Details:

Alternative Title:
PLoS One
Personal Author:
Mody, Rajal K. ; Greene, Sharon A. ; Gaul, Linda ; Sever, Adrianne ; Pichette, Sarah ; ... More +
Mody, Rajal K. ; Greene, Sharon A. ; Gaul, Linda ; Sever, Adrianne ; Pichette, Sarah ; Zambrana, Ingrid ; Dang, Thi ; Gass, Angie ; Wood, René ; Herman, Karen ; Cantwell, Laura B. ; Falkenhorst, Gerhard ; Wannemuehler, Kathleen ; Hoekstra, Robert M. ; McCullum, Isaac ; Cone, Amy ; Franklin, Lou ; Austin, Jana ; Delea, Kristin ; Behravesh, Casey Barton ; Sodha, Samir V. ; Yee, J. Christopher ; Emanuel, Brian ; Al-Khaldi, Sufian F. ; Jefferson, Val ; Williams, Ian T. ; Griffin, Patricia M. ; Swerdlow, David L. Less -
Description:
Background

In May 2008, PulseNet detected a multistate outbreak of Salmonella enterica serotype Saintpaul infections. Initial investigations identified an epidemiologic association between illness and consumption of raw tomatoes, yet cases continued. In mid-June, we investigated two clusters of outbreak strain infections in Texas among patrons of Restaurant A and two establishments of Restaurant Chain B to determine the outbreak's source.

Methodology/Principal Findings

We conducted independent case-control studies of Restaurant A and B patrons. Patients were matched to well controls by meal date. We conducted restaurant environmental investigations and traced the origin of implicated products. Forty-seven case-patients and 40 controls were enrolled in the Restaurant A study. Thirty case-patients and 31 controls were enrolled in the Restaurant Chain B study. In both studies, illness was independently associated with only one menu item, fresh salsa (Restaurant A: matched odds ratio [mOR], 37; 95% confidence interval [CI], 7.2–386; Restaurant B: mOR, 13; 95% CI 1.3–infinity). The only ingredient in common between the two salsas was raw jalapeño peppers. Cultures of jalapeño peppers collected from an importer that supplied Restaurant Chain B and serrano peppers and irrigation water from a Mexican farm that supplied that importer with jalapeño and serrano peppers grew the outbreak strain.

Conclusions/Significance

Jalapeño peppers, contaminated before arrival at the restaurants and served in uncooked fresh salsas, were the source of these infections. Our investigations, critical in understanding the broader multistate outbreak, exemplify an effective approach to investigating large foodborne outbreaks. Additional measures are needed to reduce produce contamination.


Subject:
[+]
Adolescent
Adult
Aged
Capsicum
Case-Control Studies
Child
Child, Preschool
Disease Outbreaks
Female
Humans
Male
Medicine
Middle Aged
Research Article
Research Report
Restaurants
Salmonella Enterica
Salmonella Food Poisoning
Salmonella Infections
Serotyping
Young Adult

Source:
PLoS One. 6(2).
Document Type:
Journal Article
Place as Subject:
Texas
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:659cd51aeff687692a1f9a02fc02929236dc8baa5723b8d6a774a1a8c3f9061a
File Type:

Supporting Files

• 	pone.0016579.t001.gif	gif
  	pone.0016579.t001.jpg	jpeg
  	pone.0016579.t002.gif	gif
  	pone.0016579.t002.jpg	jpeg
  	license.txt	txt
  	pone.0016579.g001.gif	gif
  	pone.0016579.g001.jpg	jpeg
  	pone.0016579.g002.gif	gif
  	pone.0016579.g002.jpg	jpeg
  	pone.0016579.g003.gif	gif
  	pone.0016579.g003.jpg	jpeg
  	pone.0016579.nxml	txt

More +