Ban Mishu, MD; Patricia M. Griffin, MD; Robert V. Tauxe, MD, MPH; Daniel N. Cameron, BS; Robert H. Hutcheson, MD, MPH; William Schaffner, MD
▪ Objective: To determine the source and to describe the clinical importance of a large outbreak of Salmonella enteritidis gastroenteritis in Tennessee, which is outside the geographic focus of the S. enteritidis pandemic.
▪ Design: A case-control study and tracing of the source eggs.
▪ Setting: A Tennessee community and a large layer farm in Indiana.
▪ Patients: Case patients ate at the implicated restaurant and subsequently developed S. enteritidis gastroenteritis; controls ate with the case patients, but did not develop gastroenteritis.
▪ Measurements: Eighty-one case patients were identified; 73 (90%) had eaten egg-containing sauces at a local restaurant on a given evening. The eggs were traced to their farm of origin in Indiana. The farm was inspected 5 weeks after the outbreak.
⅖ Main Results: Of 24 patients with culture-proved cases, 11 were hospitalized. Hollandaise and bernaise sauces prepared with intact, extra-large, grade-A eggs were strongly associated with illness (P < 0.001). Salmonella enteritidis was isolated from specimens collected from chickens and the farm. Antimicrobial susceptibility patterns, phage typing, and plasmid profiles of isolates from the farm and from patients were indistinguishable.
▪ Conclusions: Salmonella enteritidis infection is a large and growing public health problem that is spreading beyond the northeastern United States. This study shows a direct link between infected poultry flocks and an outbreak of human illness.
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Mishu B, Griffin PM, Tauxe RV, Cameron DN, Hutcheson RH, Schaffner W. Salmonella enteritidis Gastroenteritis Transmitted by Intact Chicken Eggs. Ann Intern Med. 1991;115:190–194. doi: 10.7326/0003-4819-115-3-190
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Published: Ann Intern Med. 1991;115(3):190-194.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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