RESUMO
On 15 August 2012, an increase in the number of Salmonella Thompson cases was noticed by the Salmonella surveillance in the Netherlands. A casecontrol study was performed, followed by a food investigation. In total 1,149 cases were laboratory-confirmed between August and December 2012 of which four elderly (7691 years) were reported to have died due to the infection. The cause of the outbreak was smoked salmon processed at a single site. The smoked salmon had been continuously contaminated in the processing lines through reusable dishes, which turned out to be porous and had become loaded with bacteria. This is the largest outbreak of salmonellosis ever recorded in the Netherlands. The temporary closure of the processing site and recall of the smoked salmon stopped the outbreak. An estimated four to six million Dutch residents were possibly exposed to the contaminated smoked salmon and an estimated 23,000 persons would have had acute gastroenteritis with S. Thompson during this outbreak. This outbreak showed that close collaboration between diagnostic laboratories, regional public health services, the national institute for public health and the food safety authorities is essential in outbreak investigations.
Assuntos
Surtos de Doenças , Produtos Pesqueiros/microbiologia , Salmão/microbiologia , Intoxicação Alimentar por Salmonella/mortalidade , Infecções por Salmonella/mortalidade , Salmonella enterica/isolamento & purificação , Idoso , Idoso de 80 Anos ou mais , Animais , Estudos de Casos e Controles , Diarreia/epidemiologia , Produtos Pesqueiros/análise , Manipulação de Alimentos/métodos , Gastroenterite/epidemiologia , Humanos , Masculino , Países Baixos/epidemiologia , Vigilância da População , Intoxicação Alimentar por Salmonella/diagnóstico , Intoxicação Alimentar por Salmonella/microbiologia , Infecções por Salmonella/diagnóstico , Infecções por Salmonella/microbiologia , Salmonella enterica/classificação , Inquéritos e QuestionáriosRESUMO
As a major foodborne pathogen, Campylobacter jejuni receives much attention in quantitative risk assessment. To date, all dose-response assessments have been based on a single human feeding study which unfortunately provides incomplete and possibly biased information on the dose-response relation. An incident at a dairy farm, where several children from a school class became ill as a result of drinking raw milk contaminated with C. jejuni, appeared to show a very clear dose-response relation between the amount of milk consumed and the attack rate. This relation was very nearly exponentially shaped and, therefore, seemed to conflict with the rather slowly rising dose-response relation established in the feeding study. Here we show that both datasets can be reconciled when illness and infection are considered separately. This not only provides new information on the illness dose-response relation for Campylobacter, but also amends the infection dose-response relation because of their conditional dependence.
