Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-14T04:25:56.911Z Has data issue: false hasContentIssue false

The relationship between infecting dose and severity of disease in reported outbreaks of salmonella infections

Published online by Cambridge University Press:  15 May 2009

J. R. Glynn
Affiliation:
Tropical Health Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT
D. J. Bradley
Affiliation:
Tropical Health Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The relationship between size of the infecting dose and severity of the resulting disease has been investigated for salmonella infections by reanalysis of data within epidemics for 32 outbreaks, and comparing data between outbreaks for 68 typhoid epidemics and 49 food-poisoning outbreaks due to salmonellas. Attack rate, incubation period, amount of infected food consumed and type of vehicle are used as proxy measures of infecting dose, while case fatality rates for typhoid and case hospitalization rates for food poisoning salmonellas were used to assess severity. Limitations of the data are discussed. Both unweighted and logit analysis models are used.

There is no evidence for a dose-severity relationship for Salmonella typhi, but evidence of a correlation between dose and severity is available from within-epidemic or between-epidemic analysis, or both, for Salmonella typhimurium, S. enteritidis, S. infantis, S. newport, and S. thompson. The presence of such a relationship affects the way in which control interventions should be assessed.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1992

References

REFERENCES

1.Esrey, SA, Feachem, RG, Hughes, JM. Interventions for the control of diarrhoeal diseases among young children: improving water supplies and excreta disposal facilities. Bull W H O 1985; 63: 757–72.Google ScholarPubMed
2.Hornick, RB, Greisman, SE, Woodward, TE et al. , Typhoid fever: pathogenesis and immunologic control. N Engl J Med 1970; 283: 686–91, 739–46.CrossRefGoogle ScholarPubMed
3.McCullough, NB, Eisele, CW. Experimental human salmonellosis. I. Pathogenicity of strains of Salmonella meleagridis and Salmonella anatum obtained from spray-dried whole egg. J Infect Dis 1951; 88: 278–89.CrossRefGoogle ScholarPubMed
4.McCullough, NB, Eisele, CW. Experimental human salmonellosis. II. Immunity studies following experimental illness with Salmonella meleagridis and Salmonella anatum. J Immunol 1951; 66: 595608.CrossRefGoogle ScholarPubMed
5.McCullough, NB, Eisele, CW. Experimental human salmonellosis. III. Pathogenicity of strains of Salmonella newport, Salmonella derby, and Salmonella bareilly obtained from spray-dried whole egg. J Infect Dis 1951; 89: 209–13.CrossRefGoogle ScholarPubMed
6.McCullough, NB, Eisele, CW. Experimental human salmonellosis. IV. Pathogenicity of strains of Salmonella pullorum obtained from spray-dried whole egg. J Infect Dis 1951; 88: 259–65.CrossRefGoogle Scholar
7.Meynell, GG, Meynell, EW. The growth of micro-organisms in vivo with particular reference to the relation between dose and latent period. J Hyg 1958; 56: 323–45.CrossRefGoogle Scholar
8.Schutze, H, Gorer, PA, Finlayson, MH. The resistance of four mouse lines to bacterial infection. J Hyg 1936; 36: 3749.CrossRefGoogle ScholarPubMed
9.Robson, HG, Vas, SJ. Resistance of inbred mice to Salmonella typhimurium. J Infect Dis 1972; 126: 378–86.CrossRefGoogle ScholarPubMed
10.Hormaeche, CE. Immunity mechanisms in Salmonella infections. PhD thesis, University of Cambridge, 1975.Google Scholar
11.Rao, V, Chauhan, HVS. The pathology and pathogenesis of Salmonella stanley infection in experimental chicks. Res Vet Sci 1987; 42: 287–93.CrossRefGoogle ScholarPubMed
