International Outbreak of Salmonella Eastbourne Infection Traced to Contaminated Chocolate

Craven, PhilipC.; Baine, WilliamB.; Mackel, DonaldC.; Barker, W. Halsey; Gangarosa, EugeneJ.; Goldfield, Martin; Rosenfeld, Howard; Altman, Ronald; Lachapelle, Gérard; Davies, J.W.L.; Swanson, RichardC.

doi:10.1016/s0140-6736(75)92446-0

Cited by 149 publications

(55 citation statements)

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“…Contaminated food may be retained and served over a period of several days [6], infected food handlers may perpetuate transmission through contamination of a range of food items [7,8], or dissemination of organisms and contamination of the environment may occur [9][10][11]. Relatively small doses of salmonella have been shown to cause illness in outbreak settings and salmonella can survive for long periods on or in foods not commonly implicated in outbreaks, particularly those with high fat content such as cheese and chocolate [12][13][14]. Transmission may therefore occur in settings where neither gross contamination nor prolonged growth of salmonella in food items has taken place.…”

Section: Discussionmentioning

confidence: 99%

Consecutive salmonella outbreaks traced to the same bakery

Evans¹,

Tromans²,

Dexter³

et al. 1996

Epidemiol. Infect.

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SUMMARYTwo consecutive community outbreaks of Salmonella enteritidis phage type 4 (PT4) traced to the same bakery occurred in Cardiff, Wales during August-September 1992. In the first outbreak, illness was associated with eating custard slices (odds ratio 23 8, 95 % confidence interval 6 5-94 4, P < 0-0001), and in the second, with eating fresh cream cakes (odds ratio 15-8, 95 % confidence interval 16-374, P = 0 004). Environmental investigations implicated cross-contamination during preparation of the cold-custard mix as the cause of the first outbreak, and inadequate cleaning and disinfection of nozzles used for piping cream in the second outbreak. S. enteritidis PT4 was isolated from fresh cream sponge cake retained by a case and from two fresh cream cakes and four environmental swabs obtained at the bakery. This incident illustrates the hazard of widespread environmental contamination with salmonella and the need for thorough environmental cleansing of of food poisoning.

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Section: Discussionmentioning

confidence: 99%

Consecutive salmonella outbreaks traced to the same bakery

Evans¹,

Tromans²,

Dexter³

et al. 1996

Epidemiol. Infect.

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“…Because none of the hollandaise sauce was available at the time of the investigation, it was impossible to quantify the amount of salmonella it contained or to establish that contamination was truly homogeneous. Dose-response effects in this outbreak may have been enhanced by the properties of the vehicle; the high-fat content and semi-solid state would tend to protect salmonella from exposure to gastric acid, allowing a relatively high fraction of the ingested inoculum to reach the intestinal tract in a viable state [5,14,15].…”

Section: Food-specific Attack Ratesmentioning

confidence: 99%

Dose–response effects in an outbreak of Salmonella enteritidis

et al. 1994

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SUMMARYThe effects of ingested Salmonella enteritidis (SE) dose on incubation period and on the severity and duration of illness were estimated in a cohort of 169 persons who developed gastroenteritis after eating hollandaise sauce made from grade-A shell eggs. The cohort was divided into three groups based on self-reported dose of sauce ingested. As dose increased, median incubation period decreased (37 h in the low exposure group v. 21 h in the medium exposure group v. 17T5 h in the high exposure group, P = 0 006) and greater proportions reported body aches (71 v. 85 v. 94 %, P = 00009) and vomiting (21 v. 56 v. 57%, P = 0002). Among 118 casepersons who completed a follow-up questionnaire, increased dose was associated with increases in median weight loss in kilograms (3 2 v. 4-5 v. 5 0, P = 0 0001), maximum daily number of stools (12 5 v. 15 0 v. 20-0, P = 0 02), subjective rating of illness severity (P = 0 0007), and the number of days of confinement to bed (30 v. 6-5 v. 65, P = 004). In this outbreak, ingested dose was an important determinant of the incubation period, symptoms and severity of acute salmonellosis.

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“…In a previous paper (Tamminga, Beumer, Kampelmacher & van Leusden, 1976) experiments were described carried out after we learnt about cases of food poisoning in Canada and the U.S.A. which could be traced back to consumption of chocolate, contaminated with S. eastbourne (Craven et al 1975). During these experiments nutrient broth cultures of two strains of Salmonella were mixed with chocolate mass at a temperature of ca.…”

Section: Introductionmentioning

confidence: 99%

Survival of Salmonella eastbourne and Salmonella typhimurium in milk chocolate prepared with artificially contaminated milk powder

Tamminga

Beumer

Kampelmacher

et al. 1977

J. Hyg.

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SUMMARYMilk chocolate mass containing salmonellas was prepared by mixing artificially contaminated milk powder with the other ingredients at a temperature of about 40 0C. From this mass bars were made. Two series were prepared, with S. eastbourne and S. typhimurium respectively. The number of surviving salmonellas was counted after various periods of storage, up to 19 months. S. eastbourne was reduced in numbers during 19 months from an initial count of ca. 3 x 104 to ca. 3 x 102 per 100 g of chocolate. S. typhimurium died off more rapidly, and was not detectable in about 55 g after 15 months, in spite of an initial count of ca. 105 per 100 g.In these experiments the salmonellas in the milk powder had had to survive the spraying procedure and the adverse conditions in the dried powder. This may be the reason why S. eastbourne showed a distinctly better survival on storage than the same serotype showed in previous experiments in which the organism was added as a broth culture to the chocolate mix. With S. typhimurium, however, such a difference was hardly detectable.Possible explanations of these results are discused.

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International Outbreak of Salmonella Eastbourne Infection Traced to Contaminated Chocolate

Cited by 149 publications

References 0 publications

Consecutive salmonella outbreaks traced to the same bakery

Consecutive salmonella outbreaks traced to the same bakery

Dose–response effects in an outbreak of Salmonella enteritidis

Survival of Salmonella eastbourne and Salmonella typhimurium in milk chocolate prepared with artificially contaminated milk powder

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