andrew D'Addona
- Environmental Health, Tropical Public Health Services Cairns, Cairns and Hinterland Hospital and Health Service, Queensland Department of Health, Cairns, Queensland, Australia
| | - Amy V. Jennison
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
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17
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Benson HE, Reeve L, Findlater L, Vusirikala A, Pietzsch M, Olufon O, Matthews E, Hoban A, Painset A, Balasegaram S, Larkin L, Weir S, Heinsbroek E. Local Salmonella Enteritidis restaurant outbreak investigation in England provides further evidence for eggs as source in widespread international cluster, March to April 2023. Euro Surveill 2023; 28:2300309. [PMID: 37410382 PMCID: PMC10370042 DOI: 10.2807/1560-7917.es.2023.28.27.2300309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/05/2023] [Indexed: 07/07/2023] Open
Abstract
We report a 5-single nucleotide polymorphism cluster of Salmonella Enteriditis in England, part of a global cluster of S. Enteritidis ST11. Forty-seven confirmed cases have been investigated of whom 25 were linked to a restaurant. In addition, there were 18 probable cases with restaurant exposure. Epidemiological investigations suggested eggs or chicken as the most likely cause of the outbreak but were unable to distinguish between those two food vehicles. Ongoing food chain investigations indicated links to imported eggs from Poland.
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Affiliation(s)
- Helen E Benson
- East of England Health Protection Team, UK Health Security Agency, Cambridge, United Kingdom
| | - Lucy Reeve
- Field Service East of England, UK Health Security Agency, Cambridge United Kingdom
| | - Lucy Findlater
- Field Service South East and London, UK Health Security Agency, London, United Kingdom
| | - Amoolya Vusirikala
- Field Service South East and London, UK Health Security Agency, London, United Kingdom
| | - Maaike Pietzsch
- Field Service Rapid Investigation Team, UK Health Security Agency, London, United Kingdom
| | - Oluwakemi Olufon
- Field Service Rapid Investigation Team, UK Health Security Agency, London, United Kingdom
| | - Eve Matthews
- Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, United Kingdom
| | - Ann Hoban
- Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, United Kingdom
| | - Anaïs Painset
- Gastrointestinal Bacteria Reference Unit, Public Health Microbiology Division, UK Health Security Agency, London, United Kingdom
| | - Sooria Balasegaram
- Field Service South East and London, UK Health Security Agency, London, United Kingdom
- Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, United Kingdom
| | - Lesley Larkin
- Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, United Kingdom
| | - Sarah Weir
- East of England Health Protection Team, UK Health Security Agency, Cambridge, United Kingdom
| | - Ellen Heinsbroek
- Field Service East of England, UK Health Security Agency, Cambridge United Kingdom
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18
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Obe T, Siceloff AT, Crowe MG, Scott HM, Shariat NW. Combined Quantification and Deep Serotyping for Salmonella Risk Profiling in Broiler Flocks. Appl Environ Microbiol 2023; 89:e0203522. [PMID: 36920215 PMCID: PMC10132105 DOI: 10.1128/aem.02035-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/08/2023] [Indexed: 03/16/2023] Open
Abstract
Despite a reduction of Salmonella contamination on final poultry products, the level of human salmonellosis cases attributed to poultry has remained unchanged over the last few years. There needs to be improved effort to target serovars which may survive antimicrobial interventions and cause illness, as well as to focus on lessening the amount of contamination entering the processing plant. Advances in molecular enumeration approaches allow for the rapid detection and quantification of Salmonella in pre- and postharvest samples, which can be combined with deep serotyping to properly assess the risk affiliated with a poultry flock. In this study, we collected a total of 160 boot sock samples from 20 broiler farms across four different integrators with different antibiotic management programs. Overall, Salmonella was found in 85% (68/80) of the houses, with each farm having at least one Salmonella-positive house. The average Salmonella quantity across all four complexes was 3.6 log10 CFU/sample. Eleven different serovars were identified through deep serotyping, including all three key performance indicators (KPIs; serovars Enteritidis, Infantis, and Typhimurium) defined by the U.S. Department of Agriculture-Food Safety and Inspection Service (USDA-FSIS). There were eight multidrug resistant isolates identified in this study, and seven which were serovar Infantis. We generated risk scores for each flock based on the presence or absence of KPIs, the relative abundance of each serovar as calculated with CRISPR-SeroSeq (serotyping by sequencing the clustered regularly interspaced palindromic repeats), and the quantity of Salmonella organisms detected. The work presented here provides a framework to develop directed processing approaches and highlights the limitations of conventional Salmonella sampling and culturing methods. IMPORTANCE Nearly one in five foodborne Salmonella illnesses are derived from chicken, making it the largest single food category to cause salmonellosis and indicating a need for effective pathogen mitigation. Although industry has successfully reduced Salmonella incidence in poultry products, there has not been a concurrent reduction in human salmonellosis linked to chicken consumption. New efforts are focused on improved control at preharvest, which requires improved Salmonella surveillance. Here, we present a high-resolution surveillance approach that combines quantity and identity of Salmonella in broiler flocks prior to processing which will further support improved Salmonella controls in poultry. We developed a framework for this approach, indicating that it is possible and important to harness deep serotyping and molecular enumeration to inform on-farm management practices and to minimize risk of cross-contamination between flocks at processing. Additionally, this framework could be adapted to Salmonella surveillance in other food animal production systems.
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Affiliation(s)
- Tomi Obe
- Poultry Diagnostic and Research Center, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Amy T. Siceloff
- Poultry Diagnostic and Research Center, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Megan G. Crowe
- Poultry Diagnostic and Research Center, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - H. Morgan Scott
- Department of Veterinary Pathobiology, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Nikki W. Shariat
- Poultry Diagnostic and Research Center, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
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Abstract
INTRODUCTION Increased consumer awareness of the health aspects of the diet has influenced the increased consumption of fruit and vegetables. Due to the fact that these products are mainly consumed raw and are usually not subjected to processes that reduce their microbiological contamination, they become a source of infection and transmit pathogens causing food poisoning in humans. Salmonella bacteria are a serious treat to human health and remain a serious problem in many parts of the world. OBJECTIVE The aim of this study was to review the current state of knowledge regarding the prevalence of Salmonella bacteria on fresh fruit and vegetables. Attention is also given to the mechanisms by which these bacteria adapt to colonize plants. Methods that can prevent contamination of plant products by the bacteria are also analyzed. REVIEW METHODS The review was based on data obtained from scientific articles published in the Science Direct and Pub Med database between 2007 - 2022, found with the use of the following keywords: Salmonella, fruit, vegetables, food contamination. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE Data from the literature report that fresh fruit and vegetables are a source of Salmonella contamination through contact with soil, manure, compost, water or staff. SUMMARY Actions targeting salmonellosis prevention should be undertaken by both the public and private sectors. Government regulations and stricter measures put in place can provide a framework that guides both domestic production and international imports. Periodic training of workers dealing with food is also important. Attention should be directed mainly to production control and less to the testing of final products. Education leading to increased awareness of salmonellosis should be indispensable.
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Affiliation(s)
- Beata Kowalska
- The National Institute of Horticultural Research, Skierniewice, Poland
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20
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Montague LE, Marcotrigiano JM, Keane NE, Marquardt HE, Sevin JA, Karraker NE. Online sale of small turtles circumvents public health regulations in the United States. PLoS One 2022; 17:e0278443. [PMID: 36542556 PMCID: PMC9770399 DOI: 10.1371/journal.pone.0278443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 10/20/2022] [Indexed: 12/24/2022] Open
Abstract
In the United States (U.S.), pet turtles have been associated with outbreaks of salmonellosis, a serious and sometimes-fatal intestinal illness caused by Salmonella bacteria, with nearly 300,000 people being infected in some years. Children are particularly susceptible because of their propensity to put items, including small turtles, in their mouths. In 1975, a U.S. federal regulation prohibited the sale of turtles <4 inches (101.6 mm) in size, except for the purposes of export, scientific, or educational purposes. This regulation was established to reduce the incidence of salmonellosis, particularly in small children. Previous research has not evaluated the availability of turtles <4 inches in size on websites selling wildlife. We monitored 16 websites in 2021 and quantified listings of small turtles. We determined whether information on Salmonella, the 1975 federal regulation, or related state regulations were provided on the websites and determined legality of sales of small turtles by state regulations. We found that all 16 websites openly advertised and sold turtles <4 inches in size, but only half of these websites provided information about Salmonella and/or the federal regulation. These websites required buyers to confirm that they were not purchasing a turtle as a pet, thereby putting the onus on the consumer to adhere to the regulation. We documented 515 listings of turtles <4 inches in size, including 47 species and one hybrid. Our study has demonstrated that internet sales of small turtles currently represent part of the thriving online pet trade in the U.S. Enforcement of the federal regulation faces jurisdictional challenges in most states. Therefore, we recommend continued public education campaigns by public health agencies in the U.S. to help reduce the risk that pet turtle ownership presents.