12.Collins, FM. Salmonellosis in orally infected specific pathogen-free C57B1 mice. Infect Immun 1972; 5: 191–8.CrossRefGoogle ScholarPubMed
13.Humphrey, TJ, Baskerville, A, Chart, H, Rowe, B, Whitehead, A. Salmonella enteritidis PT4 infection in specific pathogen-free hens: influence of infecting dose. Vet Rec 1991; 129: 482–5.CrossRefGoogle ScholarPubMed
14.DeJong, H, Ekdahl, MO. Salmonellosis in calves – the effect of dose rate and other factors on transmission. NZ Vet J 1965; 13: 5964.CrossRefGoogle Scholar
15.Robinson, RA, Loken, KI. Age susceptibility and excretion of Salmonella typhimurium in calves. J Hyg 1968; 66: 207–16.CrossRefGoogle ScholarPubMed
16.Wray, C, Sojka, WJ. Experimental Salmonella typhimurium infection in calves. Res Vet Sci 1978; 25: 139–43.CrossRefGoogle ScholarPubMed
17.Smith, HW, Jones, JET. Observations on experimental oral infection with Salmonella dublin in calves and Salmonella cholerasuis in pigs. J Path Bact 1967; 93: 141–56.CrossRefGoogle Scholar
18.Miner, JR. The incubation period of typhoid fever. J Infect Dis 1922; 31: 296301.CrossRefGoogle Scholar
19.Bernard, RP. The Zermatt typhoid outbreak in 1963. J Hyg 1965; 63: 537–63.Google ScholarPubMed
20.Cumming, JG. An epidemic resulting from the contamination of icecream by a typhoid carrier. JAMA 1917; 68: 1163–5.CrossRefGoogle Scholar
21.Mintz, ED, Cartter, M, Zingeser, J, Hadler, J. Dose–response effects in a food-borne outbreak of Salmonella enteritidis, Connecticut. Presented at the Epidemic Intelligence Service Conference, 04 1991.Google Scholar
22.Blaser, MJ, Newman, LS. A review of human salmonellosis. I. Infective dose. Rev Infect Dis 1982; 4: 1096–106.CrossRefGoogle ScholarPubMed
23.Naylor, GRE. Incubation period and other features of food-borne and water-borne outbreaks of typhoid fever in relation to pathogenesis and genetics of resistance. Lancet 1983; i: 864–6.CrossRefGoogle Scholar
24.Sirois, JS. An outbreak of typhoid fever due to raw milk. Canad Pub Health J 1942; 33: 168–73.Google Scholar
25.Taylor, DN, Bopp, C, Birkness, K, Cohen, ML. An outbreak of Salmonellosis associated with a fatality in a healthy child: a large dose and severe illness. Am J Epidemiol 1984; 119: 907–12.CrossRefGoogle Scholar
26.Balice, A. Salmonellosis ‘osimo’ 1958. Igiene e San Pubblica 1958; 14: 612–27.Google Scholar
27.Bierschenck, H. Eine Lebensmittelvergiftung durch Salmonella infantis im Speiseeis. Z Gesamte Hyg 1962; 8: 383–7.Google Scholar
28.De Blasi, R, Scotti, G, Alcuni aspetti della epidemiologia delle ‘Salmonellosis’. Riv Ital Igiene 1950; 10: 324–41.Google ScholarPubMed
29.Harding, KM. An outbreak of food poisoning following the consumption of infected pork pie. Medical Officer 1966; 115: 159–60.Google Scholar
30.Gomez, Lus R, Gimenez, Martinez A. Epidemia gastroenteritis aguda a Salmonella typhimurium. Med Trop (Madrid) 1965; 41: 549–51.Google Scholar
31.Palmer, SR, Watkeys, JEM, Zamiri, I, et al. Outbreak of Salmonella food poisoning amongst delegates at a medical conference. J R Coll Physicians Lond 1990; 24: 26–9.Google Scholar
32.Miller, AA, Nicol, CGM, Ramsden, F. An outbreak of food poisoning due to Salmonella bovis morbificans (Basenau) in which the vehicle of infection was meat pies. Ministry of Health. Reports on Public Health and Medical Subjects no. 96. London: HMSO, 1955.Google Scholar
33.Brockbank, W, Metcalfe, Brown C, Parker, MT. Outbreak of food-poisoning due to Salmonella aberdeen. Lancet 1950; ii: 873–6.CrossRefGoogle Scholar
34.D'aoust, J-Y. Infective dose of Salmonella typhimurium in cheddar cheese. Am J Epidemiol 1985; 122: 717–20.CrossRefGoogle ScholarPubMed
