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Salmonella enteritidis outbreak in a restaurant chain: the continuing challenges of prevention

Published online by Cambridge University Press:  15 May 2009

D. J. Vugia ,
B. Mishu ,
M. Smith ,
D. R. Tavris ,
F. W. Hickman-Brenner  and
R. V. Tauxe
D. J. Vugia*
Affiliation:
Enteric Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Disease, Centers for Disease Control, Atlanta, Georgia
B. Mishu
Affiliation:
Enteric Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Disease, Centers for Disease Control, Atlanta, Georgia
M. Smith
Affiliation:
Pennsylvania State Department of Health, Harrisburg, Pennsylvania
D. R. Tavris
Affiliation:
Pennsylvania State Department of Health, Harrisburg, Pennsylvania
F. W. Hickman-Brenner
Affiliation:
Enteric Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Disease, Centers for Disease Control, Atlanta, Georgia
R. V. Tauxe
Affiliation:
Enteric Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Disease, Centers for Disease Control, Atlanta, Georgia
*
*D. J. Vugia, Enteric Diseases Branch, Division of Bacterial and Mycotic Diseases, Mailstop C-09, Centers for Disease Control. Atlanta. GA. 30333.
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In 1990, a Salmonella enteritidis (SE) outbreak occurred in a restaurant chain in Pennsylvania. To determine its cause(s), we conducted a case-control study and a cohort study at one restaurant, and a survey of restaurants. Egg dishes were associated with illness (P = 0.03). Guests from one hotel eating at the restaurant had a diarrhocal attack rate of 14%, 4.7-fold higher than among those not eating there (P = 0.04). There were no differences in egg handling between affected and unaffected restaurants. Eggs supplied to affected restaurants were medium grade AA eggs from a single farm, and were reportedly refrigerated during distribution. Human and hen SE isolates were phage type 8 and had similar plasmid profiles and antibiograms. We estimate the prevalence of infected eggs during the outbreak to be as high as 1 in 12. Typical restaurant egg-handling practices and refrigeration during distribution appear to be insufficient by themselves to prevent similar outbreaks.

Type
Research Article
Information
Epidemiology & Infection , Volume 110 , Issue 1 , February 1993 , pp. 49 - 61
Copyright
Copyright © Cambridge University Press 1993

