TY - JOUR
T1 - Foodborne disease in our global village
T2 - A multinational investigation of an outbreak of Salmonella serotype enteritidis phage type 4 infection in Puerto Vallarta, Mexico
AU - Shane, A. L.
AU - Roels, T. H.
AU - Goldoft, M.
AU - Herikstad, H.
AU - Hedberg, C.
AU - Angulo, F. J.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2002
Y1 - 2002
N2 - Objectives: In late 1996, a multinational investigation was launched following an outbreak of diarrheal illness that caused the disruption of an international scientific conference at a first-class hotel in Puerto Vallarta, Mexico. Methods: A questionnaire was mailed to all American and to selected international attendees. Additional copies of the questionnaire were provided for any family members who may have attended the conference. A case was defined as an illness with three or more loose stools during a 24-h period in a conference attendee or accompanying family member, with illness lasting 2 or more days and onset between 6 and 9 November 1996. Results: Questionnaires were returned by 81% (232/288) of American attendees, 47% (18/38) of selected international attendees, and 25 family members; 30% (83/275) of respondents met the case definition. Ill persons resided in at least seven countries. Salmonella serotype Enteritidis phage type 4 was isolated from stool specimens from patients residing in Canada, the UK, and the USA. Attending a hotel banquet on 6 November was associated with illness; 42% (82/194) of banquet attendees became ill versus 3% (1/37) of non-attendees (relative risk (RR)=15.6, 95% confidence interval (CI) =2.3-108.9). The only banquet food item associated with illness was chili rellenos; 53% (58/109) of persons who ate chili rellenos were ill versus 22% (12/55) of those who did not (RR=2.4, 95% CI=1.4-4.1). Chili rellenos ingredients included shelled eggs and cheese; Salmonella was isolated from the leftover cheese but the isolate was not serotyped. Conclusions: Salmonella may be a cause of traveler's diarrhea and can result in outbreaks even among travelers who follow routine precautions (i.e. staying in a first-class hotel and eating hot foods). International collaboration in investigating similar outbreaks, including sharing subtyping results, will be necessary for long-term prevention. Global Salm-Surv, an international network of Salmonella reference laboratories coordinated by the World Health Organization, may facilitate such collaboration.
AB - Objectives: In late 1996, a multinational investigation was launched following an outbreak of diarrheal illness that caused the disruption of an international scientific conference at a first-class hotel in Puerto Vallarta, Mexico. Methods: A questionnaire was mailed to all American and to selected international attendees. Additional copies of the questionnaire were provided for any family members who may have attended the conference. A case was defined as an illness with three or more loose stools during a 24-h period in a conference attendee or accompanying family member, with illness lasting 2 or more days and onset between 6 and 9 November 1996. Results: Questionnaires were returned by 81% (232/288) of American attendees, 47% (18/38) of selected international attendees, and 25 family members; 30% (83/275) of respondents met the case definition. Ill persons resided in at least seven countries. Salmonella serotype Enteritidis phage type 4 was isolated from stool specimens from patients residing in Canada, the UK, and the USA. Attending a hotel banquet on 6 November was associated with illness; 42% (82/194) of banquet attendees became ill versus 3% (1/37) of non-attendees (relative risk (RR)=15.6, 95% confidence interval (CI) =2.3-108.9). The only banquet food item associated with illness was chili rellenos; 53% (58/109) of persons who ate chili rellenos were ill versus 22% (12/55) of those who did not (RR=2.4, 95% CI=1.4-4.1). Chili rellenos ingredients included shelled eggs and cheese; Salmonella was isolated from the leftover cheese but the isolate was not serotyped. Conclusions: Salmonella may be a cause of traveler's diarrhea and can result in outbreaks even among travelers who follow routine precautions (i.e. staying in a first-class hotel and eating hot foods). International collaboration in investigating similar outbreaks, including sharing subtyping results, will be necessary for long-term prevention. Global Salm-Surv, an international network of Salmonella reference laboratories coordinated by the World Health Organization, may facilitate such collaboration.
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U2 - 10.1016/S1201-9712(02)90068-8
DO - 10.1016/S1201-9712(02)90068-8
M3 - Article
C2 - 12121595
AN - SCOPUS:0036074967
SN - 1201-9712
VL - 6
SP - 98
EP - 102
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
IS - 2
ER -