35.Cook, GT, de Costabadie, LP. Food poisoning associated with infected dried egg. Monthly Bull Minist Health (London) 1947; 6: 177–80.Google ScholarPubMed
36.Semple, AB, Turner, GC, Lowry, DMO. Outbreak of food poisoning caused by Salmonella virchow in spit-roasted chicken. Br Med J 1968; 2: 801–3.CrossRefGoogle Scholar
37.Möller, A. Breslau-Gruppenerkrankung durch infizierte Hühnereier. Zbl Bakt I Abt Orig 1955; 164: 535–9.Google Scholar
38.Shaw, WV. Report to the Ministry of Health on an epidemic of enteric fever at Bolton-upon-Dearne. Ministry of Health. Reports on Public Health and Medical Subjects no. 12. London: HMSO, 1922.Google Scholar
39.Desranleau, JM. An oubreak of typhoid fever traced to a wedding breakfast. Can J Public Health 1946; 37: 244–8.Google Scholar
40.Lumsden, LL. Outbreak of gastroenteritis and typhoid fever due to drinking water on excursion steamer. Public Health Rep 1912; 27: 1960–71.CrossRefGoogle Scholar
41.Bulstrode, HT. Report upon alleged oyster-borne enteric fever and other illness following the Mayoral banquets at Winchester and Southampton, and upon enteric fever occurring simultaneously elsewhere, and also ascribed to oysters. Annual Report of the Medical Officer of the Local Government Board 1902–3. No. 9: 129–89.CrossRefGoogle Scholar
42.Mollohan, CS, Reid, G. Typhoid fever in Colorado. National Communicable Disease Center Salmonella Surveillance 1967, no. 63: 4.Google Scholar
43.Horwitz, MA, Pollard, RA, Merson, MH, Martin, SM. A large outbreak of food borne Salmonellosis on the Navajo Nation Indian Reservation, epidemiology and secondary transmission. Am J Public Health 1977; 67: 1071–6.CrossRefGoogle Scholar
44.Bille, B, Mellbin, T, Nordbring, F. An extensive outbreak of gastroenteritis caused by Salmonella newport. I. Some observations on 745 known cases. Acta Med Scand 1964; 175: 557–67.CrossRefGoogle Scholar
45.Fowinkle, EW, Armes, WH, Barrick, JH, et al. A Salmonella thompson outbreak traced to barbecued pork – Tennessee. Center for Disease Control Salmonella Surveillance 1970, no. 99: 13.Google Scholar
46.Janeway, CM, Goldfield, M, Attman, R, et al. Foodborne outbreak of gastroenteritis possibly of multiple bacterial etiology. Am J Epidemiol 1971; 94: 135–41.CrossRefGoogle Scholar
47.Holmes, M, Runte, V, Goldblatt, EL. Fatal case of Salmonella enteritidis infection. National Communicable Disease Center Salmonella Surveillance 1967, no. 67: 6.Google Scholar
48. Anonymous. Update: Salmonella enteritidis infection and grade A shell eggs – United States. MMWR 1988; 37: 490–6.Google Scholar
49.Hauser, GH, Treuting, WL, Brieffelh, LA. An outbreak of food poisoning due to a new etiological agent – Salmonella berta. Public Health Rep 1945; 60: 1138–42.CrossRefGoogle Scholar
50.Scott, HH. Some notable epidemics. London: Edward Arnold & Co, 1934.Google Scholar
51.Stallybrass, CO. The principles of epidemiology and the process of infection. London: George Routledge and Son Ltd, 1931.CrossRefGoogle Scholar
52.Greenwood, M. Epidemics and crowd-diseases. London: Williams and Norgate Ltd, 1935.Google Scholar
53.Ledingham, JCG. Report to the Local Government Board on the enteric fever ‘carrier’, being a review of current knowledge on this subject. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 43. London: HMSO, 1910.Google Scholar
54.Bracken, HM, Bass, FH, Westbrook, FF. The Mankato typhoid fever epidemic of 1908. J Infect Dis 1911; 9: 410–74.CrossRefGoogle Scholar
55.Johnstone, RW. Report to the Local Government Board upon outbreaks of enteric fever in Conway Rural District, Conway Urban District, and Llandudno Urban District, during 1908 and 1909. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 28. London: HMSO, 1910.Google Scholar