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Affiliation(s)
- Lauren E. Montague
- Department of Natural Resources Science, University of Rhode Island, Kingston, Rhode Island, United States of America
| | - Juliana M. Marcotrigiano
- Department of Natural Resources Science, University of Rhode Island, Kingston, Rhode Island, United States of America
| | - Niamh E. Keane
- Department of Natural Resources Science, University of Rhode Island, Kingston, Rhode Island, United States of America
| | - Hannah E. Marquardt
- Department of Natural Resources Science, University of Rhode Island, Kingston, Rhode Island, United States of America
| | - Jennifer A. Sevin
- Department of Biology, University of Richmond, Richmond, Virginia, United States of America
| | - Nancy E. Karraker
- Department of Natural Resources Science, University of Rhode Island, Kingston, Rhode Island, United States of America
- * E-mail:
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21
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Li YJ, Yang YF, Zhou YJ, Zhang RH, Liu CW, Liu H, Li XG, Chen W, Chen Y, Wu YN. Estimating the burden of foodborne gastroenteritis due to nontyphoidal Salmonella enterica, Shigella and Vibrio parahaemolyticus in China. PLoS One 2022; 17:e0277203. [PMID: 36342937 PMCID: PMC9639838 DOI: 10.1371/journal.pone.0277203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
To estimate the incidence of foodborne gastroenteritis caused by nontyphoidal Salmonella enterica, Shigella, and Vibrio parahaemolyticus in China, population surveys and sentinel hospital surveillance were implemented in six provinces from July 2010 to July 2011, and a multiplier calculation model for the burden of disease was constructed. The multiplier for salmonellosis and V. parahaemolyticus gastroenteritis was estimated at 4,137 [95% confidence interval (CI) 2,320–5,663], and for shigellosis at 4,356 (95% CI 2,443–5,963). Annual incidence per 100,000 population was estimated as 245 (95% CI 138–336), 67 (95% CI 38–92), and 806 (95% CI 452–1,103) for foodborne salmonellosis, shigellosis, and V. parahaemolyticus gastroenteritis, respectively, indicating that foodborne infection caused by these three pathogens constitutes an important burden to the Chinese healthcare system. Continuous implementation of active surveillance of foodborne diseases, combined with multiplier models to estimate disease burden, makes it possible for us to better understand food safety status in China.
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Affiliation(s)
- Yan-Jun Li
- NHC Key Laboratory of Food Safety Risk Assessment, Research Unit of Food Safety, Chinese Academy of Medical Sciences (No. 2019RU014), China National Center for Food Safety Risk Assessment, Beijing, People's Republic of China
| | - Yun-Fan Yang
- NHC Key Laboratory of Food Safety Risk Assessment, Research Unit of Food Safety, Chinese Academy of Medical Sciences (No. 2019RU014), China National Center for Food Safety Risk Assessment, Beijing, People's Republic of China
| | - Yi-Jing Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People's Republic of China
| | - Rong-Hua Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China
| | - Cheng-Wei Liu
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, People's Republic of China
| | - Hong Liu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Xiu-Gui Li
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, People's Republic of China
| | - Wen Chen
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, People's Republic of China
| | - Yan Chen
- NHC Key Laboratory of Food Safety Risk Assessment, Research Unit of Food Safety, Chinese Academy of Medical Sciences (No. 2019RU014), China National Center for Food Safety Risk Assessment, Beijing, People's Republic of China
| | - Yong-Ning Wu
- NHC Key Laboratory of Food Safety Risk Assessment, Research Unit of Food Safety, Chinese Academy of Medical Sciences (No. 2019RU014), China National Center for Food Safety Risk Assessment, Beijing, People's Republic of China
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22
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Schwensohn C, Nsubuga J, Cronquist L, Jose G, Mastel L, McCullough L, Smith L, Powell M, Booth H, Allen K, Classon A, Gieraltowski L. A Multiple-Serotype Outbreak of Salmonella Infections Linked to Kratom, United States, 2017-2018. Foodborne Pathog Dis 2022; 19:648-653. [PMID: 35917511 PMCID: PMC10961741 DOI: 10.1089/fpd.2022.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In early 2018, we investigated a large national multiple-serotype Salmonella outbreak linked to contaminated kratom, a raw minimally processed botanical substance. Kratom is a plant consumed for its stimulant effects and as an opioid substitute. A case was defined as a laboratory-confirmed Salmonella infection with one of the outbreak strains (serotypes I 4,[5],12:b:-, Heidelberg, Javiana, Okatie, Weltevreden, or Thompson) with illnesses onset during January 11, 2017-May 8, 2018. State and local officials collected detailed information on product consumption and sources. Suspected products were tested for Salmonella and traceback was conducted to determine product distribution chains and suppliers. We identified 199 cases from 41 states; 54 patients were hospitalized. Early interviews indicated kratom was an exposure of interest. Seventy-six (74%) of 103 people interviewed reported consuming kratom in pills, powders, or teas. Multiple serotypes of Salmonella were detected in samples of kratom collected from the homes of the patients and from retail locations. Several companies issued recalls of kratom products due to Salmonella contamination. To the authors' knowledge, this investigation is the first to establish kratom as a vehicle for Salmonella infection. Our findings underscore the serious safety concerns regarding minimally processed botanical substances intended for oral consumption and the challenges in investigating outbreaks linked to novel outbreak vehicles.
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Affiliation(s)
- Colin Schwensohn
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Johnson Nsubuga
- Coordinated Outbreak Response and Evaluation Network, Food and Drug Administration, College Park, Maryland, USA
| | - Laura Cronquist
- North Dakota Department of Health, Bismarck, North Dakota, USA
| | - Gino Jose
- North Dakota Department of Health, Bismarck, North Dakota, USA
| | - Laura Mastel
- North Dakota Department of Health, Bismarck, North Dakota, USA
| | | | - Lori Smith
- Utah Department of Health, Salt Lake City, Utah, USA
| | | | - Hillary Booth
- Oregon Public Health Division, Portland, Oregon, USA
| | - Krisandra Allen
- Washington State Department of Health, Shoreline, Washington, USA
| | - Andrew Classon
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Laura Gieraltowski
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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23
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Yan MY, Kan B. [Establishment of multi-sector collaborative mechanism and surveillance network for Salmonella infection outbreak response and control]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:996-1001. [PMID: 35856191 DOI: 10.3760/cma.j.cn112338-20220523-00449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Salmonellosis is one of the common food-borne diseases, local and cross-region outbreaks are not rare. The risk of cross-border transmission of Salmonella is increasing with the high frequency of global economic trades. The recently occurred multi-country outbreaks of Salmonella Typhimurium infection associated with chocolate products have highlighted the importance of improving capability of surveillance and warning of foodborne-disease, especially salmonellosis, in China. It is essential to strengthen the collaboration among clinical medicine, disease control and food safety institutions, improve the capability of whole-genome sequencing of Salmonella for the disease surveillance and tracing, and facilitate the information sharing and collaboration among the food safety related sectors for the timely detection, prevention and control of outbreaks of Salmonella infection in China.
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Affiliation(s)
- M Y Yan
- National Institute for Communicable Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - B Kan
- National Institute for Communicable Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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24
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Rubio Granda A, Fernández Miaja M, Delgado Nicolás S, Fernández Ibáñez A, Llaneza Velasco ME, Alonso Álvarez MA. [Clinical and epidemiologic description of a severe outbreak of Salmonellosis in an urban nursery school]. Rev Esp Quimioter 2022; 35:265-272. [PMID: 35429965 PMCID: PMC9134884 DOI: 10.37201/req/134.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/14/2022] [Accepted: 02/02/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE We describe clinically and epidemiologically an outbreak of gastrointestinal infection by Salmonella enterica ser. (serotype) Enteritidis in an urban infant school, which led to high morbidity and significant social alarm. The immediate communication, as well as the adequate study of the outbreak, in both aspects, allowed identifying the pathogen and establishing control measures in a reasonable period of time. Controversial aspects such as the indication of antibiotherapy or the moment of closing the center are discussed. METHODS We retrospectively collected clinical, analytical and epidemiological information and we reviewed the methodology of the outbreak study and its results. RESULTS A total of 57 children (3-45 months), were affected and had microbiological confirmation. Diarrhea and fever were the main symptoms. 74% went to the hospital and 37% were admitted (mean stay 3.3 days). Factors associated with admission were: dehydration, significant elevation of acute phase reactants and coagulopathy. Twelve patients received parenteral cefotaxime. There were 2 complications: 1 bacteremia and 1 readmission. The initial suspicion of the origin of the outbreak was food, but the analysis of the control samples was negative. Five workers were positive (2 symptomatic). Epidemiologic Surveillance concluded that the probable origin of the outbreak was an asymptomatic carrier and improper diapers handling. The center was closed for 8 days. Cleaning and disinfection measures were carried out, as well as instruction on diaper changing, and the carriers were followed. CONCLUSIONS Clustering in time and space of cases should be reported immediately for early control of the outbreak. Children may present severe forms of Salmonella gastroenteritis.
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Affiliation(s)
| | - M Fernández Miaja
- María Fernández Miaja. Área de Gestión Clínica de Pediatría, Hospital Universitario Central de Asturias. Avenida de Roma, s/n 33011. Oviedo. Asturias. Spain.
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25
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Greening B, Whitham HK, Aldous WK, Hall N, Garvey A, Mandernach S, Kahn EB, Nonnenmacher P, Snow J, Meltzer MI, Hoffmann S. Public Health Response to Multistate Salmonella Typhimurium Outbreak Associated with Prepackaged Chicken Salad, United States, 2018. Emerg Infect Dis 2022; 28:1254-1256. [PMID: 35608817 PMCID: PMC9155865 DOI: 10.3201/eid2806.211633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Quantifying the effect of public health actions on population health is essential when justifying sustained public health investment. Using modeling, we conservatively estimated that rapid response to a multistate foodborne outbreak of Salmonella Typhimurium in the United States in 2018 potentially averted 94 reported cases and $633,181 in medical costs and productivity losses.
