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2007-09-13Zeitschriftenartikel DOI: 10.1186/1471-2458-7-243
Protracted outbreak of S. Enteritidis PT 21c in a large Hamburg nursing home
dc.contributor.authorFrank, Christina
dc.contributor.authorBuchholz, Udo
dc.contributor.authorMaaß, Monika
dc.contributor.authorSchröder, Arthur
dc.contributor.authorBracht, Karl- Hans
dc.contributor.authorDomke, Paul-Gerhard
dc.contributor.authorRabsch, Wolfgang
dc.contributor.authorFell, Gerhard
dc.date.accessioned2018-05-07T13:17:53Z
dc.date.available2018-05-07T13:17:53Z
dc.date.created2009-09-09
dc.date.issued2007-09-13none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/reztfel9uYmxg/PDF/25WjSYuJba4mk.pdf
dc.identifier.urihttp://edoc.rki.de/176904/451
dc.description.abstractBackground: During August 2006, a protracted outbreak of Salmonella (S.) Enteritidis infections in a large Hamburg nursing home was investigated. Methods: A site visit of the home was conducted and food suppliers' premises tested for Salmonella. Among nursing home residents a cohort study was carried out focusing on foods consumed in the three days before the first part of the outbreak. Instead of relying on residents' memory, data from the home's patient food ordering system was used as exposure data. S. Enteritidis isolates from patients and suspected food vehicles were phage typed and compared. Results: Within a population of 822 nursing home residents, 94 case patients among residents (1 fatality) and 17 among staff members were counted 6 through 29 August. The outbreak peaked 7 through 9 August, two days after a spell of very warm summer weather. S. Enteritidis was consistently recovered from patients' stools throughout the outbreak. Among the food items served during 5 through 7 August, the cohort study pointed to afternoon cake on all three days as potential risk factors for disease. Investigation of the bakery supplying the cake yielded S. Enteritidis from cakes sampled 31 August. Comparison of the isolates by phage typing demonstrated both isolates from patients and the cake to be the exceedingly rare phage type 21c. Conclusion: Cake (various types served on various days) contaminated with S. Enteritidis were the likely vehicle of the outbreak in the nursing home. While the cakes were probably contaminated with low pathogen dose throughout the outbreak period, high ambient summer temperatures and failure to keep the cake refrigerated led to high pathogen dose in cake on some days and in some of the housing units. This would explain the initial peak of cases, but also the drawn out nature of the outbreak with cases until the end of August. Suggestions are made to nursing homes, aiding in outbreak prevention. Early outbreak detection is crucial, such that counter measures can be swift and drawn-out outbreaks of nosocomial food-borne infections avoided.eng
dc.language.isoeng
dc.publisherRobert Koch-Institut, Infektionskrankheiten / Erreger; Robert Koch-Institut, Infektionsepidemiologie
dc.subjectAgedeng
dc.subjectHumanseng
dc.subjectDisease Outbreakseng
dc.subjectGastroenteritis/epidemiologyeng
dc.subjectGermany/epidemiologyeng
dc.subjectHomes for the Agedeng
dc.subjectNursing Homeseng
dc.subjectSalmonella Food Poisoning/epidemiologyeng
dc.subjectSalmonella enteritidis/classificationeng
dc.subjectSalmonella enteritidis/isolation & purificationeng
dc.subjectSalmonella enteritidis/pathogenicityeng
dc.subject.ddc610 Medizin
dc.titleProtracted outbreak of S. Enteritidis PT 21c in a large Hamburg nursing home
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-1001570
dc.identifier.doi10.1186/1471-2458-7-243
dc.identifier.doihttp://dx.doi.org/10.25646/376
local.edoc.container-titleBMC Public Health
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttp://www.biomedcentral.com/1471-2458/7/243
local.edoc.container-publisher-nameBioMedCentral
local.edoc.container-volume7
local.edoc.container-issue243
local.edoc.container-year2007

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