An Outbreak of <i>Shigella sonnei</i> Infection Associated with Consumption of Iceberg Lettuce

Frost, J. A.; McEvoy, M; Bentley, Christine; Andersson, Yvonne

doi:10.3201/eid0101.950105

Cited by 66 publications

(19 citation statements)

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“…In 1990, S. sonnei was the most prevalent enteric pathogen cultured from troops engaged in the military campaign Operation Desert Shield [24]; the suspected source was contaminated fresh vegetables, notably lettuce. In 1994, 110 culture-confirmed cases of shigellosis caused by S. sonnei were reported in an outbreak in Norway, Sweden and the UK [25,26]; based on epidemiological evidence iceberg lettuce imported from Spain was suspected as the source of this multi-country outbreak. Establishments where contaminated foods have been served include the home, restaurants, camps, picnics, schools, daycare centers, airlines, sorority houses and military mess halls, among others [20].…”

Section: Discussionmentioning

confidence: 99%

A food-borne outbreak of Shigella sonnei gastroenteritis, Austria, 2008

Kuo

Kasper

Jelovcan

et al. 2009

Wien Klin Wochenschr

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We report on the first foodborne outbreak of Shigella sonnei described in Austria. On July 14 2008, AGES was informed of a cluster of 22 laboratory-confirmed cases of infection with S. sonnei restricted to public health district X in the province of Salzburg. All cases had attended a youth-group trip to a small village in the province of Tyrol from July 7 to July 9. An outbreak case among the trip participants was a person who (1) attended the trip and (2) fell ill with diarrhea in the period between July 8 and July 12. Among the 61 trip participants, 42 fitted the outbreak case definition, including 31 culture-confirmed cases. A household outbreak case was a person who (1) did not participate in the trip, (2) fell ill with diarrhea not before July 10 and (3) had household contact with an outbreak case between one and three days before onset of illness. Of the 11 household outbreak cases, 10 were tested by stool culture and four of these had a laboratory-confirmed S. sonnei infection. In addition, one of the two hostel staff tested positive for S. sonnei. All 36 isolates were biotype gl, lysotype 12, and were indistinguishable from each other by PFGE. A cohort study among the trip participants revealed a risk ratio of 2.71 for consumption of salad (on at least 1 of the 3 days of the trip) (95% CI: 1.38-5.32, P = 0.004). Among the 42cases, 34 could be explained by consumption of salad. The landlady of the hostel, who prepared the salad with bare hands, was a carrier and was assumed to be the source of contamination of the salad. Without proper epidemiological analytical investigation of this shigellosis outbreak, its association with food consumption would not have been identified.

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Section: Discussionmentioning

confidence: 99%

A food-borne outbreak of Shigella sonnei gastroenteritis, Austria, 2008

Kuo

Kasper

Jelovcan

et al. 2009

Wien Klin Wochenschr

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“…The major pathogens associated with the use of highly polluted water are the faecal coliforms, E. coli and eggs of some helminthes such as Ascaris lumbricoides, Trichuris trichura, Hymenolepis diminuta, Fasciola hepatica and Strongyloides whose resistant eggs can be found in the wastewater [2,10,11]. According to Ensink [12], farmers and irrigation workers can acquire helminth infections and parasitic diseases due to direct contact with untreated wastewater and contaminated soils especially if exposed for a long duration. It has also been reported that irrigation of salad crops with untreated wastewater caused excess disease (e.g.…”

Section: Introductionmentioning

confidence: 99%

Microbial Contamination in Vegetables at the Farm Gate Due to Irrigation with Wastewater in the Tamale Metropolis of Northern Ghana

Jerry¹,

Clement²,

Kudadam³

et al. 2013

JEP

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The rational for this study was to assess the microbial quality of fresh vegetables at the farm gate of the Water Works road vegetable farm at Gumbihini in the Tamale Metropolis. A total of thirty-six (36) vegetables comprising lettuce, amarantus and cabbages and eight (8) wastewater samples were collected at random and analysed for a period of four months, to assess the microbial contamination level. Samples were analysed for total coliforms, faecal coliforms, E. coli and helminthes eggs. All vegetables sampled during the study period recorded high levels of total and faecal coliform bacteria. Mean faecal coliforms for the various vegetables were as follows; lettuce 3.7 ± 0.5 CFU·g −1 , amarantus 3.5 ± 0.6 CFU·g −1 and cabbage 3.1 ± 0.6 log CFU·g −1 fresh weight. FC levels were above the International Commission on Microbiological Specifications for Foods (ICMSF) recommended level of 3 log CFU·g −1 fresh weight. E. coli were recorded in lettuce (3.3 ± 0.6 log CFU·g −1 fresh weight) and amarantus (0.6 ± 0.1 log CFU·g −1 fresh weight) but not in cabbages. Lettuce generally recorded high levels of microbial contamination because of the large surface area occupied by its leaves. Two helminth eggs (Strongiloides stercoralis) were identified in lettuce while four (Ascaris lumbricoides) were identified in wastewater. Microbial loads recorded in wastewater were generally higher than that of vegetables. Since most of these vegetables are eaten fresh or slightly cooked, there is course for concern as public health will be adversely affected. Education of farmers and consumers on food safety has to be intensified to avert a possible outbreak.

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“…Shigellosis is highly virulent because it is easily transmitted from person to person via the fecal-oral route (Wachsmuth and Morris, 1989). Shigellosis outbreaks are also associated with contaminated raw foods or inappropriately prepared processed foods (Cowden et al, 1995;Dunn et al, 1995;Frost et al, 1995;Gaynor et al, 2009;Hosseini and Kaffashian, 2010;Kapperud et al, 1995;Kuo et al, 2009;Lee et al, 1991;Lew et al, 1991;Terajima et al, 2004;Yagupsky et al, 1991). Various selective and differential media have been used to detect and isolate Shigella.…”

Section: Introductionmentioning

confidence: 96%

Development of selective and differential medium for Shigella sonnei using three carbohydrates (lactose, sorbitol, and xylose) and X-Gal

Na¹,

Kim

Kwon³

et al. 2015

Journal of Microbiological Methods

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An Outbreak of Shigella sonnei Infection Associated with Consumption of Iceberg Lettuce

Abstract: virus isolations from mosquitoes in arid regions of Western Australia: implication of vertical transmission as a means of persistence of the virus.

Cited by 66 publications

References 1 publication

A food-borne outbreak of Shigella sonnei gastroenteritis, Austria, 2008

A food-borne outbreak of Shigella sonnei gastroenteritis, Austria, 2008

Microbial Contamination in Vegetables at the Farm Gate Due to Irrigation with Wastewater in the Tamale Metropolis of Northern Ghana

Development of selective and differential medium for Shigella sonnei using three carbohydrates (lactose, sorbitol, and xylose) and X-Gal

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