International outbreak of Salmonella Oranienburg due to German chocolate -: art. no. 7
International outbreak of Salmonella Oranienburg due to German chocolate -: art. no. 7
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DOI：
10.1186/1471-2334-5-7
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发表时间：
2005-02-03
影响因子：
3.7
通讯作者：
Ammon, A
中科院分区：
文献类型：
--
作者：
Werber, D;Dreesman, J;Ammon, A
背景资料：这份报告描述了一个大的国际巧克力相关沙门氏菌爆发起源于德国。方法：我们进行了流行病学调查，包括病例对照研究，和食品安全调查。沙门氏菌（S.）结果：从2001年10月1日至2002年3月24日，估计有439个S。Oranienburg通知是在德国登记的。同时，S.在肠网监测网络中，在其他欧洲国家也发现了Oranienburg感染。在德国的一项多州配对病例对照研究中，（匹配优势比[莫尔]：4.8; 95%置信区间[CI]：1.3 - 26.5），在大型连锁折扣杂货店购物（莫尔：4.2;可信区间：1.2 - 23.0）和食用在那里购买的巧克力（莫尔：5.0;可信区间：1.1 - 47.0）与疾病有关。随后，来自同一家公司的两个品牌，一个专门为该连锁店生产，检测出S阳性。奥拉宁堡在另外两个欧洲国家和加拿大，A公司的巧克力也被证实含有S。奥拉宁堡来自人类和巧克力的分离株具有不可区分的PFGE谱。没有发现污染源或污染点。流行病学鉴定的巧克力作为车辆的感染需要两个月的时间，并促进代理measurement.Conclusions：尽管使用改进的生产技术，巧克力行业继续进行生产含沙门氏菌的产品的小风险。特别是在扩散性暴发的情况下，与接触替代物的明确联系应足以引发公共卫生行动。Enter-net等网络对于促进迅速和适当地管理国际疾病暴发已变得非常宝贵。
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.