title: Added value of a household-level study during an outbreak investigation of Salmonella serotype Saintpaul infections, New Mexico 2008.
abstract: In 2008, nationwide investigations of a Salmonella serotype Saintpaul outbreak led first to consumer warnings for Roma and red round tomatoes, then later for jalapeño and serrano peppers. In New Mexico, where there were a large number of cases but no restaurant-based clusters, the NM Department of Health and the Indian Health Service participated with CDC in individual-level and household-level case-control studies of infections in New Mexico and the Navajo Nation. No food item was associated in the individual-level study. In the household-level study, households with an ill member were more likely to have had jalapeño peppers present during the exposure period and to have reported ever having serrano peppers in the household. This report illustrates the complexity of this investigation, the limitations of traditional individual-level case-control studies when vehicles of infection are ingredients or commonly eaten with other foods, and the added value of a household-level study.
authors.affiliation: Scientific Education and Professional Development Program Office, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA. amyboore@gmail.com or aboore@cdc.gov
authors.forename: A L
authors.initials: AL
authors.lastname: Boore
authors.forename: J
authors.initials: J
authors.lastname: Jungk
authors.forename: E T
authors.initials: ET
authors.lastname: Russo
authors.forename: J T
authors.initials: JT
authors.lastname: Redd
authors.forename: F J
authors.initials: FJ
authors.lastname: Angulo
authors.forename: I T
authors.initials: IT
authors.lastname: Williams
authors.forename: J E
authors.initials: JE
authors.lastname: Cheek
authors.forename: L H
authors.initials: LH
authors.lastname: Gould
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002212:Capsicum / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004032:Diet / Q000706:statistics & numerical data; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D015340:Epidemiologic Research Design; D005191:Family Characteristics; D005260:Female; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D018551:Solanum lycopersicum / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009516:New Mexico / Q000453:epidemiology; D012475:Salmonella / Q000145:classification / Q000302:isolation & purification; D012480:Salmonella Infections / Q000453:epidemiology* / Q000382:microbiology