title: Outbreak investigation and case-control study: penta-resistant Salmonella Typhimurium DT104 associated with biltong in London in 2008.
abstract: In August 2008 an outbreak of Salmonella Typhimurium DT104 occurred in South West London. Sixteen cases were identified with a particular multilocus variable number tandem repeat analysis (MLVA) pattern. In a matched case-control study 14 primary cases were included. These were defined as individuals with gastrointestinal symptoms and Salmonella Typhimurium DT104 isolated from a stool specimen, with a characteristic antibiotic resistance profile and MLVA pattern, and diagnosed in a local laboratory. Four controls per case were matched on age, gender and area of residence. Cases were 26 times more likely than controls to have eaten beef biltong, a South African speciality meat product (odds ratio 25·83, 95% confidence interval 4·92–135·59, P < 0·01). Although environmental investigation failed to identify Salmonella in the food product we conclude that beef biltong consumption led to this outbreak. This conclusion has importance in informing the ongoing risk assessment relating to uncontrolled foodstuffs.
authors.affiliation: Health Protection Agency, Regional Epidemiology Unit, London, UK. miranda.mindlin@hpa.org.uk
authors.forename: M J
authors.initials: MJ
authors.lastname: Mindlin
authors.forename: N
authors.initials: N
authors.lastname: Lang
authors.forename: H
authors.initials: H
authors.lastname: Maguire
authors.forename: B
authors.initials: B
authors.lastname: Walsh
authors.forename: N Q
authors.initials: NQ
authors.lastname: Verlander
authors.forename: C
authors.initials: C
authors.lastname: Lane
authors.forename: C
authors.initials: C
authors.lastname: Taylor
authors.forename: L A
authors.initials: LA
authors.lastname: Bishop
authors.forename: P D
authors.initials: PD
authors.lastname: Crook
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008131:London / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018598:Minisatellite Repeats; D058889:Molecular Typing; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D012486:Salmonella typhimurium / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents