title: A foodborne outbreak of enterotoxigenic E. coli and Salmonella Anatum infection after a high-school dinner in Denmark, November 2006.
abstract: 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.
authors.affiliation: Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Pakalniskiene
authors.forename: G
authors.initials: G
authors.lastname: Falkenhorst
authors.forename: M
authors.initials: M
authors.lastname: Lisby
authors.forename: S B
authors.initials: SB
authors.lastname: Madsen
authors.forename: K E P
authors.initials: KE
authors.lastname: Olsen
authors.forename: E M
authors.initials: EM
authors.lastname: Nielsen
authors.forename: A
authors.initials: A
authors.lastname: Mygh
authors.forename: J
authors.initials: J
authors.lastname: Boel
authors.forename: K
authors.initials: K
authors.lastname: Mølbak
mesh_terms: 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