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26
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Whitehill FM, Stapleton GS, Koski L, Sievert D, Nichols M. Risk factors for hospitalization among adults aged ≥65 years with non-typhoidal Salmonella infection linked to backyard poultry contact. Zoonoses Public Health 2022; 69:215-223. [PMID: 35060679 PMCID: PMC10866372 DOI: 10.1111/zph.12911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 11/30/2021] [Accepted: 12/12/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We describe the epidemiology of live poultry-associated salmonellosis (LPAS) and investigate potential risk factors associated with hospitalization among adults aged ≥65 years in the United States during 2008-2017. LPAS is a public health concern in the United States, especially among people with increased risk for hospitalization, such as older adults. SAMPLE We analysed data from people aged ≥65 years with non-typhoidal salmonellosis who reported live poultry contact within seven days prior to illness onset. PROCEDURE We used logistic regression to estimate the odds of hospitalization associated with several risk factors including types of live poultry contact exposures. RESULTS LPAS among older adults in this analysis resulted in high hospitalization rates. Salmonella Hadar infection was associated with increased hospitalization. Among older adults with LPAS, 109 individuals of 127 (86%) reported contact with live poultry at their or someone else's residence, and 85 of 105 with available information (81%) reported owning poultry. CONCLUSIONS AND CLINICAL RELEVANCE Additional infection prevention information and education targeted at poultry-owning older adults are needed to prevent illness and hospitalization.
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Affiliation(s)
- Florence M. Whitehill
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Emory University Rollins School of Public Health, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - G. Sean Stapleton
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Lia Koski
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- CAITTA Inc., Herndon, VA, USA
| | - Dawn Sievert
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Megin Nichols
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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27
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Deepanjali S, Jharna M, Chanaveerappa B, Sarumathi D, Gopichand P, Anupriya K. An outbreak of Salmonella Enteritidis food poisoning following consumption of chicken shawarma: A brief epidemiological investigation. F1000Res 2022; 10:851. [PMID: 35087664 PMCID: PMC8762677 DOI: 10.12688/f1000research.54410.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Shawarma, a popular meat-based fast food could be a source of foodborne outbreak due to non-typhoidal Salmonella (NTS). A clustering of acute gastrointestinal (GI) illness following intake of chicken shawarma occurred primarily among the staff and students of a tertiary care hospital in southern India. Methods: A case-control study was conducted among 348 undergraduate medical students (33 cases, 315 controls). Data was collected using direct interviews and a simple online questionnaire. Epidemiological associations of GI illness were evaluated at three levels of exposure namely-eating food from any restaurant, eating food from the implicated food outlet, eating chicken shawarma from the implicated outlet. Results: Of 33 cases, 26 had consumed food from a particular food outlet, 4 from other outlets, and 3 did not report eating out. Consumption of food from the suspected food outlet was significantly associated with GI illness (odds ratio 121.8 [95% CI 28.41 to 522.66]; P<0.001); all the 26 cases who had eaten from the particular outlet had eaten chicken shawarma. By comparison, only one of the 315 controls had eaten this dish. Of the 27 persons (cases as well as controls) who had consumed chicken shawarma from the outlet, 26 were ill. Culture of stool samples from 10 affected individuals and implicated food item yielded Salmonella Enteritidis. Conclusions: Meat-based shawarma is a potential source of NTS infection. Food safety authorities should enforce guidelines for safe preparation and sale of shawarmas and similar products.
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Affiliation(s)
- Surendran Deepanjali
- Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvantri Nagar, Puducherry, 605006, India
| | - Mandal Jharna
- Department of Microbiology, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvantri Nagar, Puducherry, 605006, India
| | - Bammigatti Chanaveerappa
- Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvantri Nagar, Puducherry, 605006, India
| | - Dhandapani Sarumathi
- Department of Microbiology, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvantri Nagar, Puducherry, 605006, India
| | - Pallam Gopichand
- Department of Microbiology, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvantri Nagar, Puducherry, 605006, India
| | - Kaliyappan Anupriya
- Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvantri Nagar, Puducherry, 605006, India
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28
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Kerr EJ, Stafford R, Rathnayake IU, Graham RMA, Fearnley E, Gregory J, Glasgow K, Wright R, Sintchenko V, Wang Q, Howard P, Leong LEX, Valcanis M, Pitchers W, Lambert SB, Jennison AV. Multistate Outbreak of Salmonella enterica Serovar Heidelberg with Unidentified Source, Australia, 2018-2019. Emerg Infect Dis 2022; 28:238-241. [PMID: 34932458 PMCID: PMC8714228 DOI: 10.3201/eid2801.211462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a multistate Salmonella enterica serovar Heidelberg outbreak in Australia during 2018-2019. Laboratory investigation of cases reported across 5 jurisdictions over a 7-month period could not identify a source of infection but detected indicators of severity and invasiveness. The hospitalization rate of 36% suggested a moderately severe clinical picture.
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29
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Van Goethem N, Van Den Bossche A, Ceyssens PJ, Lajot A, Coucke W, Vernelen K, Roosens NHC, De Keersmaecker SCJ, Van Cauteren D, Mattheus W. Coverage of the national surveillance system for human Salmonella infections, Belgium, 2016-2020. PLoS One 2021; 16:e0256820. [PMID: 34437638 PMCID: PMC8389443 DOI: 10.1371/journal.pone.0256820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/16/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction The surveillance of human salmonellosis in Belgium is dependent on the referral of human Salmonella isolates to the National Reference Center (NRC). Knowledge of current diagnostic practices and the coverage of the national Salmonella surveillance system are important to correctly interpret surveillance data and trends over time, to estimate the true burden of salmonellosis in Belgium, and to evaluate the appropriateness of implementing whole-genome sequencing (WGS) at this central level. Methods The coverage of the NRC was defined as the proportion of all diagnosed human Salmonella cases in Belgium reported to the NRC and was assessed for 2019 via a survey among all licensed Belgian medical laboratories in 2019, and for 2016–2020 via a capture-recapture study using the Sentinel Network of Laboratories (SNL) as the external source. In addition, the survey was used to assess the impact of the implementation of culture-independent diagnostic tests (CIDTs) at the level of peripheral laboratory sites, as a potential threat to national public health surveillance programs. Results The coverage of the NRC surveillance system was estimated to be 83% and 85%, based on the results of the survey and on the two-source capture-recapture study, respectively. Further, the results of the survey indicated a limited use of CIDTs by peripheral laboratories in 2019. Conclusion Given the high coverage and the limited impact of CIDTs on the referral of isolates, we may conclude that the NRC can confidently monitor the epidemiological situation and identify outbreaks throughout the country. These findings may guide the decision to implement WGS at the level of the NRC and may improve estimates of the true burden of salmonellosis in Belgium.
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Affiliation(s)
- Nina Van Goethem
- Scientific Directorate of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Epidemiology and Biostatistics, Institut de Recherche Expérimentale et Clinique, Faculty of Public Health, Université Catholique de Louvain, Woluwe-Saint-Lambert, Belgium
- * E-mail:
| | - An Van Den Bossche
- National Reference Centre for Salmonella and Shigella, Sciensano, Brussels, Belgium
| | - Pieter-Jan Ceyssens
- National Reference Centre for Salmonella and Shigella, Sciensano, Brussels, Belgium
| | - Adrien Lajot
- Scientific Directorate of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Wim Coucke
- Quality of laboratories, Sciensano, Brussels, Belgium
| | - Kris Vernelen
- Quality of laboratories, Sciensano, Brussels, Belgium
| | | | | | - Dieter Van Cauteren
- Scientific Directorate of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Wesley Mattheus
- National Reference Centre for Salmonella and Shigella, Sciensano, Brussels, Belgium
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30
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Nettleton WD, Reimink B, Arends KD, Potter D, Henderson JJ, Dietrich S, Franks M. Protracted, Intermittent Outbreak of Salmonella Mbandaka Linked to a Restaurant — Michigan, 2008–2019. MMWR Morb Mortal Wkly Rep 2021; 70:1109-1113. [PMID: 34411074 PMCID: PMC8375710 DOI: 10.15585/mmwr.mm7033a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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31
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Payne M, Octavia S, Luu LDW, Sotomayor-Castillo C, Wang Q, Tay ACY, Sintchenko V, Tanaka MM, Lan R. Enhancing genomics-based outbreak detection of endemic Salmonella enterica serovar Typhimurium using dynamic thresholds. Microb Genom 2021; 7:000310. [PMID: 31682222 PMCID: PMC8627665 DOI: 10.1099/mgen.0.000310] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/09/2019] [Indexed: 11/18/2022] Open
Abstract
Salmonella enterica serovar Typhimurium is the leading cause of salmonellosis in Australia, and the ability to identify outbreaks and their sources is vital to public health. Here, we examined the utility of whole-genome sequencing (WGS), including complete genome sequencing with Oxford Nanopore technologies, in examining 105 isolates from an endemic multi-locus variable number tandem repeat analysis (MLVA) type over 5 years. The MLVA type was very homogeneous, with 90 % of the isolates falling into groups with a five SNP cut-off. We developed a new two-step approach for outbreak detection using WGS. The first clustering at a zero single nucleotide polymorphism (SNP) cut-off was used to detect outbreak clusters that each occurred within a 4 week window and then a second clustering with dynamically increased SNP cut-offs were used to generate outbreak investigation clusters capable of identifying all outbreak cases. This approach offered optimal specificity and sensitivity for outbreak detection and investigation, in particular of those caused by endemic MLVA types or clones with low genetic diversity. We further showed that inclusion of complete genome sequences detected no additional mutational events for genomic outbreak surveillance. Phylogenetic analysis found that the MLVA type was likely to have been derived recently from a single source that persisted over 5 years, and seeded numerous sporadic infections and outbreaks. Our findings suggest that SNP cut-offs for outbreak cluster detection and public-health surveillance should be based on the local diversity of the relevant strains over time. These findings have general applicability to outbreak detection of bacterial pathogens.
