title: An outbreak of Salmonella mikawasima associated with doner kebabs.
abstract: During October 1992 an increase in the number of isolates of Salmonella mikawasima, a rare serotype, was noted including a cluster of nine cases in the South West Thames region. A case control study was conducted and univariate analysis showed a statistical association between illness and eating at take-away A for cases compared with household controls (P = 0.003) and with neighbourhood controls (P = 0.0245). Cases were also more likely to have eaten kebabs than were controls or average take-away A customers, implicating doner kebabs as the most likely vehicle of infection. Plasmid profile analysis of the nine cases' isolates showed them to be indistinguishable and to be characterized by a single plasmid of approximately 60 MDa. The original source of the Salmonella mikawasima contamination was not determined, but food preparation practices for kebabs at take-away A were insufficient to protect against illness if contaminated. This outbreak was only recognized because of the unusual serotype, but could be an indication of a more widespread problem with doner kebabs.
authors.affiliation: PHLS Communicable Disease Surveillance Centre, London.
authors.forename: M
authors.initials: M
authors.lastname: Synnott
authors.forename: D L
authors.initials: DL
authors.lastname: Morse
authors.forename: H
authors.initials: H
authors.lastname: Maguire
authors.forename: F
authors.initials: F
authors.lastname: Majid
authors.forename: M
authors.initials: M
authors.lastname: Plummer
authors.forename: M
authors.initials: M
authors.lastname: Leicester
authors.forename: E J
authors.initials: EJ
authors.lastname: Threlfall
authors.forename: J
authors.initials: J
authors.lastname: Cowden
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D016022:Case-Control Studies; D004196:Disease Outbreaks; D004739:England; D005260:Female; D005511:Food Handling; D005516:Food Microbiology; D006801:Humans; D008297:Male; D008460:Meat / Q000382:microbiology*; D012147:Restaurants; D012475:Salmonella / Q000145:classification / Q000302:isolation & purification; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000382:microbiology; D012756:Sheep