title: Four linked outbreaks of Salmonella enteritidis phage type 4 infection--the continuing egg threat.
abstract: Four outbreaks of Salmonella enteritidis phage type (PT) 4 occurred among guests at functions for which a single commercial caterer supplied food. Retrospective cohort studies were used to describe the epidemiology of three of these outbreaks and identify the vehicle(s) responsible. Of 172 guests at these three events, 47 fitted the clinical case definition for illness and 24 cases were confirmed to have S. enteritidis PT4 infection. Food containing raw egg was identified epidemiologically as the likely vehicle of infection in two of the three outbreaks (odds ratios (OR) and 95% confidence intervals 9.1 (2.2-39.9) and 6.9 (1.2-46.4)). Logistic regression analysis yielded OR = 10.7 (p = 0.0022) and OR = 9.3 (p = 0.015) for egg consumption in two of the outbreaks. These outbreaks highlighted the continuing need to remind the public and commercial caterers of the potential high risks of contracting salmonella from shell eggs. Education of caterers includes advice to obtain eggs and other products from reputable and identifiable suppliers.
authors.affiliation: Department of Public Health Medicine, Dudley Health Authority. toyin.ejidokun@bull.dudley-ha.wmids.nhs.uk
authors.forename: O O
authors.initials: OO
authors.lastname: Ejidokun
authors.forename: D
authors.initials: D
authors.lastname: Killalea
authors.forename: M
authors.initials: M
authors.lastname: Cooper
authors.forename: S
authors.initials: S
authors.lastname: Holmyard
authors.forename: A
authors.initials: A
authors.lastname: Cross
authors.forename: C
authors.initials: C
authors.lastname: Kemp
mesh_terms: D016001:Confidence Intervals; D004196:Disease Outbreaks; D004531:Eggs / Q000009:adverse effects / Q000382:microbiology*; D005260:Female; D005511:Food Handling; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D017053:Infection Control; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000209:etiology*; D012477:Salmonella enteritidis / Q000145:classification* / Q000302:isolation & purification; D006113:United Kingdom / Q000453:epidemiology