A foodborne outbreak of enterotoxigenic E. coli and Salmonella Anatum infection after a high-school dinner in Denmark, November 2006.
In industrialized countries enterotoxigenic Escherichia coli (ETEC) is mainly diagnosed as a cause of travellers' diarrhoea, but it is also known to cause foodborne outbreaks. We report an outbreak of acute gastroenteritis caused by ETEC serotypes O92:H- and O153:H2 as well as Salmonella Anatum, which affected around 200 students and teachers after a high-school dinner in Greater Copenhagen, Denmark, November 2006. A retrospective cohort study showed that consumption of pasta salad with pesto was associated with an increased risk of illness (attack rate 59.4%; risk ratio 2.6, 95% confidence interval 1.2-5.7). Imported fresh basil used for preparation of the pesto was the most likely source of contamination. Although ETEC is associated with travellers' diarrhoea in Denmark, this outbreak suggests that a proportion of sporadic ETEC infections might be caused by contaminated imported foodstuffs. To improve food safety further, it is important to target this poorly regulated and researched area.
Pakalniskiene
J
J
Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
Falkenhorst
G
G
Lisby
M
M
Madsen
S B
SB
Olsen
K E P
KE
Nielsen
E M
EM
Mygh
A
A
Boel
J
J
Mølbak
K
K
D000293:Adolescent; D000328:Adult; D003718:Denmark / Q000453:epidemiology; D004196:Disease Outbreaks; D054307:Enterotoxigenic Escherichia coli / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000453:epidemiology*; D005260:Female; D005506:Food Contamination; D005511:Food Handling; D005516:Food Microbiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D018649:Ocimum basilicum / Q000382:microbiology*; D012189:Retrospective Studies; D012478:Salmonella Food Poisoning / Q000453:epidemiology; D012574:Schools; D011795:Surveys and Questionnaires