56.Carnwath, T. Report to the Local Government Board upon an outbreak of enteric fever at Oakenshaw, in the urban district of Willington. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 59. London: HMSO, 1912.Google Scholar
57.Grover, AL. An outbreak of typhoid fever in Cedar Falls, Iowa. J Infect Dis 1912; 10: 388408.CrossRefGoogle Scholar
58.Wheaton, SW. Report to the Local Government Board on enteric fever at Strood, in Rochester Borough, in 1912. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 79. London: HMSO, 1913.Google Scholar
59.Macewen, HA. Report to the Local Government Board on an outbreak of enteric fever in Ringwood, 1912. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 74. London: HMSO, 1912.Google Scholar
60.Hutchinson, JR. Report to the Local Government Board on an outbreak of enteric fever in the Borough of Colne (Lancashire), 1913. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 84. London: HMSO, 1913.Google Scholar
61.Jordan, EO, Irons, EE. The Rockford (Ill.) typhoid epidemic. J Infect Dis 1912; 11: 2143.CrossRefGoogle Scholar
62.Ridlon, JR. Investigation of typhoid fever at Texarkana, Ark. – Tex. (Milk outbreak). Public Health Rep 1912; 27: 219–27.CrossRefGoogle Scholar
63.Manby, EP. Report to the Local Government Board upon an outbreak of enteric fever in the Urban District of Kenilworth. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 92. London: HMSO, 1914.Google Scholar
64.Jordan, EO, Irons, EE. The Quincy (Illinois) typhoid epidemic. J Infect Dis 1913; 13: 1629.CrossRefGoogle Scholar
65.Sawyer, WA. Ninety-three persons infected by a typhoid carrier at a public dinner. JAMA 1914; 18: 1537–42.CrossRefGoogle Scholar
66.Geiger, JC. A milk borne epidemic of typhoid fever due to the use of polluted water. JAMA 1917; 68: 978–9.CrossRefGoogle Scholar
67.Geiger, JC, MacMillan, A, Gillespie, CG. A waterborne epidemic of typhoid fever. JAMA 1917; 68: 1681–3.CrossRefGoogle Scholar
68. Anonymous. A water-borne typhoid fever epidemic. Lancet 1921; i: 548–9.Google Scholar
69.Bundesen, HN. Typhoid epidemic in Chicago apparently due to oysters. JAMA 1925; 84: 641–50.CrossRefGoogle Scholar
70.Lumsden, LL. An outbreak of typhoid fever caused by a milkborne infection. Public Health Rep 1925; 40: 1302–15.CrossRefGoogle Scholar
71.Ramsey, GH, Benning, CH, Orr, PF. An epidemic of typhoid fever following a church dinner. Am J Public Health 1926; 16: 1011–6.CrossRefGoogle ScholarPubMed
72.Murata, S. On a prevalence of typhoid fever in Shizuoka Prefecture. J Pub Health Assoc Japan 1926; 2 (10): 16.Google Scholar
73. Anonymous. Epidemiology of typhoid fever in the Royal Navy. Lancet 1928; ii: 393.Google Scholar
74.Dean, AS. The Olean City epidemic of typhoid fever in 1928. Am J Public Health 1931; 21: 390402.CrossRefGoogle ScholarPubMed
75.Lessa, G, Surto de febre typhoide de origem hydrica. Brasil-Med 1930; 44: 1155–61.Google Scholar
76.Miner, HE, Forsbeck, FC. An outbreak of typhoid fever traced to a chicken salad infected by a carrier. N Engl J Med 1929; 200: 440–1.CrossRefGoogle Scholar
77.Garrido-Morales, E, Costa, Mandry O. Typhoid fever spread by water from a cistern contaminated by a carrier. J Preventive Med 1931; 5: 351–5.Google Scholar
78. Anonymous. Typhoid in Yorkshire. Lancet 1932; ii: 1029–30.Google Scholar
79.Magliano, G. Epidemia circoscritta di febbre tifoide di origine idrica. Ann d'igiene 1935; 45: 727. In: Bull Hyg 1935; 10: 437.Google Scholar
80.Gomez, Jimenez F. Un brote epidémico de fiebre tifoidea en Erla. Rev Sanid Hig Pública (Madr) 1934; 9 (1): 108–18.Google Scholar