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Affiliation(s)
- Michael Payne
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Sophie Octavia
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Laurence Don Wai Luu
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Cristina Sotomayor-Castillo
- Centre for Infectious Diseases and Microbiology – Public Health, Institute of Clinical Pathology and Medical Research, Westmead Hospital, New South Wales, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead NSW, New South Wales, Australia
| | - Qinning Wang
- Centre for Infectious Diseases and Microbiology – Public Health, Institute of Clinical Pathology and Medical Research, Westmead Hospital, New South Wales, Australia
| | - Alfred Chin Yen Tay
- Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Vitali Sintchenko
- Centre for Infectious Diseases and Microbiology – Public Health, Institute of Clinical Pathology and Medical Research, Westmead Hospital, New South Wales, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead NSW, New South Wales, Australia
| | - Mark M. Tanaka
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Ruiting Lan
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
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32
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Buytaers FE, Saltykova A, Mattheus W, Verhaegen B, Roosens NHC, Vanneste K, Laisnez V, Hammami N, Pochet B, Cantaert V, Marchal K, Denayer S, De Keersmaecker SC. Application of a strain-level shotgun metagenomics approach on food samples: resolution of the source of a Salmonella food-borne outbreak. Microb Genom 2021; 7:000547. [PMID: 33826490 PMCID: PMC8208685 DOI: 10.1099/mgen.0.000547] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/23/2021] [Indexed: 02/04/2023] Open
Abstract
Food-borne outbreak investigation currently relies on the time-consuming and challenging bacterial isolation from food, to be able to link food-derived strains to more easily obtained isolates from infected people. When no food isolate can be obtained, the source of the outbreak cannot be unambiguously determined. Shotgun metagenomics approaches applied to the food samples could circumvent this need for isolation from the suspected source, but require downstream strain-level data analysis to be able to accurately link to the human isolate. Until now, this approach has not yet been applied outside research settings to analyse real food-borne outbreak samples. In September 2019, a Salmonella outbreak occurred in a hotel school in Bruges, Belgium, affecting over 200 students and teachers. Following standard procedures, the Belgian National Reference Center for human salmonellosis and the National Reference Laboratory for Salmonella in food and feed used conventional analysis based on isolation, serotyping and MLVA (multilocus variable number tandem repeat analysis) comparison, followed by whole-genome sequencing, to confirm the source of the contamination over 2 weeks after receipt of the sample, which was freshly prepared tartar sauce in a meal cooked at the school. Our team used this outbreak as a case study to deliver a proof of concept for a short-read strain-level shotgun metagenomics approach for source tracking. We received two suspect food samples: the full meal and some freshly made tartar sauce served with this meal, requiring the use of raw eggs. After analysis, we could prove, without isolation, that Salmonella was present in both samples, and we obtained an inferred genome of a Salmonella enterica subsp. enterica serovar Enteritidis that could be linked back to the human isolates of the outbreak in a phylogenetic tree. These metagenomics-derived outbreak strains were separated from sporadic cases as well as from another outbreak circulating in Europe at the same time period. This is, to our knowledge, the first Salmonella food-borne outbreak investigation uniquely linking the food source using a metagenomics approach and this in a fast time frame.
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Affiliation(s)
- Florence E. Buytaers
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium
- Department of Plant Biotechnology and Bioinformatics, Ghent University, Ghent, Belgium
| | - Assia Saltykova
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium
- Department of Plant Biotechnology and Bioinformatics, Ghent University, Ghent, Belgium
| | - Wesley Mattheus
- National Reference Center for Salmonella and Shigella spp., Sciensano, Brussels, Belgium
| | - Bavo Verhaegen
- National Reference Laboratory for Salmonella and Food-Borne Infections, Food-Borne Pathogens, Sciensano, Brussels, Belgium
| | | | - Kevin Vanneste
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium
| | | | | | - Brigitte Pochet
- Federal Agency for the Security of the Food Chain, Brussels, Belgium
| | - Vera Cantaert
- Federal Agency for the Security of the Food Chain, Brussels, Belgium
| | - Kathleen Marchal
- Department of Plant Biotechnology and Bioinformatics, Ghent University, Ghent, Belgium
- Department of Information Technology, IDlab, IMEC, Ghent University, Ghent, Belgium
- Department of Genetics, University of Pretoria, Pretoria, South Africa
| | - Sarah Denayer
- National Reference Laboratory for Salmonella and Food-Borne Infections, Food-Borne Pathogens, Sciensano, Brussels, Belgium
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Milczarek M, Sadkowska-Todys M, Czarkowski MP. Salmonellosis in Poland in 2018 and 2019. Przegl Epidemiol 2021; 75:665-668. [PMID: 35543609 DOI: 10.32394/pe.75.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM The aim of this study is to assess the epidemiological situation of salmonellosis in Poland, in 2018 and 2019 compared with previous years. MATERIAL AND METHODS The assessment of the epidemiological situation was performed on the basis of data provided to the Department of Epidemiology Infectious Diseases and Surveillance of NIPH NIH - NRI by sanitary-epidemiological stations through the Epidemiological Case Reporting System (SRWE) and the Registry of Epidemic Outbreaks (ROE), as well as on the basis of data from the annual bulletins "Infectious Diseases and Poisonings in Poland" 2018 and 2019 (NIPH NIH - NRI, GIS, Warsaw, 2019 and 2020) and from information received from laboratories of sanitary-epidemiological stations and data from the Demographic Research Department of Statistics Poland (GIS). RESULTS In Poland in 2018 a total of 9,957 cases of salmonellosis were reported in the sanitaryepidemiological surveillance, among these infections 9,651 were cases of intestinal salmonellosis, 306 were cases of extraintestinal salmonellosis. The incidence rate for total salmonellosis was 25.9 per 100,000 population, for parenteral salmonellosis alone was 0.80 per 100,000 population. There were 9,370 cases of confirmed and 587 cases of probable salmonellosis registered. Hospital treatment was given to 65% of patients with intestinal salmonellosis and 88.6% of patients with extraintestinal forms of the disease. The increase in salmonellosis cases in 2018 occurred during the summer months with a peak in cases in August. The highest incidence of salmonellosis nationwide was in the Podkarpackie voivodeship 42.2/100,000, the lowest in the Lubuskie voivodeship 9.4/100,000. More cases were registered in urban areas - 5,866 salmonellosis cases. Cases in the age group 0-4 constituted 37.7% of all cases. Among parenteral salmonellosis 64.7% were people over 60 years of age. In ROE system there were 351 food poisoning outbreaks with Salmonella spp. as the etiological agent, mainly Enteritidis serotype. The most frequently isolated serotypes in Poland in 2018 were S. Enteritidis, S. Typhimurium and S. Infantis, the first of which was responsible for 76.3% of all Salmonella infections. There were 1,719 cases registered in which the serotype was not determined, most of them came from the Pomorskie voivodeship. Sanitary-epidemiological stations performed 547,976 bacteriological tests for Salmonella and Shigella, 0.2% of people working in contact with food had a positive result. There were 43 cases imported from abroad. Due to Salmonella infection 4 people died in 2018. In 2019 a total of 9,234 cases of salmonellosis were registered in Poland, including 8,919 food poisoning and 315 parenteral salmonellosis. The incidence for total salmonellosis in Poland was 24.1 per 100,000 population. There were 8,687 confirmed and 547 probable cases of salmonellosis reported. Due to food poisoning 63.1% of patients were hospitalized, while due to parenteral salmonellosis 87.6% of patients were hospitalized. The peak incidence in 2019 occurred in August. The highest incidence per 100,000 population of total salmonellosis by voivodeship was recorded in the Podkarpackie voivodeship 55.1, the lowest in the Zachodniopomorskie voivodeship 8.8. Almost 40% of all salmonellosis cases in the country were among children aged 0-4; as far as parenteral salmonellosis is concerned, the main group of patients 68.6%, were people over 60 years old. Sanitaryepidemiological stations reported in the ROE system 303 outbreaks of food poisoning of salmonellosis etiology. The most commonly isolated serotype in 2019 in Poland was Salmonella Enteritidis 75.6% of all recorded salmonellosis cases, followed by Salmonella Typhimurium 3% and Salmonella Infantis 1%. The serotype was not determined in 1,692 cases, the highest number in the Pomorskie and Kujawsko-Pomorskie voivodeships - 51% of undetermined isolates each. Laboratories of sanitary-epidemiological stations carried out 610,164 bacteriological tests for Salmonella and Shigella. Among people working in contact with food 0.2% had a positive test result. 71 cases of imported intestinal salmonellosis were registered. Nine deaths due to Salmonella infection were reported. CONCLUSIONS The salmonellosis situation in Poland in 2018 and 2019 remains at a high but stable level. The significant increase in the number of laboratory tests performed for Salmonella in 2018-2019 and the decrease in the number of people refusing the carrier exclusion test, is an important step in the process of enhancing salmonellosis surveillance.
