Document Detail

Salmonella enterica outbreak in a banqueting hall in Jerusalem: the unseen hand of the epidemiological triangle?
MedLine Citation:
PMID:  19432037     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Foodborne Salmonella enterica outbreaks constitute both a threat to public health and an economic burden worldwide. OBJECTIVES: To characterize the pathogen(s) involved and possible source of infection of an outbreak of acute gastroenteritis in a banqueting hall in Jerusalem. METHODS: We conducted interviews of guests and employees of the banqueting hall, and analyzed food items, samples from work surfaces and stool cultures. RESULTS: Of 770 persons participating in three events on 3 consecutive days at a single banqueting hall, 124 were interviewed and 75 reported symptoms. Salmonella enterica, serovar Enteritidis, phage type C-8, was isolated from 10 stool cultures (eight guests, one symptomatic employee and one asymptomatic employee) and a sample of a mayonnaise-based egg salad. Pulsed-field gel electrophoresis of the isolates revealed an identical pattern in the outbreak isolates, different from SE C-8 controls. A culture-positive asymptomatic employee was linked to all three events. After a closure order, allowing for cleaning of the banqueting hall, revision of food preparation procedures and staff instruction on hygiene, the banqueting hall was reopened with no subsequent outbreaks. CONCLUSIONS: It is often difficult to pinpoint the source of infection in S. enterica outbreaks. Using molecular subtyping methods, a link was confirmed between patients, a food handler (presumably a carrier) and a food item--all showing an identical specific Salmonella enterica serovar Enteritidis. Testing asymptomatic as well as symptomatic food handlers in outbreak investigations is imperative. Pre- and post-hiring screening might be considered as preventive measures; hygiene and sanitation education are essential.
Chen Stein-Zamir; Esther Tallen-Gozani; Nitza Abramson; Hanna Shoob; Ruth Yishai; Vered Agmon; Avi Reisfeld; Lea Valinsky; Esther Marva
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  11     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-05-12     Completed Date:  2009-05-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  94-7     Citation Subset:  IM    
Jerusalem District Health Office, Jerusalem, Ministry of Health, Israel.
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MeSH Terms
Child, Preschool
Cohort Studies
Disease Outbreaks*
Food Contamination / prevention & control
Food Handling
Food Services
Gastroenteritis / microbiology*
Middle Aged
Salmonella Food Poisoning / diagnosis*,  epidemiology*,  prevention & control
Salmonella enterica*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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