title: Dose-response effects in an outbreak of Salmonella enteritidis.
abstract: The effects of ingested Salmonella enteritidis (SE) dose on incubation period and on the severity and duration of illness were estimated in a cohort of 169 persons who developed gastroenteritis after eating hollandaise sauce made from grade-A shell eggs. The cohort was divided into three groups based on self-reported dose of sauce ingested. As dose increased, median incubation period decreased (37 h in the low exposure group v. 21 h in the medium exposure group v. 17.5 h in the high exposure group, P = 0.006) and greater proportions reported body aches (71 v. 85 v. 94%, P = 0.0009) and vomiting (21 v. 56 v. 57%, P = 0.002). Among 118 case-persons who completed a follow-up questionnaire, increased dose was associated with increases in median weight loss in kilograms (3.2 v. 4.5 v. 5.0, P = 0.0001), maximum daily number of stools (12.5 v. 15.0 v. 20.0, P = 0.02), subjective rating of illness severity (P = 0.0007), and the number of days of confinement to bed (3.0 v. 6.5 v. 6.5, P = 0.04). In this outbreak, ingested dose was an important determinant of the incubation period, symptoms and severity of acute salmonellosis.
authors.affiliation: Division of Field Epidemiology, Centers for Disease Control and Prevention, Atlanta, Georgia 30333.
authors.forename: E D
authors.initials: ED
authors.lastname: Mintz
authors.forename: M L
authors.initials: ML
authors.lastname: Cartter
authors.forename: J L
authors.initials: JL
authors.lastname: Hadler
authors.forename: J T
authors.initials: JT
authors.lastname: Wassell
authors.forename: J A
authors.initials: JA
authors.lastname: Zingeser
authors.forename: R V
authors.initials: RV
authors.lastname: Tauxe
mesh_terms: D000328:Adult; D000818:Animals; D001434:Bacteriophage Typing; D002645:Chickens; D015331:Cohort Studies; D004196:Disease Outbreaks; D004435:Eating; D004531:Eggs / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005500:Follow-Up Studies; D005511:Food Handling; D005516:Food Microbiology; D005759:Gastroenteritis / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008875:Middle Aged; D012478:Salmonella Food Poisoning / Q000453:epidemiology / Q000382:microbiology*; D012477:Salmonella enteritidis / Q000145:classification / Q000254:growth & development / Q000302:isolation & purification; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D015431:Weight Loss