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Affiliation(s)
- Małgorzata Milczarek
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Małgorzata Sadkowska-Todys
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Mirosław P Czarkowski
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
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Costard S, Pouzou JG, Belk KE, Morley PS, Schmidt JW, Wheeler TL, Arthur TM, Zagmutt FJ. No Change in Risk for Antibiotic-Resistant Salmonellosis from Beef, United States, 2002-2010. Emerg Infect Dis 2020; 26:2108-2117. [PMID: 32818395 PMCID: PMC7454111 DOI: 10.3201/eid2609.190922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Restricting antibiotic use in food production animals is a target for reducing antimicrobial drug–resistant infections in humans. To estimate the probability of antibiotic-resistant nontyphoidal salmonellosis per meal made with beef during 2002–2010, we used US surveillance data. Applying data for nontyphoidal Salmonella in raised-without-antibiotics cattle, we tested the effect of removing antibiotic use from all beef cattle production. We found an average of 1.2 antibiotic-resistant nontyphoidal salmonellosis cases per 1 million beef meals made with beef initially contaminated with antibiotic-resistant nontyphoidal Salmonella at slaughter or retail and 0.031 cases per 1 million meals irrespective of beef contamination status. Neither outcome showed sustained change except for increases in 2003 and 2009 (>98% confidence) when larger or more outbreaks occurred. Switching all beef production to a raised-without-antibiotics system may not have a significant effect on antibiotic-resistant nontyphoidal salmonellosis (94.3% confidence).
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Shaw KA, Wright K, Privett K, Holloman K, Levine S, McCombs K, Turner L, Holsinger C, Woolard D. Salmonellosis Outbreak After a Large-Scale Food Event in Virginia, 2017. Public Health Rep 2020; 135:668-675. [PMID: 32791024 DOI: 10.1177/0033354920944861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The Virginia Department of Health (VDH) identified an outbreak of Salmonella serotype Javiana infections in Virginia after a chili and chowder cook-off with 11 competitors and about 2500 attendees on September 30, 2017. The objectives of this study were to assess the extent of the outbreak and identify the most likely source of exposure. METHODS To identify people with suspected Salmonella infection, VDH used press releases and social media posts to recruit event attendees to take an online survey about foods eaten at the cook-off and any gastrointestinal (GI) symptoms experienced. VDH defined a case as reported GI illness that occurred within 1 week after eating food from the cook-off. Confirmed cases required a clinical specimen culture positive for Salmonella. Probable cases reported diarrhea or related clinical symptoms. "Not ill" people did not report GI illness. Investigators calculated unadjusted relative risks of illness and performed stratified analysis to address potential confounding. Available food samples were tested for Salmonella. Environmental health specialists interviewed food handlers and inspected restaurants where 3 competitors had prepared food. RESULTS Of 438 survey responses, 171 (39%) met the case definition. Of all chilies and chowders consumed, Chowder A was associated with the highest relative risk of illness (8.9; 95% CI, 5.7-13.7). A Chowder A sample tested positive for Salmonella serotype Javiana. The environmental investigation did not identify an original contamination source but did find deficiencies in maintaining safe cooking temperatures. CONCLUSIONS Epidemiologic and laboratory findings indicated that Chowder A was the most likely cause of outbreak. Recommendations to prevent future outbreaks include preparation of all food on-site to ensure safe temperatures during food preparation and service.
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Affiliation(s)
- Kelly A Shaw
- 1242 Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, GA, USA
- 2396 Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA
| | - Kimberly Wright
- 2396 Eastern Shore Health District, Virginia Department of Health, Accomac, VA, USA
| | - Keith Privett
- 2396 Eastern Shore Health District, Virginia Department of Health, Accomac, VA, USA
| | - Kelsey Holloman
- 2396 Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA
| | - Seth Levine
- 2396 Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA
| | - Katherine McCombs
- 2396 Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA
| | - Lauren Turner
- 2396 Division of Consolidated Laboratory Services, Virginia Department of General Services, Richmond, VA, USA
| | - Caroline Holsinger
- 2396 Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA
| | - Diane Woolard
- 2396 Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA
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Richards AK, Hopkins BA, Shariat NW. Conserved CRISPR arrays in Salmonella enterica serovar Infantis can serve as qPCR targets to detect Infantis in mixed serovar populations. Lett Appl Microbiol 2020; 71:138-145. [PMID: 32333808 DOI: 10.1111/lam.13296] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 12/20/2022]
Abstract
Salmonellosis is a leading bacterial cause of foodborne illness, and numerous Salmonella enterica serovars have been responsible for foodborne outbreaks. In the United States outbreaks are often linked to poultry and poultry-related products. The prevalence of Salmonella serovar Infantis has been increasing in poultry processing facilities over the past few years and in 2018 was identified as the causative agent for a large multistate outbreak linked to raw chicken. CRISPR-typing is a subtyping approach based on PCR and the sequencing of two Salmonella loci, CRISPR1 and CRISPR2. CRISPR-typing was used to interrogate 138 recent (2018-2019) isolates and genomes of ser. Infantis. Results show that the CRISPR elements are remarkably conserved in this serovar. The most conserved spacers, and those also unique to ser. Infantis, were used as targets to develop a ser. Infantis-specific qPCR assay. This assay was able to detect ser. Infantis in mixed serovar cultures of Salmonella, down to 0·1% of the population, highlighting the utility of this molecular approach in improving surveillance sensitivity for this important food safety pathogen. SIGNIFICANCE AND IMPACT OF THE STUDY: The incidence of human salmonellosis cases caused by Salmonella enterica serovar Infantis (ser. Infantis) has been increasing, as has its prevalence in broiler chickens, which are a frequent reservoir of Salmonella. A cluster of ser. Infantis genetically linked to an outbreak strain have been identified in numerous processing facilities. A qPCR assay targeting CRISPR elements that are unique to ser. Infantis has been developed and can detect this serovar directly from mixed cultures. This assay is sensitive enough to reveal ser. Infantis within a mixed Salmonella population where it constitutes only 0·1% of the population. The rapid nature of qPCR lends this assay to high-throughput screening of poultry samples to detect this important pathogen.
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Affiliation(s)
- A K Richards
- Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - B A Hopkins
- International Technical Animal Production and Processing Solutions (iTAPPS), Overland Park, KS, USA
| | - N W Shariat
- Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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Latash J, Greene SK, Stavinsky F, Li S, McConnell JA, Novak J, Rozza T, Wu J, Omoregie E, Li L, Peterson ER, Gutelius B, Reddy V. Salmonellosis Outbreak Detected by Automated Spatiotemporal Analysis - New York City, May-June 2019. MMWR Morb Mortal Wkly Rep 2020; 69:815-819. [PMID: 32614808 PMCID: PMC7332097 DOI: 10.15585/mmwr.mm6926a2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
In May 2019, the New York City Department of Health and Mental Hygiene (NYCDOHMH) detected an unusual cluster of five salmonellosis patients via automated spatiotemporal analysis of notifiable diseases using free SaTScan software (1). Within 1 day of cluster detection, graduate student interviewers determined that three of the patients had eaten prepared food from the same grocery store (establishment A) located inside the cluster area. NYCDOHMH initiated an investigation to identify additional cases, establish the cause, and provide control recommendations. Overall, 15 New York City (NYC) residents with laboratory-diagnosed salmonellosis who reported eating food from establishment A were identified. The most commonly consumed food item was chicken, reported by 10 patients. All 11 clinical isolates available were serotyped as Salmonella Blockley, sequenced, and analyzed by core genome multilocus sequence typing; isolates had a median difference of zero alleles. Environmental assessments revealed food not held at the proper temperature, food not cooled properly, and potential cross-contamination during chicken preparation. Elevated fecal coliform counts were found in two of four ready-to-eat food samples collected from establishment A, and Bacillus cereus was detected in three. The outbreak strain of Salmonella was isolated from one patient's leftover chicken. Establishing automated spatiotemporal cluster detection analyses for salmonellosis and other reportable diseases could aid in the detection of geographically focused, community-acquired outbreaks even before laboratory subtyping results become available.
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Hassan R, Buuck S, Noveroske D, Medus C, Sorenson A, Laurent J, Rotstein D, Schlater L, Freiman J, Douris A, Simmons M, Donovan D, Henderson J, Tewell M, Snyder K, Oni O, Von Stein D, Dassie K, Leeper M, Adediran A, Dowell N, Gieraltowski L, Basler C. Multistate Outbreak of Salmonella Infections Linked to Raw Turkey Products - United States, 2017-2019. MMWR Morb Mortal Wkly Rep 2019; 68:1045-1049. [PMID: 31751325 PMCID: PMC6871895 DOI: 10.15585/mmwr.mm6846a1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zhang Y, O'Connor AM, Wang C, Dickson JS, Hurd HS, Wang B. Interventions Targeting Deep Tissue Lymph Nodes May Not Effectively Reduce the Risk of Salmonellosis from Ground Pork Consumption: A Quantitative Microbial Risk Assessment. Risk Anal 2019; 39:2237-2258. [PMID: 31039285 DOI: 10.1111/risa.13317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/21/2019] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
The inclusion of deep tissue lymph nodes (DTLNs) or nonvisceral lymph nodes contaminated with Salmonella in wholesale fresh ground pork (WFGP) production may pose risks to public health. To assess the relative contribution of DTLNs to human salmonellosis occurrence associated with ground pork consumption and to investigate potential critical control points in the slaughter-to-table continuum for the control of human salmonellosis in the United States, a quantitative microbial risk assessment (QMRA) model was established. The model predicted an average of 45 cases of salmonellosis (95% CI = [19, 71]) per 100,000 Americans annually due to WFGP consumption. Sensitivity analysis of all stochastic input variables showed that cooking temperature was the most influential parameter for reducing salmonellosis cases associated with WFGP meals, followed by storage temperature and Salmonella concentration on contaminated carcass surface before fabrication. The input variables were grouped to represent three main factors along the slaughter-to-table chain influencing Salmonella doses ingested via WFGP meals: DTLN-related factors, factors at processing other than DTLNs, and consumer-related factors. The evaluation of the impact of each group of factors by second-order Monte Carlo simulation showed that DTLN-related factors had the lowest impact on the risk estimate among the three groups of factors. These findings indicate that interventions to reduce Salmonella contamination in DTLNs or to remove DTLNs from WFGP products may be less critical for reducing human infections attributable to ground pork than improving consumers' cooking habits or interventions of carcass decontamination at processing.
