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      Salmonella Enteritidis Infections, United States, 1985–1999

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          Abstract

          Salmonella enterica serotype Enteritidis emerged as an important illness during the 1980s. Investigations showed that consumption of undercooked eggs was the major risk factor for disease, and a variety of prevention and control efforts were initiated during the 1990s. We describe sporadic infections and outbreaks of S. Enteritidis in the United States from 1985 through 1999 and discuss prevention and control efforts. After reaching a high of 3.9 per 100,000 population in 1995, S. Enteritidis infections declined to 1.98 per 100,000 in 1999. While the total number of outbreaks decreased by half, those in the western states tripled. Outbreaks of S. Enteritidis phage type 4 infections accounted for 49% of outbreaks in 1999. Outbreak-associated deaths in health facilities decreased from 14 in 1987 to 0 in 1999. Overall, rates of sporadic S. Enteritidis infection, outbreaks, and deaths have declined dramatically. For further reductions, control measures should continue to be applied along the entire farm-to-table continuum.

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          Most cited references15

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          A phage-typing scheme for Salmonella enteritidis.

          For many years phage typing has proved invaluable in epidemiological studies on Salmonella typhi, S. paratyphi A and B, S. typhimurium and a few other serotypes. A phage-typing scheme for S. enteritidis is described. This scheme to date differentiates 27 types using 10 typing phages.
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            The emergence of grade A eggs as a major source of Salmonella enteritidis infections. New implications for the control of salmonellosis.

            From 1976 to 1986, reported Salmonella enteritidis infections increased more than sixfold in the northeastern United States. From January 1985 to May 1987, sixty-five foodborne outbreaks of S enteritidis were reported in the Northeast that were associated with 2119 cases and 11 deaths. Twenty-seven (77%) of the 35 outbreaks with identified food vehicles were caused by Grade A shell eggs or foods that contained such eggs. National data from 1973 to 1984 showed that S enteritidis outbreaks (44%) were more frequently associated with egg-containing foods than were outbreaks of other Salmonella serotypes (15%). Reflecting the geographic distribution of human illness, cultures of bulk raw eggs from pasteurization plants in the Northeast more frequently yielded S enteritidis (10%) than did eggs from other regions of the United States (0%). The epidemic rise in S enteritidis infections due to Grade A shell eggs is unlike past problems of salmonellosis associated with cracked or soiled eggs and raises the possibility of trans-ovarian contamination of eggs with S enteritidis. New techniques may therefore be needed to control resurgent egg-associated salmonellosis in the United States.
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              Outbreaks of Salmonella enteritidis infections in the United States, 1985-1991.

              The spread of Salmonella enteritidis infections in the United States was tracked to identify potential risk factors and preventive measures. Isolation rates and information regarding outbreaks of S. enteritidis from 1985 through 1991 were determined by reports to the national Salmonella surveillance system and through the foodborne disease outbreak surveillance system. From 1985 through 1991, 380 outbreaks were reported involving 13,056 ill persons and 50 deaths. The proportion of Northeast outbreaks fell from 81% in 1985 to 55% in 1991 as the number of outbreaks in other areas increased. Grade A shell eggs were implicated in 82% of outbreaks. Case-fatality rates in nursing homes and hospitals were 70 times higher than in other settings. Cultures of environmental or animal specimens from all farms tested yielded S. enteritidis. Eggborne S. enteritidis infections are a major public health problem. Preventive measures, including educating consumers about proper handling of eggs, using pasteurized eggs, and controlling infections on egg farms, may stem the impact of this disease.
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                Author and article information

                Journal
                Emerg Infect Dis
                Emerging Infect. Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                January 2004
                : 10
                : 1
                : 1-7
                Affiliations
                [* ]Centers for Disease Control and Prevention, Atlanta, Georgia, USA
                []U.S. Department of Agriculture, Atlanta, Georgia, USA
                []Food and Drug Administration, Rockville, Maryland, USA
                Author notes
                Address for correspondence: Mary E. Patrick, Division of Health Assessment and Promotion, DeKalb County Board of Health, Decatur, Georgia 30031, USA; fax: 404-294-3842; email: mcevans@ 123456gdph.state.ga.us
                Article
                02-0572
                10.3201/eid1001.020572
                3322758
                15078589
                1b4e29ce-3ffe-4087-85da-8cb1850f476c
                History
                Categories
                Perspective

                Infectious disease & Microbiology
                salmonella enteritidis,eggs,outbreaks
                Infectious disease & Microbiology
                salmonella enteritidis, eggs, outbreaks

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