Outbreak of Salmonella infantis gastroenteritis among people who had eaten at a hash house in southern Italy

• Published in: Public health (London) Vol. 128; no. 5; pp. 438 - 443
• Main Authors: Chironna, M, Tafuri, S, Gallone, M.S, Sallustio, A, Martinelli, D, Prato, R, Germinario, C
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-05-2014
• Subjects: Acute Disease; Adolescent; Adult; Anti-Bacterial Agents - therapeutic use; Case-Control Studies; Case–control study; Child; Disease Notification; Disease Outbreaks; Feces - microbiology; Female; Food Analysis - statistics & numerical data; Food Handling - standards; Food safety; Gastroenteritis - drug therapy; Gastroenteritis - epidemiology; Gastroenteritis - etiology; Humans; Infectious Disease; Internal Medicine; Italy - epidemiology; Male; Microbial Sensitivity Tests; Middle Aged; Molecular characterization; Multivariate Analysis; Odds Ratio; Outbreak; Polymerase Chain Reaction; Population Surveillance; Restaurants; Salmonella; Salmonella enterica - isolation & purification; Salmonella Food Poisoning - drug therapy; Salmonella Food Poisoning - epidemiology; Salmonella Food Poisoning - etiology; Salmonella infantis; Surveys and Questionnaires; Young Adult; Italy; Food safety; Outbreak; Molecular characterization; Salmonella infantis; Case–control study
• ISSN: 0033-3506; 1476-5616
• DOI: 10.1016/j.puhe.2014.02.002

Abstract Objectives To describe an outbreak of acute gastroenteritis in people who had eaten at a hash house in southern Italy. Study design Case–control study. Methods A clinical case of gastroenteritis was defined as a person who had eaten at the hash house from 29 August to 4 September 2011 and who experienced defined gastrointestinal symptoms within 72 hours, or a person with a laboratory-confirmed salmonella infection without symptoms. A convenience sample was enrolled as the control group. Environmental and human samples were collected, and Salmonella infantis was identified by polymerase chain reaction. Univariate analysis was performed for each food type, and multivariate analysis was performed for each food type and demographic variable (gender, age). Results Twenty-three cases of gastroenteritis were notified between 1 and 4 September 2011, two of which were admitted to the local hospital. Multivariate analysis showed that porchetta [odds ratio (OR) 22.0, 95% confidence interval (CI) 3.2–152.6, z  = 3.13, P  = 0.002] and roasted meat (OR 14.4, 95% CI 1.7–122.0, z  = 2.45, P  = 0.014) were associated with gastrointestinal symptoms. Environmental and human isolates exhibited the same sequence type (ST 32). Conclusions This experience highlighted that, in the control of a foodborne outbreak, integrated epidemiological and laboratory surveillance enables rapid identification of the source of infection, thus reducing the risk of an epidemic.