title: Public health investigations of Salmonella Enteritidis in catering raw shell eggs, 2002-2004.
abstract: OBJECTIVE
  In response to a dramatic change in the epidemiology of Salmonella Enteritidis in England and Wales thought to be associated with raw shell eggs, the Health Protection Agency initiated public health investigations to establish the incidence of Salmonella contamination and origin of eggs used by catering premises implicated in outbreaks of Salm. Enteritidis.
  
  
  RESULTS
  Between October 2002 and November 2004, 16 971 eggs were sampled and Salmonella were recovered from 3.4%. Salmonella was isolated from 5.5% and 6.3% of Spanish and eggs of unknown origin, respectively, used in catering premises linked to outbreaks, a level significantly higher than that (1.1%) found in nonLion Quality UK eggs sampled. The small sample of UK Lion Quality eggs tested (reflecting their lack of use in premises visited) did not contain Salmonella. Several phage types of Salm. Enteritidis other than phage type 4 (PT 4) were identified with nonUK eggs.
  
  
  CONCLUSIONS
  Eggs from Spain were implicated as a major source of infection. Eggs were contaminated more frequently with Salmonella when shells were dirty and/or cracked, and stored at above 8 degrees C.
  
  
  CONCLUSIONS
  The use of Spanish eggs by the catering sector has been identified as a consistent significant factor in many of the outbreaks caused by Salm. Enteritidis nonPT4 in England and Wales during 2002-2004. Advice to caterers and hospitals that raw shell eggs should not be used in food that will either not be cooked or only lightly cooked should be reinforced.
authors.affiliation: Department of Gastrointestinal Infections, Health Protection Agency Centre for Infections, London, UK. christine.little@hpa.org.uk
authors.forename: C L
authors.initials: CL
authors.lastname: Little
authors.forename: S
authors.initials: S
authors.lastname: Surman-Lee
authors.forename: M
authors.initials: M
authors.lastname: Greenwood
authors.forename: F J
authors.initials: FJ
authors.lastname: Bolton
authors.forename: R
authors.initials: R
authors.lastname: Elson
authors.forename: R T
authors.initials: RT
authors.lastname: Mitchell
authors.forename: G N
authors.initials: GN
authors.lastname: Nichols
authors.forename: S K
authors.initials: SK
authors.lastname: Sagoo
authors.forename: E J
authors.initials: EJ
authors.lastname: Threlfall
authors.forename: L R
authors.initials: LR
authors.lastname: Ward
authors.forename: I A
authors.initials: IA
authors.lastname: Gillespie
authors.forename: S
authors.initials: S
authors.lastname: O'Brien
mesh_terms: D000818:Animals; D004196:Disease Outbreaks; D004528:Egg Shell / Q000382:microbiology*; D004739:England / Q000453:epidemiology; D005523:Food Supply; D006801:Humans; D011634:Public Health; D012480:Salmonella Infections / Q000453:epidemiology*; D012477:Salmonella enteritidis / Q000302:isolation & purification*; D013030:Spain