An institutional outbreak of Salmonella enteritidis in Singapore.

ABSTRACT

A large outbreak of food poisoning occurred in Singapore in March 1995 when a total of 188 inmates in an institution was taken ill. Salmonella enteritidis was isolated from the stool cultures of 35 inmates (16 symptomatic and 19 asymptomatic). All the isolates were of the serotype profile 01, 9, 12 and Hg, m (antigen phase I); all were sensitive to ampicillin, ceftriaxone, chloramphenicol, co-trimoxazole and ciprofloxacin. Plasmid profile analysis and restriction enzyme fragmentation patterns (REFPs), as generated with EcoRI and HindIII, of a 60 kb plasmid obtained from these isolates were all identical, confirming that the outbreak resulted from a single source of infection. Stratified statistical analysis of food-specific attack rates strongly implicated imported canned luncheon pork consumed by the inmates on 26 March 95 as the single most probable cause of the food poisoning [p < 10(6), Mantel-Haenszel weighted odds ratio (OR) = 14.33; 95% confidence interval (CI) = 6.20-33.15]. The median incubation period of this outbreak was 19.3 hours and the median duration of illness was three days. The outbreak was rapidly brought under control through prompt implementation of epidemic control measures which comprised active search for diarrheal cases, rectal swabbing of asymptomatic inmates, isolation of those found to be infected, and maintenance of a high standard of personal, food and environmental hygiene.