[Salmonellosis outbreaks and the size and role of the Chilean State].
During year 2011 two outbreaks of Salmonella infection captured media attention in the Metropolitan Area (MA) in Chile: one of typhoid fever associated to Salmonella serotype Typhi, and the other, of gastroenteritis related to Salmonella serotype Enteritidis, both with decreasing or stable rates in the previous years. The aim of this work is to analyze probable causes of their reemergence.


METHODS
Several government websites were searched looking for epidemiological data.


RESULTS
Typhoid fever rates have declined to current values of 1 case per 100.000 habitants, a decreased associated to improvements in the human development index. The typhoid outbreak was associated to a predominant clone within the MA. The only risk factor identified was consumption of raw vegetables acquired in open fairs, but without identifying a common source. Despite improvements in disease notification and molecular epidemiology capabilities, this outbreak is coincidental with a reduced number of food inspection visits in the MA, probably explained by the limited personnel available for this task. In the case of Salmonella Enteritidis, rates have increased twice since 1998 (5.3 to 10.7 per 100.000 habitants) with an important increase in the number of outbreaks linked to this agent (7 to 31 annual outbreaks) since year 2005. Persistence of this problem is probably associated to the low surveillance of poultry farms made by the Chilean state, to the absence of a cold chain during collection, distribution and selling of eggs, and to the lack of an educational program directed to the population. The recent regulation that bans home-made mayonnaise in restaurant or fast food stores is an important advance that requires further evaluation.


CONCLUSIONS
The persistence and reemergence of different kind of Salmonellosis in Chile suggests chronic problems on the size and role of the Chilean state regarding food safety.
Servicio de Infectología, Hospital Militar de Santiago, Chile. albertofica@gmail.com
Alberto
A
Fica
Gerardo
G
Acosta
Jeannette
J
Dabanch
Cecilia
C
Perret
Marisa
M
Torres
Javier
J
López
Leonor
L
Jofré
Thomas
T
Weitzel
D002677:Chile / Q000453:epidemiology; D021821:Communicable Diseases, Emerging / Q000453:epidemiology / Q000382:microbiology; D018563:Disease Notification; D004196:Disease Outbreaks; D005511:Food Handling / Q000331:legislation & jurisprudence*; D059022:Food Safety; D005759:Gastroenteritis / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D012307:Risk Factors; D012478:Salmonella Food Poisoning / Q000453:epidemiology*; D014435:Typhoid Fever / Q000453:epidemiology*; D014505:Urban Population