Emergence of Salmonella enteritidis phage type 4 in the Caribbean: case-control study in Trinidad and Tobago, West Indies.
A prospective case-control study involving 46 case patients and 92 age- and neighborhood-matched control subjects was conducted in Trinidad and Tobago (T&T) between March 1998 and May 1999 to determine the etiology, sources, and risk factors for Salmonella enteritidis (SE) infection. SE infection in T&T was found to be associated with the consumption of shell eggs, and in particular raw or undercooked eggs. SE isolates from 30 (88%) of 34 patients and from 9 implicated egg or egg-containing food samples were phage type 4. Homemade eggnog and ice cream, cake batter, and egg-containing beverages were the main raw egg-containing foods, reflecting the cultural practices of the people of T&T. Public health education on the risks of eating raw or undercooked eggs, thorough cooking of all egg dishes, and refrigeration of shell eggs and egg dishes; studies tracing infected eggs to their sources; and testing of flocks of layer chickens for SE are needed to reduce the incidence of this infection.
Caribbean Epidemiology Centre, Pan American Health Organization/World Health Organization, Port of Spain, Trinidad and Tobago, West Indies. north@carib-link.net
L
L
Indar-Harrinauth
N
N
Daniels
P
P
Prabhakar
C
C
Brown
G
G
Baccus-Taylor
E
E
Comissiong
J
J
Hospedales
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004531:Eggs; D005260:Female; D005502:Food; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D012477:Salmonella enteritidis / Q000145:classification / Q000302:isolation & purification*; D014300:Trinidad and Tobago / Q000453:epidemiology