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Salmonella Enteritidis outbreak associated with a school-lunch dessert: cross-contamination and a long incubation period, Japan, 2001

Published online by Cambridge University Press:  08 November 2004

T. MATSUI ,
S. SUZUKI ,
H. TAKAHASHI ,
T. OHYAMA ,
J. KOBAYASHI ,
H. IZUMIYA ,
H. WATANABE ,
F. KASUGA ,
H. KIJIMA  and
K. SHIBATA
...Show all authors
T. MATSUI
Affiliation:
Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan
S. SUZUKI
Affiliation:
Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan
H. TAKAHASHI
Affiliation:
Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
T. OHYAMA
Affiliation:
Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
J. KOBAYASHI
Affiliation:
Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
H. IZUMIYA
Affiliation:
Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
H. WATANABE
Affiliation:
Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
F. KASUGA
Affiliation:
Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan Division of Biomedical Food Research, National Institute of Health Sciences, Tokyo, Japan
H. KIJIMA
Affiliation:
Toyohashi City Health Centre, Toyohashi City, Aichi Prefecture, Japan
K. SHIBATA
Affiliation:
Toyohashi City Health Centre, Toyohashi City, Aichi Prefecture, Japan
N. OKABE
Affiliation:
Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
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Abstract

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A Salmonella Enteritidis (SE) outbreak in Japan was investigated with an observational study, analytical epidemiology and bacteriological examination (including phage typing). The outbreak occurred among 96 schoolchildren, and was caused by SE phage type 1. The outbreak source was dessert buns served at a school lunch (RR 42·55, 95% CI 5·93–305·11, P<0·001). The buns were probably cross-contaminated from eggs from a factory with a history of SE-contaminated products. The incubation period was longer than usual (3–16 days, median 8 days). A low contaminating dose may account for the long incubation period and low attack rate. Outbreak detection was hampered by the absence of routine Salmonella surveillance in Japan. The investigation was complicated by concurrent illnesses from other SE phage types. It was successful, in part, because adequate food samples were available for microbiological testing.

Type
Research Article
Information
Epidemiology & Infection , Volume 132 , Issue 5 , October 2004 , pp. 873 - 879
Copyright
© 2004 Cambridge University Press