title: An outbreak of Salmonella München in Germany associated with raw pork meat.
abstract: In summer 2001, an outbreak of Salmonella München occurred in Germany. We conducted descriptive epidemiology and hypothesis-generating interviews among case patients, two retrospective cohort studies, and a case-control study of suboutbreaks. We performed pulsed-field gel electrophoresis (PFGE) from selected patient isolates and a limited trace-back investigation for analytical purposes. Four states were consecutively affected: Saxonia (SX), Brandenburg (BB), Berlin (BE), and Baden-Württemberg (BW). Although hypothesis-generating interviews failed to identify a plausible food item, descriptive data and investigations of the suboutbreaks suggested pork meat as a probable source in three states (SX, BB, and BE) but not in BW. The PFGE profiles from isolates of case patients in the first three states were indistinguishable but differed from PFGE profiles of case patients in BW. Trace-back investigation suggested that contamination of pork meat occurred early in the rearing-production chain. This outbreak demonstrates how contamination early in the production process that can yield different end products may complicate multistate outbreaks. Investigation of suboutbreaks and use of the trace-back method as investigational tools may be useful adjuncts in solving the problem of multistate outbreaks.
authors.affiliation: Department for Infectious Disease Epidemiology, Robert Koch-Institute, Seestrasse 10, 13353 Berlin, Germany. buchholzu@who.int
authors.forename: U
authors.initials: U
authors.lastname: Buchholz
authors.forename: B
authors.initials: B
authors.lastname: Brodhun
authors.forename: S O
authors.initials: SO
authors.lastname: Brockmann
authors.forename: C M
authors.initials: CM
authors.lastname: Dreweck
authors.forename: R
authors.initials: R
authors.lastname: Prager
authors.forename: H
authors.initials: H
authors.lastname: Tschäpe
authors.forename: A
authors.initials: A
authors.lastname: Ammon
mesh_terms: D017677:Age Distribution; D000818:Animals; D016022:Case-Control Studies; D015331:Cohort Studies; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005506:Food Contamination / Q000032:analysis* / Q000517:prevention & control; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008460:Meat / Q000382:microbiology*; D008875:Middle Aged; D012189:Retrospective Studies; D012475:Salmonella / Q000145:classification / Q000302:isolation & purification*; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000209:etiology*; D017678:Sex Distribution; D013552:Swine