title: Investigation into an unusual increase of human cases of Salmonella Goldcoast infection in Hungary in 2009.
abstract: We describe the outbreak investigation associated with an unusual increase in Salmonella Goldcoast cases in Hungary observed in autumn 2009, which included descriptive and analytical epidemiological studies and microbiological and veterinary investigations. Sixty cases were identified between 1 January 2009 and 1 March 2010, 50 of them from late July 2009 to January 2010. Of 50 S. Goldcoast isolates, 44 showed an indistinguishable pulsed-field gel electrophoresis profile. We conducted a matched case-control study that indicated a statistically significant association between S. Goldcoast infection and the consumption of pork cheese. The majority of cases (seven of nine) reporting consumption of this product belonged to a single family cluster. After removing six cases of this cluster, pork cheese still showed an elevated but non-significant risk for being a case in the univariable analysis (Mantel-Haenszel odds ratio (MH OR): 3.87, 95% confidence interval (CI): 0.38-39.47). A single S. Goldcoast isolate was identified during routine veterinary surveillance activities in 2009 in minced beef from a butcher's shop, originating from an abattoir where also pigs were slaughtered. We conclude that the outbreak was probably due to multiple sources of contaminated meat, probably pork, released on the market over a period of several months in 2009.
authors.affiliation: National Center for Epidemiology, Budapest, Hungary. horvath.krisztina@oth.antsz.hu
authors.forename: J K
authors.initials: JK
authors.lastname: Horváth
authors.forename: M
authors.initials: M
authors.lastname: Mengel
authors.forename: K
authors.initials: K
authors.lastname: Krisztalovics
authors.forename: N
authors.initials: N
authors.lastname: Nogrady
authors.forename: J
authors.initials: J
authors.lastname: Pászti
authors.forename: A
authors.initials: A
authors.lastname: Lenglet
authors.forename: J
authors.initials: J
authors.lastname: Takkinen
mesh_terms: D016022:Case-Control Studies; D002611:Cheese / Q000382:microbiology; D018563:Disease Notification; D004196:Disease Outbreaks; D005516:Food Microbiology / Q000592:standards; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008461:Meat Products / Q000382:microbiology; D011159:Population Surveillance; D012475:Salmonella / Q000145:classification / Q000302:isolation & purification; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000382:microbiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000150:complications