81.Leeder, FS. An outbreak of milk-borne typhoid fever. Canad Pub Health J 1932; 23: 503–6.Google Scholar
82.Ritchie, J, Armstrong, E. A waterborne epidemic of typhoid fever. J Hyg 1932; 32: 417–20.CrossRefGoogle ScholarPubMed
83.Shaw, WV. Report on an outbreak of enteric fever in the Malton Urban District. Ministry of Health. Reports on Public Health and Medical Subjects no. 69. London: HMSO. 1933.Google Scholar
84.Morris, ES. An outbreak of typhoid fever at a Religious Convention probably caused by a ‘carrier’. Rep Director General Public Health, New South Wales, for Year 1933: 4751. In: Bull Hyg 1935; 10: 777.Google Scholar
85.Hornung, H. Eine Trunkwasser-Typhusepidemie in Swarzwald. Arch Hyg Bakt 1934; 113: 158–69.Google Scholar
86. Anonymous. Sequel to a pilgrimage. Lancet 1935; ii: 452.Google Scholar
87.Johnson, GE. Epidemiological features of a typhoid fever outbreak in West Philadelphia following a supper. Am J Public Health 1936; 26: 913–17.CrossRefGoogle ScholarPubMed
88. Anonymous. Typhoid after camping. Lancet 1936; ii: 654.Google Scholar
89.Watson, Smith S. The 1936 outbreak of typhoid fever at Poole, Bournemouth and Christchurch. Bournemouth: Pardy and Son Ltd, 1942.Google Scholar
90.Roelcke, K. Eine Gruppenerkrankung an Typhus durch Speiseeis. Z Hyg Infektionskr 1937; 119: 549–57.CrossRefGoogle Scholar
91.Lembecke, PA, von Haesseler, P. An epidemic of typhoid fever attributed to salad contaminated by a chronic typhoid carrier. Am J Public Health 1936; 28: 1212–16.CrossRefGoogle Scholar
92.Holden, OM. The Croydon typhoid outbreak. Public Health 1939; 52: 135–46.CrossRefGoogle Scholar
93.Caudill, FW. Small college suffers outbreak of water-borne typhoid fever. Water Works Engineering 1937; 90: 106. In: Bull Hyg 1938; 13:106.Google Scholar
94.Landau, D. Notes on a milk-borne typhoid outbreak. S Afr Med J 1938; 12: 463–5.Google Scholar
95.Old, HN, Gill, SL. A typhoid fever epidemic caused by carrier ‘bootlegging’ oysters. Am J Public Health 1940; 30: 633–40.CrossRefGoogle ScholarPubMed
96.Constam, ZF, Steiner, H. Ueber eine Typhus-epidemie mit Vorkrankheit. Schweiz Med Woch 1945; 75: 573–8. In: Bull Hyg 1945; 20: 723–4.Google Scholar
97.Galea, J. The typhoid epidemic of 1943 in Malta. Lux Press, 1944. In: Bull Hyg 1944; 19: 927–8.Google Scholar
98.Jordan, J, Everley, Jones H. Typhoid fever in immunised personnel. Lancet 1945; ii: 333–5.CrossRefGoogle Scholar
99.Marmion, DE, Naylor, GRE, Stewart, IO. Second attacks of typhoid fever. J Hyg 1953; 51: 260–7.CrossRefGoogle ScholarPubMed
100.Neill, WA, Martin, JD, Belden, EA., Trotter, WY. A widespread epidemic of typhoid fever traced to a common exposure. N Engl J Med 1958; 259: 667–72.CrossRefGoogle ScholarPubMed
101.Caraway, CT, Bruce, JM. Typhoid fever epidemic following a wedding reception. Public Health Rep 1961; 76: 427–30.CrossRefGoogle ScholarPubMed
102.Mallory, A, Belden, EA, Brachman, PS. The current status of typhoid fever in the United States and a description of an outbreak. J Infect Dis 1969; 119: 673–6.CrossRefGoogle Scholar
103.Taylor, A, Santiago, A, Gonzalez-Cortes, A, Gangarosa, EJ. Outbreak of typhoid fever in Trinidad in 1971 traced to a commercial icecream product. Am J Epidemiol 1974; 100: 150–7.CrossRefGoogle Scholar
104.Hanson, SM, Bender, G, Schrack, WD, Goldenson, RH. S. typhi – Coatsville Pennsylvania. Center for Disease Control Salmonella Surveillance 1972, no. 113: 34.Google Scholar
105.Hornick, RB, Woodward, TE. Appraisal of typhoid vaccine in experimentally infected human subjects. Trans Am Clin Climatol Assoc 1966; 78: 70–8.Google Scholar