Abstract Beginning in the s, the incidence of Salmonella enterica serotype Enteritidis SE infection and the number of related outbreaks in the United States has increased dramatically. Open in new tab Download slide. FoodNet estimate of the burden of illness caused by nontyphoidal Salmonella infections in the United States. Google Scholar Crossref. Search ADS. Identification and serotyping of Salmonella and an update of the Kauffman-White scheme.
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Accessed 27 June Egg quality assurance programs and egg-associated Salmonella Enteritidis infections, United States. Risk assessments of Salmonella Enteritidis shell eggs and Salmonella spp. Issue Section:. Download all slides. Comments 0. Add comment Close comment form modal. I agree to the terms and conditions.
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Infectious Disease Physician. This change is mirrored in passive national surveillance data. The greatest relative increases were in young children, older adults, and FoodNet sites in the southern United States. The proportion of patients with SE infection who reported recent international travel has decreased in recent years, whereas the proportion of chickens from which SE was isolated has increased. Similar molecular subtypes of SE are commonly isolated from humans and chickens.
Most SE infections in the United States are acquired from domestic sources, and the problem is growing. Chicken and eggs are likely major sources of SE. Continued close attention to surveillance data is needed to monitor the impact of recent regulatory control measures.
Effective control of SE infection has been a moving target. An epidemic of SE illnesses associated with shell eggs began in the northeastern United States in and spread throughout the rest of the country. Voluntary farm-based interventions, use of pasteurized egg products in institutions, consumer education, and increased attention to refrigeration of eggs helped decrease rates of SE infection during the late s [ 3—5 ].
Several high-profile outbreaks during the late s, including the largest SE outbreak ever reported from shell eggs in [ 6 ], have refocused national attention on food safety. National health objectives ie, Healthy People include as a top food safety priority reducing Salmonella infection [ 7 ]. Public health authorities, regulatory agencies, food producers, and food processors need clear, accurate SE surveillance information to inform and evaluate evidence-based SE control policies and practices.
To examine burden of human SE infections and understand changes over time, we analyzed FoodNet data from the period — We compared FoodNet SE data with passively collected data from a complementary surveillance system and with rates of SE isolation from processed chickens and egg products, 2 important sources of human SE infection.
We also compared molecular subtyping patterns of SE isolated from humans with those from chickens. FoodNet actively collects data on laboratory-confirmed human cases of infection caused by 9 pathogens transmitted commonly through food, including Salmonella , in select sites around the United States. During —, counties and states were added to the FoodNet surveillance area, which now includes the entire states of Connecticut, Georgia, Maryland, Minnesota, New Mexico, Oregon, and Tennessee and selected counties in California, Colorado, and New York.
The surveillance area has remained unchanged since and is, in general, similar demographically to the US population [ 12 ]. For each case reported, FoodNet personnel collect information on demographic characteristics eg, age and sex , hospitalization status within 7 days of specimen collection or if hospitalized as a result of infection , and outcome alive or dead at hospital discharge or within 7 days of specimen collection for nonhospitalized patients.
Data on recent international travel illness onset within 7 days after return to United States or during travel for Salmonella and whether the case was associated with an outbreak have been routinely collected since [ 12 ]. Clinical diagnostic laboratories submit Salmonella isolates to state public health laboratories, which confirm the isolates as Salmonella , perform serotyping, and voluntarily submit a report to the CDC.
PulseNet is a national subtyping network for isolates for foodborne diseases surveillance [ 14 ]. PulseNet data are used to identify and investigate enteric diseases outbreaks. Inspectors collect and submit broiler chicken carcass rinsates for a polymerase chain reaction PCR —based screening test for Salmonella, with culture confirmation for PCR-positive rinsates.
The sampling strategy does not account for production volume or regional or seasonal effects. It is used to verify whether Salmonella performance standards are being met but not to determine prevalence of contamination or to track trends. Beginning in , the testing strategy changed from random sampling to a sampling method focusing on establishments with the highest frequency of rinsates that yielded Salmonella and on those serotypes most frequently associated with human salmonellosis [ 15 ].
Shell eggs that originate from SE-positive flocks or are at higher risk of Salmonella contamination for other reasons are diverted for processing into pasteurized egg products; not all shell eggs entering processing facilities are at increased risk for contamination.
FSIS inspects liquid, frozen, and dried egg products and tests samples from pasteurization processes monthly with use of PCR for Salmonella , followed by culture for PCR-positive samples [ 16 ]. We included all reported human cases of SE infection during — in the analyses.
