Document Detail

A large, multiple-restaurant outbreak of infection with Shigella flexneri serotype 2a traced to tomatoes.
MedLine Citation:
PMID:  16355324     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Foodborne outbreaks of Shigella infection are uncommon and tomatoes are an unusual vehicle. We describe a large, multiple-restaurant outbreak of Shigella flexneri serotype 2a infection that was associated with tomatoes. METHODS: We conducted nationwide surveillance and a case-control study, collected fecal specimens for culture, and measured the survival of the outbreak strain of S. flexneri in tomatoes. RESULTS: We interviewed 306 of 886 ill restaurant patrons and 167 control subjects. Matched univariate analysis showed that several food items were associated with illness, but only tomatoes remained significant in multivariate models. Illness peaked at each restaurant within 24 h after the arrival of hand-sorted bruised and overripe tomatoes from a new distributor; all patient isolates that were tested were indistinguishable by PFGE. Sliced tomatoes from the distributor were inoculated with the outbreak strain, and viable S. flexneri were recovered for 72 h. CONCLUSION: To prevent such outbreaks, persons with shigellosis should be excluded from handling food at all points along the distribution chain.
Megan E Reller; Jennifer M Nelson; Kåre Mølbak; David M Ackman; Dianna J Schoonmaker-Bopp; Timothy P Root; Eric D Mintz
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.     Date:  2005-12-13
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  42     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-15     Completed Date:  2006-07-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  163-9     Citation Subset:  IM    
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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MeSH Terms
Case-Control Studies
Disease Outbreaks*
Dysentery, Bacillary / epidemiology*,  microbiology*
Food Microbiology*
Lycopersicon esculentum / microbiology*
Middle Aged
New York / epidemiology
Population Surveillance
Shigella flexneri / classification,  isolation & purification*

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

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