Abstract
A large outbreak of Shigella sonnei gastroenteritis occurred in Murcia Region (Southeast Spain) in the winter of 1995–1996. More than 200 people were affected. Epidemiological investigations implicated a regionally manufactured fresh pasteurised milk cheese as the vehicle of infection. A case–control study showed a statistically significant association between the illness and consumption of the suspect cheese. The dispersed sale of the cheese resulted in a regional dissemination of the organism and people were affected in eight townships. Research suggested that an infected foodhandler at the cheese factory might have been the source of contamination and that the processing method might have allowed cross-contamination to occur. This study emphasises the importance of increasing the control of strict hygiene during the processing of fresh cheese, since legislation does not forbid direct contact by hand that could result in contamination of cheese even when the milk pasteurisation process was correctly performed.
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References
Dupont HL. Shigella species. In: Mandell GL, Bennett JE, Dolin R (eds), Principles and Practice of Infectious Diseases. New York: Churchill Livingstone, 1995: 2033–2035.
Newman CPS. Surveillance and control of Shigella sonnei infection. Commun Dis Rep CDR Rev 1993; 3: R63–68.
Cano R, Mangas Y, Velasco ML, et al. Vigilancia Epidemiológica de la disenteria bacilar en Espaîa. Aîos 1990–1994. Boletín Epidemiológico Semanal 1995; 3: 305–308.
Kapperud G, Rorvik LM, Hasseltvedt V, et al. Outbreak of Shigella sonnei infection traced to imported iceberg lettuce. J Clin Microbiol 1995; 33: 609–614.
Davis H, Taylor JP, Perdue JN, et al. A shigellosis outbreak traced to commercially distributed shredded lettuce. Am J Epidemiol 1988; 128: 1312–1321.
Mølbak K, Neimman J. Outbreak of Shigella sonnei infections related to uncooked ‘baby maize’ imported from Thailand. Eurosurveillance weekly 1998; 2: 980813. Avaiable at http://www.outbreak.org/1998/980813.html.
Desenclos JC, Bouvet P, Benz-Lemoine E, et al. Large outbreak of Salmonella enterica serotype paratyphi B infection caused by a goats' milk cheese, France 1993: A case finding and epidemiological study. BMJ 1996; 312: 91–94.
Maguire H, Cowden J, Jacob M, et al. An outbreak of Salmonella dublin infection in England and Wales associated with a soft unpasteurized cows' milk cheese. Epidemiol Infect 1992; 109: 389–396.
Maguire HCF, Boyle M, Lewis MJ, et al. A large outbreak of food poisoning of unknown aetiology associated with Stilton cheese. Epidemiol Infect 1991; 106: 497–505.
Raw milk cheeses and salmonella (editorial). BMJ 1996; 312: 67–68.
Djuretic T, Wall PG, Nichols G. General outbreaks of infectious intestinal disease associated with milk and dairy products in England and Wales: 1992–1996. Commun Dis Rep CDR Rev 1997; 7: R41–45.
Hedberg CW, Korlath JA, D'Aoust JY, et al. A multistate outbreak of Salmonella javiana and Salmonella oranienburg infections due to consumption of contaminated cheese. JAMA 1992; 268: 3203–3207.
Garcíá-Fulgueiras A, Gutierrez Perez E, Gutierrez Martíń ML. Sãnchez Verdoux S. Estadisicas Básicas de las Enfermedades de Declaracioń Obligatoria. Serie Informes n_22. Murcia: Consejeria de sanidad y Poli-tica Social, 1998.
National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility testing, vol 19. Ninth informational supplement. National Committee for Clinical Laboratory Standards. Wayne Pa, 1999.
Kado CI, Liu ST. Rapid procedure for detection and isolation of large and small plasmid. J Bacteriol 1981; 145: 1365–1373.
Bentley CA, Frost JA, Rowe B. Phage typing and drug resistance of Shigella sonnei isolated in England and Wales. Epidemiol Infect 1996; 116: 295–302.
Hedberg CW, Levine WC, White KE, et al. An international foodborne outbreak of Shigellosis associated with a commercial airline. JAMA 1992; 268: 3208–3212.
Parashar UD, Dow L, Fankhauser RL, et al. An outbreak of viral gastroenteritis associated with consumption of sandwiches: Implication for the control of transmission by food handlers. Epidemiol Infect 1998: 121: 615–621.
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García-Fulgueiras, A., Sánchez, S., Guillén, J. et al. A large outbreak of Shigella sonnei gastroenteritis associated with consumption of fresh pasteurised milk cheese. Eur J Epidemiol 17, 533–538 (2001). https://doi.org/10.1023/A:1014504305666
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DOI: https://doi.org/10.1023/A:1014504305666