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Affiliation(s)
- Yangjunna Zhang
- Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Annette M O'Connor
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, IA, USA
| | - Chong Wang
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, IA, USA
- Department of Statistics, Iowa State University, Ames, IA, USA
| | - James S Dickson
- Department of Animal Science, Iowa State University, Ames, IA, USA
| | - H Scott Hurd
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, IA, USA
| | - Bing Wang
- Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, USA
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Meinen A, Simon S, Banerji S, Szabo I, Malorny B, Borowiak M, Hadziabdic S, Becker N, Luber P, Lohr D, Harms C, Plenge-Bönig A, Mellou K, Mandilara G, Mossong J, Ragimbeau C, Weicherding P, Hau P, Dědičová D, Šafaříková L, Nair S, Dallman TJ, Larkin L, McCormick J, De Pinna E, Severi E, Kotila S, Niskanen T, Rizzi V, Deserio D, Flieger A, Stark K. Salmonellosis outbreak with novel Salmonella enterica subspecies enterica serotype (11:z41:e,n,z15) attributable to sesame products in five European countries, 2016 to 2017. Euro Surveill 2019; 24:1800543. [PMID: 31507266 PMCID: PMC6737830 DOI: 10.2807/1560-7917.es.2019.24.36.1800543] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 04/29/2019] [Indexed: 11/20/2022] Open
Abstract
In spring 2016, Greece reported an outbreak caused by a previously undescribed Salmonella enterica subsp. enterica serotype (antigenic formula 11:z41:e,n,z15) via the Epidemic Intelligence Information System for Food- and Waterborne Diseases and Zoonoses (EPIS-FWD), with epidemiological evidence for sesame products as presumptive vehicle. Subsequently, Germany, Czech Republic, Luxembourg and the United Kingdom (UK) reported infections with this novel serotype via EPIS-FWD. Concerned countries in collaboration with the European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA) adopted a common outbreak case definition. An outbreak case was defined as a laboratory-confirmed notification of the novel Salmonella serotype. Between March 2016 and April 2017, 47 outbreak cases were notified (Greece: n = 22; Germany: n = 13; Czech Republic: n = 5; Luxembourg: n = 4; UK: n = 3). Whole genome sequencing revealed the very close genetic relatedness of isolates from all affected countries. Interviews focusing on sesame product consumption, suspicious food item testing and trace-back analysis following Salmonella spp. detection in food products identified a company in Greece where sesame seeds from different countries were processed. Through European collaboration, it was possible to identify and recall sesame spread as one contaminated food item serving as vehicle of infection and trace it back to its origin.
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Affiliation(s)
- Anika Meinen
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
- These authors contributed equally
| | - Sandra Simon
- These authors contributed equally
- Robert Koch Institute, Department of Infectious Diseases, National Reference Centre for Salmonella and Other Bacterial Enteric Pathogens, Wernigerode, Germany
| | - Sangeeta Banerji
- Robert Koch Institute, Department of Infectious Diseases, National Reference Centre for Salmonella and Other Bacterial Enteric Pathogens, Wernigerode, Germany
| | - Istvan Szabo
- German Federal Institute for Risk Assessment (BfR), Department for Biological Safety, Berlin, Germany
| | - Burkhard Malorny
- German Federal Institute for Risk Assessment (BfR), Department for Biological Safety, Berlin, Germany
| | - Maria Borowiak
- German Federal Institute for Risk Assessment (BfR), Department for Biological Safety, Berlin, Germany
| | - Sead Hadziabdic
- German Federal Institute for Risk Assessment (BfR), Department for Biological Safety, Berlin, Germany
| | - Natalie Becker
- Federal Office of Consumer Protection and Food Safety, Crisis Unit Office, Foodborne Outbreaks, Prevention, Berlin, Germany
| | - Petra Luber
- Federal Office of Consumer Protection and Food Safety, Crisis Unit Office, Foodborne Outbreaks, Prevention, Berlin, Germany
| | - Dorothee Lohr
- Baden-Wuerttemberg State Health Office, Stuttgart, Germany
| | - Carolin Harms
- Institute for Hygiene and Environment Hamburg, Department of Microbiology, Hamburg, Germany
| | - Anita Plenge-Bönig
- Institute for Hygiene and Environment Hamburg, Infectious Disease Surveillance Unit, Hamburg, Germany
| | - Kassiani Mellou
- Hellenic National Public Health Organization, Athens, Greece
| | - Georgia Mandilara
- National School of Public Health, National Reference Centre for Salmonella, Athens, Greece
| | - Joël Mossong
- Laboratoire National de Santé, Département de Microbiologie, Dudelange, Luxembourg
| | - Catherine Ragimbeau
- Laboratoire National de Santé, Département de Microbiologie, Dudelange, Luxembourg
| | | | - Patrick Hau
- Direction de la Santé, Luxembourg, Luxembourg
| | - Daniela Dědičová
- Státní zdravotní ústav (National Institute of Public Health), Prague, Czech Republic
| | - Lucie Šafaříková
- Státní zdravotní ústav (National Institute of Public Health), Prague, Czech Republic
| | | | | | | | | | | | - Ettore Severi
- European Centre for Disease Prevention and Control (ECDC), Surveillance and Response Support, Stockholm, Sweden
| | - Saara Kotila
- European Centre for Disease Prevention and Control (ECDC), Surveillance and Response Support, Stockholm, Sweden
| | - Taina Niskanen
- European Centre for Disease Prevention and Control (ECDC), Surveillance and Response Support, Stockholm, Sweden
| | | | | | - Antje Flieger
- Robert Koch Institute, Department of Infectious Diseases, National Reference Centre for Salmonella and Other Bacterial Enteric Pathogens, Wernigerode, Germany
| | - Klaus Stark
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
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Plumb ID, Schwensohn CA, Gieraltowski L, Tecle S, Schneider ZD, Freiman J, Cote A, Noveroske D, Kolsin J, Brandenburg J, Chen JC, Tagg KA, White PB, Shah HJ, Francois Watkins LK, Wise ME, Friedman CR. Outbreak of Salmonella Newport Infections with Decreased Susceptibility to Azithromycin Linked to Beef Obtained in the United States and Soft Cheese Obtained in Mexico - United States, 2018-2019. MMWR Morb Mortal Wkly Rep 2019; 68:713-717. [PMID: 31437141 PMCID: PMC6705891 DOI: 10.15585/mmwr.mm6833a1] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In September 2018, CDC identified Salmonella enterica serotype Newport (Newport) infections that were multidrug resistant (MDR), with decreased susceptibility to azithromycin, a recommended oral treatment agent. Until 2017, decreased susceptibility to azithromycin had occurred in fewer than 0.5% of Salmonella isolates from U.S. residents. This report summarizes the investigation of a multistate MDR Salmonella outbreak conducted by CDC, state and local health departments, and the U.S. Department of Agriculture's Food Safety and Inspection Service. During June 2018-March 2019, 255 cases of infection with the outbreak strain were identified in 32 states; 43% of patients (89 of 206 with information on travel) reported recent travel to Mexico. Infections were linked to consumption of soft cheese obtained in Mexico and beef obtained in the United States. Consumers should avoid eating soft cheese that could be made from unpasteurized milk, regardless of the source of the cheese. When preparing beef, a food thermometer should be used to ensure that appropriate cooking temperatures are reached. When antibiotic treatment is needed for a patient, clinicians should choose antibiotics based on susceptibility testing wherever possible.
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Mikkelä A, Ranta J, Tuominen P. A Modular Bayesian Salmonella Source Attribution Model for Sparse Data. Risk Anal 2019; 39:1796-1811. [PMID: 30893499 PMCID: PMC6849795 DOI: 10.1111/risa.13310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 02/13/2019] [Accepted: 02/14/2019] [Indexed: 06/09/2023]
Abstract
Several statistical models for salmonella source attribution have been presented in the literature. However, these models have often been found to be sensitive to the model parameterization, as well as the specifics of the data set used. The Bayesian salmonella source attribution model presented here was developed to be generally applicable with small and sparse annual data sets obtained over several years. The full Bayesian model was modularized into three parts (an exposure model, a subtype distribution model, and an epidemiological model) in order to separately estimate unknown parameters in each module. The proposed model takes advantage of the consumption and overall salmonella prevalence of the studied sources, as well as bacteria typing results from adjacent years. The latter were used for a smoothed estimation of the annual relative proportions of different salmonella subtypes in each of the sources. The source-specific effects and the salmonella subtype-specific effects were included in the epidemiological model to describe the differences between sources and between subtypes in their ability to infect humans. The estimation of these parameters was based on data from multiple years. Finally, the model combines the total evidence from different modules to proportion human salmonellosis cases according to their sources. The model was applied to allocate reported human salmonellosis cases from the years 2008 to 2015 to eight food sources.
