title: Outbreak of Salmonella Strathcona caused by datterino tomatoes, Denmark, 2011.
abstract: In September 2011, a patient cluster with a rare Salmonella serotype - Strathcona - was identified in Denmark. An outbreak investigation was initiated to reveal the source in order to stop the outbreak. In addition to hypothesis-generating interviews, comparable analyses of patients' household shopping receipts were conducted. A matched case-control study with 25 cases and 56 population register controls was conducted to test the findings of the hypothesis-generating investigation. In total, 43 cases of Salmonella Strathcona were reported in Denmark. Additionally, 28 cases were reported from Germany, Italy, Austria and Belgium. The results of the investigation in Denmark showed that 8/10 cases had bought datterino tomatoes prior to disease onset. Illness was associated with a specific supermarket chain [matched odds ratio (mOR) 16·9, 95% confidence interval (CI) 2·2-130], and having consumed elongated small tomatoes (OR 28·1, 95% CI 2·6-302). Traceback investigation showed that the tomatoes came from an Italian producer. This outbreak, linked to tomatoes, underpins the growing recognition of the broad source range of Salmonella and the ability of fresh produce to cause multi-country outbreaks. It is important to strengthen the international cooperation between public-health and food-safety authorities in the European Union to investigate future multi-country outbreaks in order to prevent illness from ready-to-eat produce.
authors: Department of Infectious Disease Epidemiology,Statens Serum Institut,Copenhagen,Denmark.
authors: L
authors: L
authors: Müller
authors: Department of Infectious Disease Epidemiology,Statens Serum Institut,Copenhagen,Denmark.
authors: C
authors: C
authors: Kjelsø
authors: Department for Infectious Disease Epidemiology,Robert Koch Institute,Berlin,Germany.
authors: C
authors: C
authors: Frank
authors: Danish Veterinary and Food Administration,Copenhagen,Denmark.
authors: T
authors: T
authors: Jensen
authors: Department of Microbiology and Infection Control,Statens Serum Institut,Copenhagen,Denmark.
authors: M
authors: M
authors: Torpdahl
authors: Department of Infectious Disease Epidemiology,Statens Serum Institut,Copenhagen,Denmark.
authors: B
authors: B
authors: Søborg
authors: Department of Infectious Disease Epidemiology,Statens Serum Institut,Copenhagen,Denmark.
authors: F
authors: F
authors: Dorleans
authors: National Reference Centre for Salmonella and other Enterics,Robert Koch Institute,Wernigerode,Germany.
authors: W
authors: W
authors: Rabsch
authors: National Reference Centre for Salmonella and other Enterics,Robert Koch Institute,Wernigerode,Germany.
authors: R
authors: R
authors: Prager
authors: European Centre for Disease Prevention and Control (ECDC),Solna,Sweden.
authors: C M
authors: CM
authors: Gossner
authors: Department of Infectious Disease Epidemiology,Statens Serum Institut,Copenhagen,Denmark.
authors: S
authors: S
authors: Ethelberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003718:Denmark / Q000453:epidemiology; D004196:Disease Outbreaks; D005060:Europe / Q000453:epidemiology; D005260:Female; D005516:Food Microbiology; D006801:Humans; D007223:Infant; D007558:Italy; D018551:Solanum lycopersicum / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D012478:Salmonella Food Poisoning / Q000453:epidemiology* / Q000382:microbiology; D019779:Salmonella enterica / Q000302:isolation & purification*; D055815:Young Adult
keywords: Case-control study; Salmonella; outbreaks