title: Raw eggs--lessons learned from an outbreak of Salmonella serotype enteritidis infections associated with meringue pie.
abstract: OBJECTIVE
  We investigated a salmonellosis outbreak related to a cafeteria to determine its extent and to identify illness risk factors.
  
  
  METHODS
  A case was defined as isolation of Salmonella Group D or serotype Enteritidis from the stool of a person who ate at the cafeteria during June 22-July 10, 2003, and developed diarrhea in 3 days or less. Food histories of case patients (n = 11) were compared with those of their well meal companions (n = 16).
  
  
  RESULTS
  Consumption of coconut meringue pie was associated with illness (odds ratio = 150.0; 95% confidence interval = 6.4-6901.4). Meringue was made with raw shell eggs and was baked to an internal temperature of 83 degrees F.
  
  
  CONCLUSIONS
  Restaurant operators and public health officials should be alert for recipes containing raw shell eggs. Food service operators should use pasteurized egg products in meringue recipes if meringue will not be cooked to the required temperature of 155 degrees F. For clarification purposes, policy makers should consider adding "meringue" to the Food Safety Rule that lists foods in which pasteurized eggs should be substituted for raw shell eggs.
authors.affiliation: Epidemic Intelligence Service Officer, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. JMAZUREK@gw.odh.state.oh.us
authors.forename: Jacek
authors.initials: J
authors.lastname: Mazurek
authors.forename: Lawrence
authors.initials: L
authors.lastname: Holbert
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Parrish
authors.forename: Ellen
authors.initials: E
authors.lastname: Salehi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015373:Bacterial Typing Techniques; D016022:Case-Control Studies; D004196:Disease Outbreaks / Q000517:prevention & control; D004531:Eggs / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D012147:Restaurants; D012307:Risk Factors; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000517:prevention & control; D012477:Salmonella enteritidis / Q000302:isolation & purification*; D014903:West Virginia / Q000453:epidemiology