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Affiliation(s)
- Antti Mikkelä
- Risk Assessment UnitFinnish Food AuthorityHelsinkiFinland
| | - Jukka Ranta
- Risk Assessment UnitFinnish Food AuthorityHelsinkiFinland
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Siira L, MacDonald E, Holmbakken GM, Sundar T, Meyer-Myklestad L, Lange H, Brandal LT, Naseer U, Johannessen GS, Bergsjø B, Espenhain L, Vold L, Nygård K. Increasing incubation periods during a prolonged monophasic Salmonella Typhimurium outbreak with environmental contamination of a commercial kitchen at Oslo Airport, Norway, 2017. Euro Surveill 2019; 24:1900207. [PMID: 31456559 PMCID: PMC6712930 DOI: 10.2807/1560-7917.es.2019.24.34.1900207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/13/2019] [Indexed: 11/20/2022] Open
Abstract
In September 2017, a cluster of monophasic Salmonella Typhimurium isolates was identified at the National Reference Laboratory for Enteropathogenic Bacteria in Norway. We investigated the cluster to identify the source and implement control measures. We defined a case as a person with laboratory-confirmed salmonellosis with the outbreak strain multiple locus variable-number tandem repeat analysis type. We conducted descriptive epidemiological and environmental investigations and performed whole genome sequencing (WGS) with core and accessory genome multilocus sequence typing of all isolates from cases or the environment connected with this outbreak. We identified 21 cases, residing in 10 geographically dispersed counties, all of whom had consumed food or drinks from a café at Oslo Airport. Case distribution by date of symptom onset suggested that a point source was introduced in mid-August followed by continued environmental contamination. The incubation periods ranged 0-16 days and increased as the outbreak progressed, likely due to increasingly low-dose exposure as control measures were implemented. WGS confirmed an identical cluster type-944 in all cases and six environmental specimens from the café. Control measures, including temporary closure and kitchen refurbishment, failed to eliminate the environmental source. We recommend strengthened hygiene measures for established environmental contamination during an outbreak.
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Affiliation(s)
- Lotta Siira
- Norwegian Institute of Public Health, Oslo, Norway
- European Program for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden
| | | | | | - Tom Sundar
- Municipality of Nannestad, Akershus, Norway
| | | | - Heidi Lange
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Umaer Naseer
- Norwegian Institute of Public Health, Oslo, Norway
| | | | | | - Laura Espenhain
- Norwegian Institute of Public Health, Oslo, Norway
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden
| | - Line Vold
- Norwegian Institute of Public Health, Oslo, Norway
| | - Karin Nygård
- Norwegian Institute of Public Health, Oslo, Norway
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Zeng YB, Xiong LG, Tan MF, Li HQ, Yan H, Zhang L, Yin DF, Kang ZF, Wei QP, Luo LG. Prevalence and Antimicrobial Resistance of Salmonella in Pork, Chicken, and Duck from Retail Markets of China. Foodborne Pathog Dis 2019; 16:339-345. [PMID: 31013442 DOI: 10.1089/fpd.2018.2510] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Salmonella is one of the most important foodborne pathogens associated with animal and human diseases. In this study, 672 samples of fresh meat (pork, 347; chicken, 196; and duck, 129) were collected from retail markets in different provinces of China from 2010 to 2014. We identified 10 different serotypes among 80 Salmonella isolates, whereas 12 isolates were nonmotile precluding conventional identification of complete serotype. Among these 92 isolates, Salmonella enterica serovar Derby (n = 21) was the most prevalent serotype, followed by Salmonella Enteritidis (n = 17), Salmonella Typhimurium (n = 15), Salmonella Indiana (n = 9), Salmonella Agona (n = 7), and Salmonella Assinie (n = 5). Antimicrobial resistance testing for 18 antimicrobial agents revealed that all 92 isolates were resistant to at least 1 antimicrobial agent, and 39 different resistance profiles were identified. The highest resistance was to trimethoprim-sulfamethoxazole (n = 87), followed by tetracycline (n = 51), carbenicillin (n = 38), amoxicillin/A.clav (n = 30), and piperacillin (n = 24). Our results demonstrated that meats presented a potential public health risk, thereby underlining the necessity for local regulatory enforcement agencies in China to monitor salmonellosis.
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Affiliation(s)
- Yan-Bing Zeng
- 1 Institute of Animal Husbandry and Veterinary Science, Jiangxi Academy of Agricultural Sciences, Nanchang, China
| | - Li-Gen Xiong
- 1 Institute of Animal Husbandry and Veterinary Science, Jiangxi Academy of Agricultural Sciences, Nanchang, China
| | - Mei-Fang Tan
- 1 Institute of Animal Husbandry and Veterinary Science, Jiangxi Academy of Agricultural Sciences, Nanchang, China
| | - Hai-Qin Li
- 1 Institute of Animal Husbandry and Veterinary Science, Jiangxi Academy of Agricultural Sciences, Nanchang, China
| | - Han Yan
- 2 Agricultural Product Quality Safety and Standards Institute, Jiangxi Academy of Agricultural Sciences, Nanchang, China
| | - Li Zhang
- 2 Agricultural Product Quality Safety and Standards Institute, Jiangxi Academy of Agricultural Sciences, Nanchang, China
| | - De-Feng Yin
- 2 Agricultural Product Quality Safety and Standards Institute, Jiangxi Academy of Agricultural Sciences, Nanchang, China
| | - Zhao-Feng Kang
- 1 Institute of Animal Husbandry and Veterinary Science, Jiangxi Academy of Agricultural Sciences, Nanchang, China
| | - Qi-Peng Wei
- 1 Institute of Animal Husbandry and Veterinary Science, Jiangxi Academy of Agricultural Sciences, Nanchang, China
| | - Lin-Guang Luo
- 2 Agricultural Product Quality Safety and Standards Institute, Jiangxi Academy of Agricultural Sciences, Nanchang, China
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Sanaa M, Pouillot R, Vega FG, Strain E, Van Doren JM. GenomeGraphR: A user-friendly open-source web application for foodborne pathogen whole genome sequencing data integration, analysis, and visualization. PLoS One 2019; 14:e0213039. [PMID: 30818354 PMCID: PMC6394949 DOI: 10.1371/journal.pone.0213039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 02/13/2019] [Indexed: 11/18/2022] Open
Abstract
Food safety risk assessments and large-scale epidemiological investigations have the potential to provide better and new types of information when whole genome sequence (WGS) data are effectively integrated. Today, the NCBI Pathogen Detection database WGS collections have grown significantly through improvements in technology, coordination, and collaboration, such as the GenomeTrakr and PulseNet networks. However, high-quality genomic data is not often coupled with high-quality epidemiological or food chain metadata. We have created a set of tools for cleaning, curation, integration, analysis and visualization of microbial genome sequencing data. It has been tested using Salmonella enterica and Listeria monocytogenes data sets provided by NCBI Pathogen Detection (160,000 sequenced isolates in 2018). GenomeGraphR presents foodborne pathogen WGS data and associated curated metadata in a user-friendly interface that allows a user to query a variety of research questions such as, transmission sources and dynamics, global reach, and persistence of genotypes associated with contamination in the food supply and foodborne illness across time or space. The application is freely available (https://fda-riskmodels.foodrisk.org/genomegraphr/).
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Affiliation(s)
- Moez Sanaa
- Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, Maryland, United States of America
| | - Régis Pouillot
- Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, Maryland, United States of America
- * E-mail:
| | - Francisco Garcés Vega
- Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, Maryland, United States of America
| | - Errol Strain
- Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, Maryland, United States of America
| | - Jane M. Van Doren
- Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, Maryland, United States of America
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Siira L, Naseer U, Alfsnes K, Hermansen NO, Lange H, Brandal LT. Whole genome sequencing of Salmonella Chester reveals geographically distinct clusters, Norway, 2000 to 2016. Euro Surveill 2019; 24:1800186. [PMID: 30696528 PMCID: PMC6352000 DOI: 10.2807/1560-7917.es.2019.24.4.1800186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 11/06/2018] [Indexed: 11/20/2022] Open
Abstract
IntroductionDuring summer 2016, Norway observed an increase in Salmonella enterica subsp. enterica serovar Chester cases among travellers to Greece.AimOur aim was to investigate genetic relatedness of S. Chester for surveillance and outbreak detection by core genome multilocus sequence typing (cgMLST) and compare the results to genome mapping.MethodsWe included S. Chester isolates from 51 cases of salmonellosis between 2000 and 2016. Paired-end sequencing (2 × 250 bp) was performed on Illumina MiSeq. Genetic relatedness by cgMLST for Salmonella enterica subsp. enterica, including 3,002 genes and seven housekeeping genes, was compared by reference genome mapping with CSI Phylogeny version 1.4 and conventional MLST.ResultsConfirmed travel history was available for 80% of included cases, to Europe (n = 13), Asia (n = 12) and Africa (n = 16). Isolates were distributed into four phylogenetic clusters corresponding to geographical regions. Sequence type (ST) ST411 and a single-locus variant ST5260 (n = 17) were primarily acquired in southern Europe, ST1954 (n = 15) in Africa, ST343 (n = 11) and ST2063 (n = 8) primarily in Asia. Part of the European cluster was further divided into a Greek (n = 10) and a Cypriot (n = 4) cluster. All isolates in the African cluster displayed resistance to ≥ 1 class of antimicrobials, while resistance was rare in the other clusters.ConclusionWhole genome sequencing of S. Chester in Norway showed four geographically distinct clusters, with a possible outbreak occurring during summer 2016 related to Greece. We recommend public health institutes to implement cgMLST-based real-time Salmonella enterica surveillance for early and accurate detection of future outbreaks and further development of cluster cut-offs.
