An outbreak of Salmonella gastrointestinal illness in a military camp. 2009

Vernon J Lee, and Alan E S Ong, and Matthew Auw
Army Medical Services, Singapore Armed Forces, Singapore. vernonljm@hotmail.com

BACKGROUND Non-typhoidal Salmonellae are important causes of bacterial food-borne infection, especially in institutional settings. An outbreak of gastrointestinal infection occurred in a military camp in January 2007, and an epidemiological outbreak investigation was conducted. METHODS A survey was conducted on soldiers in the camp on their clinical symptoms, and recent meals consumed. After determining the affected meal, a subsequent survey was conducted on those who had eaten the meal. A case-control study was then performed to determine the outbreak's likely food source. Laboratory tests were also conducted to determine the bacteriological cause. RESULTS Of the 94 responders, 55 (58.5%) met our case definition of gastrointestinal illness. The dinner on 9 January was the most likely affected meal, with the onset of symptoms occurring within 6 to 36 hours. The mashed potato was the most likely food source with an attack rate of 80.7% for those who consumed it versus 32.7% for those who did not (P <0.01). From the multivariate analysis, the mashed potato remained the only food item independently and significantly associated with infection, with a relative risk of infection 9.49 times those who did not consume it (95% CI, 2.73-32.97). Salmonella group E was cultured from 4 individuals. Although no specific contamination was identified, the mashed potato was stored for more than 5 hours before the last serving. CONCLUSIONS Risk during preparation of large quantities of food should be identified a priori, and measures taken to reduce them, to prevent outbreaks.

UI MeSH Term Description Entries
D008887 Military Medicine The practice of medicine as applied to special circumstances associated with military operations. Medicine, Military
D011198 Solanum tuberosum A plant species of the genus SOLANUM, family SOLANACEAE. The starchy roots are used as food. SOLANINE is found in green parts. Potatoes,Potato,Solanum tuberosums,tuberosum, Solanum,tuberosums, Solanum
D004196 Disease Outbreaks Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS. Outbreaks,Infectious Disease Outbreaks,Disease Outbreak,Disease Outbreak, Infectious,Disease Outbreaks, Infectious,Infectious Disease Outbreak,Outbreak, Disease,Outbreak, Infectious Disease,Outbreaks, Disease,Outbreaks, Infectious Disease
D005516 Food Microbiology The presence of bacteria, viruses, and fungi in food and food products. This term is not restricted to pathogenic organisms: the presence of various non-pathogenic bacteria and fungi in cheeses and wines, for example, is included in this concept. Microbiology, Food
D005759 Gastroenteritis INFLAMMATION of any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Causes of gastroenteritis are many including genetic, infection, HYPERSENSITIVITY, drug effects, and CANCER. Gastroenteritides
D012475 Salmonella A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria that utilizes citrate as a sole carbon source. It is pathogenic for humans, causing enteric fevers, gastroenteritis, and bacteremia. Food poisoning is the most common clinical manifestation. Organisms within this genus are separated on the basis of antigenic characteristics, sugar fermentation patterns, and bacteriophage susceptibility.
D012478 Salmonella Food Poisoning Poisoning caused by ingestion of food harboring species of SALMONELLA. Conditions of raising, shipping, slaughtering, and marketing of domestic animals contribute to the spread of this bacterium in the food supply. Food Poisoning, Salmonella,Food Poisonings, Salmonella,Poisoning, Salmonella Food,Poisonings, Salmonella Food,Salmonella Food Poisonings
D012846 Singapore Country of islands in Southeastern Asia, islands between Malaysia and Indonesia. The capital is Singapore.
D016022 Case-Control Studies Comparisons that start with the identification of persons with the disease or outcome of interest and a control (comparison, referent) group without the disease or outcome of interest. The relationship of an attribute is examined by comparing both groups with regard to the frequency or levels of outcome over time. Case-Base Studies,Case-Comparison Studies,Case-Referent Studies,Matched Case-Control Studies,Nested Case-Control Studies,Case Control Studies,Case-Compeer Studies,Case-Referrent Studies,Case Base Studies,Case Comparison Studies,Case Control Study,Case Referent Studies,Case Referrent Studies,Case-Comparison Study,Case-Control Studies, Matched,Case-Control Studies, Nested,Case-Control Study,Case-Control Study, Matched,Case-Control Study, Nested,Case-Referent Study,Case-Referrent Study,Matched Case Control Studies,Matched Case-Control Study,Nested Case Control Studies,Nested Case-Control Study,Studies, Case Control,Studies, Case-Base,Studies, Case-Comparison,Studies, Case-Compeer,Studies, Case-Control,Studies, Case-Referent,Studies, Case-Referrent,Studies, Matched Case-Control,Studies, Nested Case-Control,Study, Case Control,Study, Case-Comparison,Study, Case-Control,Study, Case-Referent,Study, Case-Referrent,Study, Matched Case-Control,Study, Nested Case-Control

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