References

REFERENCES

1.Tauxe, RV, Lee, LA, Rodrigue, D, Farmer, JJ, Blake, PA. Outbreaks of Salmonella enteritidis gastroenteritis. United States 1985–1989 [Abstract]. Intersci Conf Antimicrob Agents Chemother, 1990.Google Scholar
2.Centers for Disease Control. Update: Salmonella enteritidis infections and grade A shell eggs – United States, 1989 MMWR 1990: 38: 877–80.Google Scholar
3.Centers for Disease Control. Update: Salmonella enteritidis infections and shell eggs – United States, 1990 MMWR 1990; 39: 909–12.Google Scholar
4.Enteric Diseases Branch. Division of Bacterial Diseases. Centers for Infectious Diseases. Centers for Disease Control. Salmonella Surveillance Annual Summary 1990. Centers for Disease Control. Atlanta.Google Scholar
5.U.S. Department of Agriculture. Poultry infected by Salmonella enteritidis. Federal Register 1990; 55: 5576–84.Google Scholar
6.U.S. Food and Drug Administration. Retail Food Protection Program Information Manual. Issued by the Center for Food Safety and Applied Nutrition. Washington. DC: U.S. Food and Drug Administration. 1990: 1–8.Google Scholar
7.Edwards, PR. Ewing, WH. Identification of Enterobacteriaceae, 3rd ed. Minneapolis: Burgess. 1972.Google Scholar
8.Ward, LR. de Sa, JDH. Rowe, B. A phage-typing scheme for Salmonella enteritidis. Epidemiol Infect 1987: 99: 291–4.CrossRefGoogle ScholarPubMed
9.Birnboim, HC. A rapid alkaline method for the isolation of plasmid DNA. Methods Enzymol 1983; 100: 243–55.CrossRefGoogle ScholarPubMed
10.Fleiss, JL. Statistical methods for rates and proportions. New York: John Wiley and Sons. 1981.Google Scholar
11.Greenland, S, Robins, JM. Estimation of a common effect parameter from sparse follow-up data. Biometrics 1985; 41: 55–68.CrossRefGoogle ScholarPubMed
12.St, Louis ME, Morse, DL. Potter, ME, et al. The emergence of grade A eggs as a major source of Salmonella enteritidis infections: new implications for the control of salmonellosis. JAMA 1988; 259: 2103–7.Google Scholar
13.Coyle, EF, Palmer, SR, Ribeiro, CD, et al. Salmonella enteritidis phage type 4 infection: association with hens' eggs. Lancet 1988; ii: 1295–7.CrossRefGoogle Scholar
14.Cowden, JM, Chisholm, D. O'Mahony, M, et al. Two outbreaks of Salmonella enteritidis phage type 4 infection associated with the consumption of fresh shell-egg products. Epidemiol Infect 1989; 103: 47–52.CrossRefGoogle ScholarPubMed
15.Telzak, EE, Budnick, LD. Zweig, Greenberg MS, et al. A nosocomial outbreak of Salmonella enteritidis infection due to the consumption of raw eggs. N Engl J Med 1990; 323: 394–7.CrossRefGoogle Scholar
16.Mishu, B, Griffin, PM, Tauxe, RV, Cameron, DN, Hutcheson, RH, Schaffner, W. Salmonella enteritidis gastroenteritis transmitted by intact chicken eggs. Ann Intern Med 1991; 115: 190–4.CrossRefGoogle ScholarPubMed
17.Lin, F-YC, Morris, JG, Trump, D, et al. Investigation of an outbreak of Salmonella enteritidis gastroenteritis associated with consumption of eggs in a restaurant chain in Maryland. Am J Epidemiol 1988; 128: 839–44.CrossRefGoogle Scholar
18.Humphrey, TJ, Whitehead, A, Gawler, AHL, Henley, A, Rowe, B. Numbers of Salmonella enteritidis in the contents of naturally contaminated hens' eggs. Epidemiol Infect 1991; 106: 489–96.CrossRefGoogle ScholarPubMed
19.Humphrey, TJ, Baskerville, A, Mawer, S, Rowe, B, Hopper, S. Salmonella enteritidis phage type 4 from the contents of intact eggs: a study involving naturally infected hens. Epidemiol Infect 1989; 103: 415–23.CrossRefGoogle ScholarPubMed
20.Mawer, SL, Spain, GE, Rowe, B. Salmonella enteritidis phage type 4 and hens' eggs. Lancet 1989; i: 280–1.CrossRefGoogle Scholar
21.Gast, RK, Beard, CW. Production of Salmonella enteritidis-contaminated eggs by experimentally infected hens. Avian Dis 1990; 34: 438–46.CrossRefGoogle ScholarPubMed
22.Shivaprasad, HL, Timoney, JF, Morales, S, Lucio, B, Baker, RC. Pathogenesis of Salmonella enteritidis infection in laying chickens. I. Studies on egg transmission, clinical signs, fecal shedding, and serologic responses. Avian Dis 1990; 34: 548–57.CrossRefGoogle ScholarPubMed
23.O'Brien, JDP. Salmonella enteritidis infection in broiler chickens. Vet Record 1988; 122: 214.CrossRefGoogle ScholarPubMed
24.Lister, SA. Salmonella enteritidis infection in broilers and broiler breeders. Vet Record 1988; 123: 350.CrossRefGoogle ScholarPubMed
25.Hopper, SA. Mawer, S. Salmonella enteritidis in a commercial layer flock. Vet Record 1988; 123: 351.CrossRefGoogle Scholar
26.Humphrey, TJ, Greenwood, M, Gilbert, RJ, Rowe, B, Chapman, PA. The survival of salmonellas in shell eggs cooked under simulated domestic conditions. Epidemiol Infect 1989; 103: 35–45.CrossRefGoogle ScholarPubMed