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Affiliation(s)
- Lotta Siira
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
- European Program for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Umaer Naseer
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Kristian Alfsnes
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Nils Olav Hermansen
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Heidi Lange
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Lin T Brandal
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
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Gurman PM, Ross T, Kiermeier A. Quantitative Microbial Risk Assessment of Salmonellosis from the Consumption of Australian Pork: Minced Meat from Retail to Burgers Prepared and Consumed at Home. Risk Anal 2018; 38:2625-2645. [PMID: 30144103 DOI: 10.1111/risa.13163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Pork burgers could be expected to have an elevated risk of salmonellosis compared to other pork products due to their comminuted nature. A stochastic risk assessment was performed to estimate the risk of salmonellosis from Australian pork burgers and considered risk-affecting factors in the pork supply chain from retail to consumption at home. Conditions modeled included prevalence and concentration of Salmonella in pork mince, time and temperature effects during retail, consumer transport, and domestic storage and the effect of cooking, with the probability of illness from consumption estimated based on these effects. The model was two-dimensional, allowing for the separation of variability and uncertainty. Potential changes to production practices and consumer behaviors were examined through alternative scenarios. Under current conditions in Australia, the mean risk of salmonellosis from consumption of 100 g pork burgers was estimated to be 1.54 × 10 - 8 per serving or one illness per 65,000,000 servings consumed. Under a scenario in which all pork mince consumed is served as pork burgers, and with conservative (i.e., worst-case) assumptions, 0.746 cases of salmonellosis per year from pork burgers in Australia were predicted. Despite the adoption of several conservative assumptions to fill data gaps, it is predicted that pork burgers have a low probability of causing salmonellosis in Australia.
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Affiliation(s)
- Phillip M Gurman
- Animal Genetics and Breeding Unit, University of New England, Armidale, New South Wales, Australia
- South Australian Research and Development Institute, Urrbrae, South Australia, 5064, Australia
- Tasmanian Institute of Agriculture, University of Tasmania, Hobart, Tasmania, Australia
| | - Tom Ross
- Tasmanian Institute of Agriculture, University of Tasmania, Hobart, Tasmania, Australia
| | - Andreas Kiermeier
- Statistical Process Improvement Consulting and Training Pty Ltd, Gumeracha, South Australia, 5233, Australia
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Luna S, Taylor M, Galanis E, Asplin R, Huffman J, Wagner D, Hoang L, Paccagnella A, Shelton S, Ladd-Wilson S, Seelman S, Whitney B, Elliot E, Atkinson R, Marshall K, Basler C. Outbreak of Salmonella Chailey Infections Linked To Precut Coconut Pieces - United States and Canada, 2017. MMWR Morb Mortal Wkly Rep 2018; 67:1098-1100. [PMID: 30286052 PMCID: PMC6171899 DOI: 10.15585/mmwr.mm6739a5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Foodborne salmonellosis causes an estimated 1 million illnesses and 400 deaths annually in the United States (1). In recent years, salmonellosis outbreaks have been caused by foods not typically associated with Salmonella. On May 2, 2017, PulseNet, CDC's national molecular subtyping network for foodborne disease surveillance, identified a cluster of 14 Salmonella Chailey isolates with a rare pulsed-field gel electrophoresis (PFGE) pattern. On May 29, Canadian health officials informed CDC that they were also investigating a cluster of five Salmonella Chailey infections in British Columbia with the same PFGE pattern. Nineteen cases were identified and investigated by CDC, U.S. state health departments, the Public Health Agency of Canada, and the British Columbia Centre for Disease Control. Isolates from all cases were highly related by whole genome sequencing (WGS). Illness onset dates ranged from March 10 to May 7, 2017. Initial interviews revealed that infected persons consumed various fresh foods and shopped at grocery chain A; focused questionnaires identified precut coconut pieces from grocery chain A as a common vehicle. The Canadian Food Inspection Agency (CFIA) and the U.S. Food and Drug Administration (FDA) conducted a traceback investigation that implicated a single lot of frozen, precut coconut as the outbreak source. Grocery chain A voluntarily removed precut coconut pieces from their stores. This action likely limited the size and scope of this outbreak.
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Gori M, Ebranati E, Scaltriti E, Huedo P, Ciceri G, Tanzi E, Pontello M, Zehender G, Pongolini S, Bolzoni L. High-resolution diffusion pattern of human infections by Salmonella enterica serovar Napoli in Northern Italy explained through phylogeography. PLoS One 2018; 13:e0202573. [PMID: 30133519 PMCID: PMC6104998 DOI: 10.1371/journal.pone.0202573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/06/2018] [Indexed: 01/31/2023] Open
Abstract
Salmonella enterica serovar Napoli (serovar Napoli) is an emerging cause of human salmonellosis in Northern Italy. No specific reservoirs of serovar Napoli have been identified in Italy, so far. However, the environment, especially surface waters, has been hypothesized as an important source of infection based on the observation that genotypically different clusters of serovar Napoli are detected in different geographical macro-areas. To further support the hypothesis of a spatially-restricted pattern of serovar Napoli diffusion, a spatial segregation of serovar Napoli lineages should be observed also at smaller geographical scale. However, classical genotyping techniques used for Salmonella, such as pulsed-field gel electrophoresis (PFGE), did not possess enough discriminatory power to highlight spatial clustering of serovar Napoli within the macro-areas. To this purpose, we performed phylogeographical analyses based on genome-wide single nucleotide polymorphisms to test whether spatio-temporal evolution patterns of serovar Napoli in Northern Italy could be recognized with high geographical resolution, i.e. at local level. Specifically, we analyzed the local spread of the main PFGE clonal group, responsible for more than 60% of human infections in the study area, that did not show any geographical differentiation by PFGE within Northern Italy, i.e. the macro-area considered in the study. Both discrete and continuous phylogeography highlighted the existence of two main geographically-restricted clades: a Southern clade corresponding to the Po Valley and a Northern clade corresponding to the Pre-Alps area. Furthermore, the phylogeographical analyses suggested that the most probable site of origin of the clone was in an area of the Po Valley at the confluence of the Po and Ticino rivers, one of the most important Italian wetlands. These findings provide further support to the hypothesis that environmental transmission may play an important role in the ecology of serovar Napoli.
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Affiliation(s)
- Maria Gori
- Department of Health Sciences, University of Milan, Milano, Italy
| | - Erika Ebranati
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milano, Italy
| | - Erika Scaltriti
- Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Parma, Italy
| | - Pol Huedo
- Department of Health Sciences, University of Milan, Milano, Italy
| | - Giulia Ciceri
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
| | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
- CRC-Coordinated Research Center “EpiSoMI”, University of Milan, Milano, Italy
| | - Mirella Pontello
- Department of Health Sciences, University of Milan, Milano, Italy
- CRC-Coordinated Research Center “EpiSoMI”, University of Milan, Milano, Italy
| | - Gianguglielmo Zehender
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milano, Italy
- CRC-Coordinated Research Center “EpiSoMI”, University of Milan, Milano, Italy
| | - Stefano Pongolini
- Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Parma, Italy
| | - Luca Bolzoni
- Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Parma, Italy
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Nguyen SV, Harhay DM, Bono JL, Smith TPL, Fields PI, Dinsmore BA, Santovenia M, Wang R, Bosilevac JM, Harhay GP. Comparative genomics of Salmonella enterica serovar Montevideo reveals lineage-specific gene differences that may influence ecological niche association. Microb Genom 2018; 4:e000202. [PMID: 30052174 PMCID: PMC6159554 DOI: 10.1099/mgen.0.000202] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 07/05/2018] [Indexed: 01/01/2023] Open
Abstract
Salmonella enterica serovar Montevideo has been linked to recent foodborne illness outbreaks resulting from contamination of products such as fruits, vegetables, seeds and spices. Studies have shown that Montevideo also is frequently associated with healthy cattle and can be isolated from ground beef, yet human salmonellosis outbreaks of Montevideo associated with ground beef contamination are rare. This disparity fuelled our interest in characterizing the genomic differences between Montevideo strains isolated from healthy cattle and beef products, and those isolated from human patients and outbreak sources. To that end, we sequenced 13 Montevideo strains to completion, producing high-quality genome assemblies of isolates from human patients (n=8) or from healthy cattle at slaughter (n=5). Comparative analysis of sequence data from this study and publicly available sequences (n=72) shows that Montevideo falls into four previously established clades, differentially occupied by cattle and human strains. The results of these analyses reveal differences in metabolic islands, environmental adhesion determinants and virulence factors within each clade, and suggest explanations for the infrequent association between bovine isolates and human illnesses.
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Affiliation(s)
- Scott V. Nguyen
- UCD-Centre for Food Safety, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin D04 N2E5, Ireland
| | - Dayna M. Harhay
- USDA-ARS-US Meat Animal Research Center, Clay Center, NE 68933, USA
| | - James L. Bono
- USDA-ARS-US Meat Animal Research Center, Clay Center, NE 68933, USA
| | | | - Patricia I. Fields
- Enteric Disease Laboratory Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Blake A. Dinsmore
- Enteric Disease Laboratory Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Monica Santovenia
- Enteric Disease Laboratory Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Rong Wang
- USDA-ARS-US Meat Animal Research Center, Clay Center, NE 68933, USA
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