title: An outbreak of food-borne salmonellosis linked to a bread takeaway shop in Ben Tre City, Vietnam.
abstract: OBJECTIVE
  To identify the vehicle, source, and causative agent of a community-wide food-borne outbreak of gastroenteritis.
  
  
  METHODS
  We conducted a case-control study. Cases were city residents diagnosed with gastroenteritis and hospitalized in Ben Tre City from 22 to 25 May 2013; 41 cases were selected randomly from a list of hospitalized patients. Controls were age- and gender-matched healthy neighbours of cases. Participants were interviewed using a standard questionnaire. Samples from patients and food were tested at reference laboratories. We used conditional logistic regression to calculate matched odds ratios (mORs) for the association of gastroenteritis with food items consumed.
  
  
  RESULTS
  Of the 41 cases enrolled in the study, 61% were males and the median age was 33 years; cases resided in 12 wards of the City. Of 13 food items consumed by the cases, only stuffed bread was significantly associated with gastroenteritis (mOR 21.3, 95% confidence interval 6.3-71.8). Among the 29 cases who ate stuffed bread, the median time to illness onset was 9h. Patient stool samples and bread samples were positive for Salmonella species.
  
  
  CONCLUSIONS
  Stuffed bread was the likely vehicle of the outbreak. The laboratory testing capacity for serotypes of Salmonella should be strengthened in Vietnam. Food-handler training in basic food safety measures should be improved.
authors: Department of Planning and Technical Support, Institute of Hygiene and Public Health, 159 Hung Phu Street, District 8, Ho Chi Minh City, Vietnam; School of Health Sciences, University of Tampere, Tampere, Finland. Electronic address: vo.huuthuan@yahoo.com.
authors: Thuan Huu
authors: TH
authors: Vo
authors: Department of Planning and Technical Support, Institute of Hygiene and Public Health, 159 Hung Phu Street, District 8, Ho Chi Minh City, Vietnam.
authors: Ninh Hoang
authors: NH
authors: Le
authors: Food Safety Agency, Ben Tre Department of Health, Ben Tre City, Vietnam.
authors: Thuy Thanh Diem
authors: TT
authors: Cao
authors: School of Health Sciences, University of Tampere, Tampere, Finland.
authors: J Pekka
authors: JP
authors: Nuorti
authors: Vietnam Field Epidemiology Training Programme, Dong Da District, Hanoi, Vietnam.
authors: Nguyen Nhu Tran
authors: NN
authors: Minh
mesh_terms: D000293:Adolescent; D000328:Adult; D001939:Bread / Q000382:microbiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005511:Food Handling; D005759:Gastroenteritis / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012478:Salmonella Food Poisoning / Q000453:epidemiology*; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult
keywords: Developing countries; Food safety; Gastroenteritis; Salmonella; Stuffed bread