We used a negative binomial regression model to estimate incidence of SE infection, adjusting for changes to the surveillance areas and site-to-site variation in disease rates [ 17 ]. We compared model-adjusted incidence of SE infection across all sites for each year during — with the mean model-adjusted incidence during — When the data were further stratified, the model no longer converged.
Therefore, for stratified analyses, we examined crude incidence during —, when the FoodNet catchment population was unchanged. Change in relative incidence from through was calculated from a least squares best-fit line through the plotted — incidence rates. Seasonality of 1 incidence of SE infection and 2 percentage of all reported cases of Salmonella infection due to SE were examined using month of specimen collection. We compared crude SE incidence during — with the mean crude incidence during — We examined SE contamination of broiler chickens during —, the period of random sampling.
We describe yearly changes in the percentage of broiler chicken rinsates collected that yielded SE. We examined yearly percentages of samples of pasteurized egg products that yielded SE during — Because reporting to PulseNet was limited before , we examined data during — for yearly changes in the most common PFGE patterns in SE isolated from humans.
Because SE is a clonal organism that has a limited number of different PFGE patterns, we examined changes in the 5 most commonly reported patterns by year. Statistical analyses were performed using SAS, version 9.
This surveillance data review was determined not to be research; thus, the project did not undergo human subjects review. Model-adjusted annual incidence of SE infection during — remained similar to the — mean of 1. Incidence then steadily increased to a maximum of 2. During —, SE infections were reported. Incidences among male and female individuals were similar during this period Table 1. By FoodNet site, the mean annual incidence was highest in Maryland, followed by Connecticut and California.
A total of cases of Salmonella serotype Enteritidis infection were reported. Calculated from least squares best-fit line through plotted — incidence data.
The percentage of patients with SE infection who did not report recent international travel increased steadily during —, from The percentage of cases reported to be sporadic ie, not part of an outbreak and the percentage of patients who were hospitalized or who died remained generally stable during — International travel: illness date of onset within 7 days of return to United States or during travel.
Incidence of SE infection in FoodNet during — peaked during the summer months and was lowest during the late winter months. Serotype infections are considered invasive when the Salmonella is isolated from blood or another part of the body that usually has no bacteria in it at all. Since the s, public health scientists in the US have used serotyping to help find Salmonella outbreaks and track them to their sources.
An Atlas of Salmonella pdf icon [PDF — pages] is the first-of-its-kind report that charts over 40 years of laboratory-confirmed surveillance data on 32 Salmonella serotypes. The Atlas is available to download in its entirety or in 32 individual Salmonella serotypes reports. These snapshots highlight five Salmonella serotypes, their history, and some surprising facts. In while studying swine diseases, microbiologist Theobold Smith and veterinarian Daniel Salmon discovered the first type of Salmonella and found that it caused a serious illness in pigs.
Salmonella Choleraesuis, named for Dr. Salmon, is not included in the Atlas because it is so rare. Human cases of infection with this serotype are unusual in the United States and typically occur in adults who live in rural areas and work with pigs.
The average age of people infected with serotype Choleraesuis is around Few infections occur in children. Salmonella Choleraesuis is unusual—although not unique—because it often invades the bloodstream. Unlike many more common Salmonella serotypes, over half of the serotype Choleraesuis infections are invasive. Outbreaks caused from eating contaminated pork are extremely rare. The reports from sources other than humans are almost all from pigs. It remains an important cause of disease in pigs to this day.
Salmonella serotype Enteritidis pdf icon [PDF — 15 pages]. Like the majority of other serotypes affecting humans, Salmonella Enteritidis SE affects people of all ages. Infections increased in the early s in the Northeastern states, spread to the mid-Atlantic region by the end of the decade, then catapulted to California and gradually, the rest of the country. At the same time, it spread around the world.
Now, SE is the most common serotype in the United States and in many other countries. Enteritidis and S. Compared to the standard methods, these rapid methods usually bring ease of use to the users as well as reduced times to results which add flexibility to the management of the analytical and business flows. Typhimurium along the Food Chain. Arnold M. Bayesian Source attribution of Salmonella Typhimurium isolates from human patients and farm animals in England and Wales.
Banerji S. Genome-based Salmonella serotyping as the new gold standard. Nature Research, , Cadel-Six S. Sites, — Wkly Rep. Cheng RA. EFSA Journal ;19 2 , p. Second Edition. To prohibit the movement in interstate commerce of adulterated and misbranded food, drugs, devices, and cosmetics, and for other purposes.
Food Safety Modernization Act. Grimont P. Antigenic Formulae of the Salmonella Serovars. Foods , 10, Huang X. Transcriptional sequencing uncovers survival mechanisms of Salmonella enterica serovar Enteritidis in antibacterial egg white.
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