title: Shigellosis outbreak linked to canteen-food consumption in a public institution: a matched case-control study.
abstract: On 13 November 2009, the authorities of Flemish Brabant, Belgium, received an alert concerning a potential outbreak of Shigella sonnei at a public institution. A study was conducted to assess the extent, discover the source and to implement further measures. We performed a matched case-control study to test an association between shigellosis and canteen-food consumption. Water samples and food handlers' faecal samples were tested. The reference laboratory characterized the retrospectively collected Shigella specimens. We found 52 cases distributed over space (25/35 departments) and time (2 months). We found a matched odds ratio of 3·84 (95% confidence interval 1·02-14·44) for canteen-food consumption. A food handler had travelled to Morocco shortly before detection of the first laboratory-confirmed case. Water samples and food handlers' faecal samples tested negative for Shigella. Confirmed cases presented PFGE profiles, highly similar to archived isolates from Morocco. Foodborne transmission associated with the canteen was strongly suspected.
authors.affiliation: European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Gutiérrez Garitano
authors.forename: M
authors.initials: M
authors.lastname: Naranjo
authors.forename: A
authors.initials: A
authors.lastname: Forier
authors.forename: R
authors.initials: R
authors.lastname: Hendriks
authors.forename: K
authors.initials: K
authors.lastname: DE Schrijver
authors.forename: S
authors.initials: S
authors.lastname: Bertrand
authors.forename: K
authors.initials: K
authors.lastname: Dierick
authors.forename: E
authors.initials: E
authors.lastname: Robesyn
authors.forename: S
authors.initials: S
authors.lastname: Quoilin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D016022:Case-Control Studies; D016000:Cluster Analysis; D004196:Disease Outbreaks; D004405:Dysentery, Bacillary / Q000453:epidemiology* / Q000209:etiology; D005243:Feces / Q000382:microbiology; D005260:Female; D005511:Food Handling; D005522:Food Services; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D016017:Odds Ratio; D012189:Retrospective Studies; D012764:Shigella sonnei / Q000302:isolation & purification*; D011795:Surveys and Questionnaires; D055815:Young Adult