title: A beef-associated outbreak of Salmonella Typhimurium DT104 in The Netherlands with implications for national and international policy.
abstract: A ten-fold increase in Salmonella Typhimurium DT104 cases in The Netherlands during September-November 2005 prompted an outbreak investigation. A population-based matched case-control study included 56 cases and 100 controls. Risk factors for infection were consumption of a pre-processed raw beef product (odds ratio 4.2, 95% confidence interval 1.5-12.0) and of food from mobile caterers (odds ratio 4.9, 95% confidence interval 1.1-22.1). Bacterial molecular typing established a link with another DT104 outbreak in Denmark caused by beef from a third European country. The incriminated beef was traced in The Netherlands and sampling yielded DT104 of the outbreak-associated molecular type. We concluded that this outbreak was caused by imported contaminated beef. Consumers should be informed about presence of raw meat in pre-processed food products. Optimal utilization of international networks and testing and traceability of foodstuffs has the potential to prevent foodborne infections.
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. marten.kivi@rivm.nl
authors.forename: M
authors.initials: M
authors.lastname: Kivi
authors.forename: A
authors.initials: A
authors.lastname: Hofhuis
authors.forename: D W
authors.initials: DW
authors.lastname: Notermans
authors.forename: W J B
authors.initials: WJ
authors.lastname: Wannet
authors.forename: M E O C
authors.initials: ME
authors.lastname: Heck
authors.forename: A W
authors.initials: AW
authors.lastname: Van De Giessen
authors.forename: Y T H P
authors.initials: YT
authors.lastname: Van Duynhoven
authors.forename: O F J
authors.initials: OF
authors.lastname: Stenvers
authors.forename: A
authors.initials: A
authors.lastname: Bosman
authors.forename: W
authors.initials: W
authors.lastname: Van Pelt
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D005516:Food Microbiology; D006291:Health Policy; D006801:Humans; D007223:Infant; D007391:International Cooperation; D008297:Male; D008460:Meat / Q000382:microbiology*; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012480:Salmonella Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D012486:Salmonella typhimurium / Q000145:classification* / Q000302:isolation & purification