title: An outbreak of monophasic and biphasic Salmonella Typhimurium, and Salmonella Derby associated with the consumption of dried pork sausage in Castellon (Spain).
abstract: An outbreak of S.Typhimurium occurred in several towns and cities in the province of Castellon (Spain) between 23 February and 27 May 2011. On April 5, the microbiology laboratory of a hospital in Castellon alerted the health authorities to the increase in S.Typhimurium isolated in fecal culture of children with gastroenteritis. The serotype and phage-type of 83 positive cases of S.Typhimurium isolated in these period included 49 monophasic/biphasic S.Typhimurium phage type 138, phage type 193, S.Derby, and 34 other S.Typhimurium phage-types. The median of age of patients was 4 years with a range of 0.6-80 years, and the 18% of patients were hospitalised. Two incident matched case-control studies were carried out; the first with S.Typhimurium phage type 138, 193, and S.Derby cases and the second with the other cases. The two studies found that the consumption of brand X dried pork sausage, purchased in a supermarket chain A, was associated with the disease (matched Odds Ratio [mOR]=13.74 95% Confidence Interval [CI] 4.84-39.06 and mOR=8.20 95% CI 2.32-28.89), respectively). S.Typhimurium phage type 193 and S.Derby were isolated in the food taken from the household of two patients and from the supermarket chain's A central warehouse. The pulsed-field gel electrophoresis study confirmed the similarity of the strains from the patients and the food. On May 25 2011, a national food alert led to the withdrawal of the food from the chain A and the outbreak ended.
authors.affiliation: Epidemiology Division, Public Health Centre, Castellón, Spain; CIBER Epidemiology and Public Health, Barcelona, Spain. Electronic address: arnedo_alb@gva.es.
authors.forename: Alberto
authors.initials: A
authors.lastname: Arnedo-Pena
authors.affiliation: Microbiology Laboratory, Hospital General, Castellón, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Sabater-Vidal
authors.affiliation: Servicio de Bacteriología, Centro Nacional de Microbiología, Majadahonda, Madrid, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Herrera-León
authors.affiliation: Epidemiology Division, Public Health Centre, Castellón, Spain; CIBER Epidemiology and Public Health, Barcelona, Spain.
authors.forename: Juan B
authors.initials: JB
authors.lastname: Bellido-Blasco
authors.affiliation: Public Health Centre, Castellón, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Silvestre-Silvestre
authors.affiliation: Epidemiology Division, Public Health Centre, Castellón, Spain.
authors.forename: Noemi
authors.initials: N
authors.lastname: Meseguer-Ferrer
authors.affiliation: Microbiology Laboratory, Hospital La Plana, Vila-real, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Yague-Muñoz
authors.affiliation: Microbiology Laboratory, Hospital La Plana, Vila-real, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Gil-Fortuño
authors.affiliation: Epidemiology Division, Public Health Centre, Castellón, Spain.
authors.forename: Angeles
authors.initials: A
authors.lastname: Romeu-García
authors.affiliation: Microbiology Laboratory, Hospital General, Castellón, Spain.
authors.forename: Rosario
authors.initials: R
authors.lastname: Moreno-Muñoz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D000069466:Red Meat / Q000382:microbiology*; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000382:microbiology; D019779:Salmonella enterica; D012486:Salmonella typhimurium; D013030:Spain / Q000453:epidemiology; D013552:Swine
keywords: Brote; Children; Dried pork sausage; Longaniza seca cerdo; Monofásica; Monophasic; Niños; Outbreak; Salmonella typhimurium