title: Seasonality in human salmonellosis: assessment of human activities and chicken contamination as driving factors.
abstract: This study used integrated surveillance data to assess the seasonality in retail chicken contamination and of human activities and their role on the seasonality of human endemic salmonellosis. From June 2005 to May 2008, reported cases of salmonellosis were followed-up comprehensively using a standardized questionnaire, and 616 retail chicken breasts were systematically tested for Salmonella, in one Canadian community. Poisson regression was used to model seasonality of human cases, Salmonella in retail chicken, and to assess the relationship between these and selected meteorological variables. The case-case approach was used to compare the activities of salmonellosis cases that occurred during the summer peak to the other cases. There were 216 human endemic salmonellosis cases (incidence rate: 14.7 cases/100,000 person-years), predominantly of Typhimurium and Enteritidis serotypes (28.4% and 20.8%, respectively). The monthly distribution of cases was associated with ambient temperature (p < 0.001) with a significant seasonal peak in June (p = 0.03) and July (p = 0.0005), but it was not associated with precipitation (p = 0.38). Several activities reported by cases tended to be more frequent during summer. Particularly, attending a barbeque and gardening within the 3 days before the disease onset were two significant risk factors for salmonellosis in June or July compared with the salmonellosis cases that occurred in the other months. Out of all chicken samples, 185 (30%) tested positive for Salmonella spp., Kentucky being the dominant serotype (44.3% of positive samples). The monthly proportion of positive chicken samples showed no seasonal variations (p = 0.30) and was not associated with the monthly count of human cases (p = 0.99). In conclusion, even though evidence generally supports chicken as a primary vehicle of Salmonella to humans, the contamination of retail chicken was not driving the seasonality in human salmonellosis. Attending a barbeque or gardening during the hotter months of the year should be further assessed for their risk.
authors.affiliation: Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Saint-Hyacinthe, QC, Canada. andre_ravel@phac-aspc.gc.ca
authors.forename: André
authors.initials: A
authors.lastname: Ravel
authors.forename: E
authors.initials: E
authors.lastname: Smolina
authors.forename: Jan M
authors.initials: JM
authors.lastname: Sargeant
authors.forename: Angela
authors.initials: A
authors.lastname: Cook
authors.forename: Barbara
authors.initials: B
authors.lastname: Marshall
authors.forename: Manon D
authors.initials: MD
authors.lastname: Fleury
authors.forename: Frank
authors.initials: F
authors.lastname: Pollari
mesh_terms: D000818:Animals; D002170:Canada / Q000453:epidemiology; D002645:Chickens / Q000382:microbiology*; D003710:Demography; D019353:Endemic Diseases / Q000706:statistics & numerical data*; D005243:Feces / Q000382:microbiology; D005516:Food Microbiology; D006358:Hot Temperature; D006801:Humans; D015994:Incidence; D007899:Leisure Activities; D008460:Meat / Q000382:microbiology*; D016012:Poisson Distribution; D012307:Risk Factors; D012475:Salmonella / Q000145:classification / Q000302:isolation & purification*; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D012621:Seasons; D018571:Sentinel Surveillance; D012703:Serotyping; D011795:Surveys and Questionnaires