Published Date: 2005-03-25 23:50:00
Subject: PRO/AH/EDR> Salmonellosis, serovar Bovismorbificans, raw pork - Germany
Archive Number: 20050325.0869

SALMONELLOSIS, SEROVAR BOVISMORBIFICANS, RAW PORK - GERMANY
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Date: Thu, 24 Mar 2005
From: ProMED-mail <promed@promedmail.org>
Source: Eurosurveillance Weekly 24 Mar 2005 [edited]
<http://www.eurosurveillance.org/ew/2005/050324.asp>

Outbreak of _Salmonella_ Bovismorbificans PT24, Germany, Dec 2004-Mar 2005
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Since late 2004, there has been an increase in
notifications of _Salmonella enterica_ serovar
Bovismorbificans infections in northwest Germany.
Over the 13 weeks between 29 Nov 2004 and 17 Mar
2005, 525 cases of laboratory-confirmed _S.
Bovismorbificans_ were reported to the Robert
Koch-Institut (RKI) with a peak of onset of
symptoms in the 3rd week of 2005 [Figure - see
URL link above]. A 62-year-old woman has died of
the infection.
An inquiry through Enter-net in Jan 2005 did not
show any increase [in cases] of _Salmonella
Bovismorbificans_ in other European countries
[1]. This serovar was one of the 10 most
frequently notified salmonella serovars detected
in humans between 2001 and 2003 in Germany: 152
cases of _S. Bovismorbisficans_ were notified in
2003 (0.3 percent of all notified salmonella
cases with serovar information), 186 cases in
2002 (0.3 percent), and 388 cases in 2001 (0.5
percent).
We report the preliminary results of a
case-control study conducted by the RKI in
cooperation with the federal states involved.
Figure. _S. Bovismorbificans_ outbreak 2004/2005,
Germany: Number of cases with the week of
reported symptom onset. Weeks 48/2004 to 07/2005
(n=402) [see URL link above]
On the basis of initial laboratory results and
exploratory interviews with patients by the
responsible local health authorities, the
hypothesis evolved that raw pork products were
the likely vehicle of transmission. Raw meat
products are consumed frequently in various
regions of Germany.
In cooperation with the federal states with the
highest number of cases (Nordrhein-Westfalen,
Hessen, Mecklenburg-Vorpommern,
Schleswig-Holstein, Hamburg and Niedersachsen) a
case-control study was conducted to validate this
hypothesis.
Cases were defined as people living in one of the
federal states listed above with onset of
gastroenteritis between 1 Dec 2004 and 10 Feb
2005 and stool cultures positive for _S.
Bovismorbificans_. For every case, one control
was chosen at random by sequential sequence
telephone dialling.
Altogether, 141 cases and 135 controls were
included in the study. Among the queried food
items, raw minced pork was clearly associated
with illness (Odds Ratio= 11.0; 95 percent
Confidence Interval: 4.2-28.9). Additionally, a
particular fermented raw pork sausage was
associated with infection (Zwiebelmettwurst). The
consumption of all other food items was similar
between cases and controls.
Comparative subtyping of the _S.
Bovismorbificans_ isolates by pulsed-field gel
electrophoresis (PFGE) and phage typing found
that case isolates and isolates from some pork
products were indistinguishable (phage type 24).
On the basis of these findings, intensive efforts
are being made to trace the possible food source
of this outbreak at the level of meat suppliers.
Since one of the implicated meat suppliers
exports products to other European and
non-European countries, associated cases may have
appeared in other countries. If the occurrence of
_S. Bovismorbificans_ PT 24 is observed in other
countries in humans or food samples, the
following authors would like to be informed:
Andreas Jansen (<jansena@rki.de>), Andreas Gilsdorf , Juliane Braeunig
References:
Enter-net website.
<http://www.hpa.org.uk/hpa/inter/enter-net_menu.htm>
Robert Koch-Institut. Zu einem �berregionalen
Ausbruch von Salmonella Bovismorbificans: Erste
Ergebnisse einer Fall-Kontroll-Studie.
Epidemiologisches Bulletin 2005; 07: 54-55
<http://www.rki.de/cln_011/nn_335538/DE/Content/Infekt/EpidBull/Archiv/2005/07__05,templateId=raw,property=publicationFile.pdf/07_05>
--
ProMED-mail
<promed@promedmail.org
[In 2001, an outbreak of the _S. enterica_
serotype Bovismorbificans (36 cases due to phage
type 32) was linked to iceberg lettuce in
Australia (ProMED posting 20010901.2088.
In addition to salmonellosis, other infections
associated with the ingestion of raw or
undercooked pork include trichinosis, _Taenia
solium_ (the pork tapeworm), and the bacterium
_Yersinia enterocolitica_ - Mod.LL]

See Also

Salmonellosis, kebab shop - UK (London)(03) 20050317.0776
Salmonellosis, kebab shop - UK (London) 20050311.0719
Salmonellosis, food-borne - Australia (VIC)(05) 20050127.0298
Salmonellosis, food-borne - Australia (VIC) 20050122.0231
Gastroenteritis - Australia (Victoria): salmonellosis susp, RFI 20050121.0208
2004
----
Salmonellosis, tomatoes, convenience stores - USA (10) 20041227.3423
Salmonellosis, serotype Thompson, lettuce - Norway: alert 20041128.3178
Salmonella, eggs - UK ex Spain 20041019.2835
Salmonellosis, serotype Newport - UK (England)(03) 20041012.2786
Salmonellosis, serotype Newport - UK (England) 20040920.2604
Salmonellosis, meat products - UK (Durham) (02) 20040808.2185
Salmonellosis, meat products - UK (Durham) 20040804.2124
Salmonellosis, foodborne - Russia (W. Siberia): RFI 20040803.2114
Salmonellosis, tomatoes, convenience stores - USA (Multistate) 20040715.1911
Salmonella, almonds - worldwide recall 20040523.1381
Salmonella, almonds - USA (multistate): recall 20040519.1336
2003
----
Salmonellosis, restaurant related - Greece 20030810.1975
Salmonellosis, restaurant related - USA (IL) 20030709.1682
Salmonellosis, foodborne - UK (England), USA (NM) 20030626.1578
Salmonellosis, sesame seed prod. - Australia (NSW) 20030407.0847
2001
----
Salmonellosis - Australia (Queensland) 20010901.2088
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