title: Nontyphoidal Salmonella Gastroenteritis in Baoshan, Shanghai, China, 2010 to 2014: An Etiological Surveillance and Case-Control Study.
abstract: Nontyphoidal Salmonella (NTS) gastroenteritis is a widespread global foodborne disease. To identify the epidemiologic characteristics, sources of food contamination, and risk factors of NTS gastroenteritis, epidemiologic data and stool specimens of diarrheal patients were collected from sentinel hospitals in Baoshan, Shanghai, People's Republic of China, between 2010 and 2014. Food products from nearby farmers' markets and animal feces from live poultry markets and livestock farms were sampled to identify the pathogen; a case-control study was conducted to characterize risk factors of NTS gastroenteritis. Of 3,906 diarrheal patients examined, 266 (6.8%) were positive for Salmonella. The positive rates were higher in summer than in the other seasons. Salmonella Typhimurium (36.1%) and Salmonella Enteritidis (30.8%) were the dominant serovars in the patients. Salmonella was detected in 26.2% pork samples, 7.1 to 7.8% poultry meats, and 3.3 to 8.9% poultry feces. Salmonella Typhimurium was the major serovar in contaminated food and animal feces. Multivariate conditional logistic regression analysis indicated that consumption of pork and quickly cooked eggs increased, whereas separating kitchen knives for cooked and raw food decreased the risk of NTS gastroenteritis, independently. We believe that NTS in poultry feces contaminated the meat products in the same markets and then infected humans if these foods were not sufficiently cooked. To prevent NTS gastroenteritis, it is necessary to survey Salmonella in meats and poultry feces, to cook eggs and pork sufficiently, to separate kitchen knives for cooked and raw food, and to prohibit live poultry trade in fresh meat markets.
authors.affiliation: 1 Department of Infectious Diseases, Baoshan District Center for Disease Control and Prevention, 158 Yueming Road, Baoshan District, Shanghai 201901, People's Republic of China.
authors.forename: Xingtang
authors.initials: X
authors.lastname: Yang
authors.affiliation: 1 Department of Infectious Diseases, Baoshan District Center for Disease Control and Prevention, 158 Yueming Road, Baoshan District, Shanghai 201901, People's Republic of China.
authors.forename: Kai
authors.initials: K
authors.lastname: Jin
authors.affiliation: 2 Department of Epidemiology, Shanghai Key Laboratory of Medical Biodefense, Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, People's Republic of China.
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.affiliation: 1 Department of Infectious Diseases, Baoshan District Center for Disease Control and Prevention, 158 Yueming Road, Baoshan District, Shanghai 201901, People's Republic of China.
authors.forename: Guoping
authors.initials: G
authors.lastname: Yuan
authors.affiliation: 2 Department of Epidemiology, Shanghai Key Laboratory of Medical Biodefense, Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, People's Republic of China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Liu
authors.affiliation: 1 Department of Infectious Diseases, Baoshan District Center for Disease Control and Prevention, 158 Yueming Road, Baoshan District, Shanghai 201901, People's Republic of China.
authors.forename: Lunhui
authors.initials: L
authors.lastname: Xiang
authors.affiliation: 1 Department of Infectious Diseases, Baoshan District Center for Disease Control and Prevention, 158 Yueming Road, Baoshan District, Shanghai 201901, People's Republic of China.
authors.forename: Zhenqiang
authors.initials: Z
authors.lastname: Wu
authors.affiliation: 2 Department of Epidemiology, Shanghai Key Laboratory of Medical Biodefense, Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, People's Republic of China.
authors.forename: Zixiong
authors.initials: Z
authors.lastname: Li
authors.affiliation: 1 Department of Infectious Diseases, Baoshan District Center for Disease Control and Prevention, 158 Yueming Road, Baoshan District, Shanghai 201901, People's Republic of China.
authors.forename: Jianying
authors.initials: J
authors.lastname: Mao
authors.affiliation: 1 Department of Infectious Diseases, Baoshan District Center for Disease Control and Prevention, 158 Yueming Road, Baoshan District, Shanghai 201901, People's Republic of China.
authors.forename: Junqing
authors.initials: J
authors.lastname: Shen
authors.affiliation: 2 Department of Epidemiology, Shanghai Key Laboratory of Medical Biodefense, Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, People's Republic of China.
authors.forename: Nelson
authors.initials: N
authors.lastname: Lombe
authors.affiliation: 2 Department of Epidemiology, Shanghai Key Laboratory of Medical Biodefense, Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, People's Republic of China.
authors.forename: Hemitério
authors.initials: H
authors.lastname: Zandamela
authors.affiliation: 2 Department of Epidemiology, Shanghai Key Laboratory of Medical Biodefense, Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, People's Republic of China.
authors.forename: Lucrece
authors.initials: L
authors.lastname: Hazoume
authors.affiliation: 2 Department of Epidemiology, Shanghai Key Laboratory of Medical Biodefense, Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, People's Republic of China.
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Hou
authors.affiliation: 2 Department of Epidemiology, Shanghai Key Laboratory of Medical Biodefense, Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, People's Republic of China.
authors.forename: Yibo
authors.initials: Y
authors.lastname: Ding
authors.affiliation: 2 Department of Epidemiology, Shanghai Key Laboratory of Medical Biodefense, Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, People's Republic of China.
authors.forename: Guangwen
authors.initials: G
authors.lastname: Cao
mesh_terms: D000818:Animals; D016022:Case-Control Studies; D002681:China; D005759:Gastroenteritis / Q000453:epidemiology; D006801:Humans; D008460:Meat; D000069466:Red Meat; D012475:Salmonella; D012478:Salmonella Food Poisoning / Q000517:prevention & control*; D013552:Swine
keywords: Animal feces; Case-control study; China; Food product; Gastroenteritis; Salmonella