Document Detail


International outbreak of Salmonella Oranienburg due to German chocolate.
MedLine Citation:
PMID:  15691371     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This report describes a large international chocolate-associated Salmonella outbreak originating from Germany.
METHODS: We conducted epidemiologic investigations including a case-control study, and food safety investigations. Salmonella (S.) Oranienburg isolates were subtyped by the use of pulsed-field gel electrophoresis (PFGE).
RESULTS: From 1 October 2001 through 24 March 2002, an estimated excess of 439 S. Oranienburg notifications was registered in Germany. Simultaneously, an increase in S. Oranienburg infections was noted in other European countries in the Enter-net surveillance network. In a multistate matched case-control study in Germany, daily consumption of chocolate (matched odds ratio [MOR]: 4.8; 95% confidence interval [CI]: 1.3-26.5), having shopped at a large chain of discount grocery stores (MOR: 4.2; CI: 1.2-23.0), and consumption of chocolate purchased there (MOR: 5.0; CI: 1.1-47.0) were associated with illness. Subsequently, two brands from the same company, one exclusively produced for that chain, tested positive for S. Oranienburg. In two other European countries and in Canada chocolate from company A was ascertained that also contained S. Oranienburg. Isolates from humans and from chocolates had indistinguishable PFGE profiles. No source or point of contamination was identified. Epidemiological identification of chocolate as a vehicle of infections required two months, and was facilitated by proxy measures.
CONCLUSIONS: Despite the use of improved production technologies, the chocolate industry continues to carry a small risk of manufacturing Salmonella-containing products. Particularly in diffuse outbreak-settings, clear associations with surrogates of exposure should suffice to trigger public health action. Networks such as Enter-net have become invaluable for facilitating rapid and appropriate management of international outbreaks.
Authors:
Dirk Werber; Johannes Dreesman; Fabian Feil; Ulrich van Treeck; Gerhard Fell; Steen Ethelberg; Anja M Hauri; Peter Roggentin; Rita Prager; Ian S T Fisher; Susanne C Behnke; Edda Bartelt; Ekkehard Weise; Andrea Ellis; Anja Siitonen; Yvonne Andersson; Helmut Tschäpe; Michael H Kramer; Andrea Ammon
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-02-03
Journal Detail:
Title:  BMC infectious diseases     Volume:  5     ISSN:  1471-2334     ISO Abbreviation:  BMC Infect. Dis.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-03-07     Completed Date:  2006-04-20     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  100968551     Medline TA:  BMC Infect Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  7     Citation Subset:  IM    
Affiliation:
Department of Infectious Disease Epidemiology, Robert Koch-Institut, Berlin, Germany. Dirk.Werber@nphs.wales.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cacao / microbiology*
Canada / epidemiology
Candy / microbiology*
Case-Control Studies
Child
Child, Preschool
Disease Outbreaks*
Electrophoresis, Gel, Pulsed-Field / methods
Europe / epidemiology
Female
Food Microbiology*
Germany / epidemiology
Humans
Infant
Male
Middle Aged
Risk Factors
Salmonella / genetics,  isolation & purification*
Salmonella Food Poisoning / epidemiology,  microbiology*
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