The paper describes the introduction of Mycobacterium bovis into Swedish deer herds and its possible consequences. The different control strategies applied are summarized as well as their shortcomings under the conditions of the Swedish outbreak. An alternative control, to be used in extensive deer herds, based only on slaughter and meat inspection is described. Finally, the efficiency of the implemented control and surveillance systems are discussed and possible improvements suggested.
Campylobacteriosis is the most frequently reported zoonosis in the EU and the epidemiology of sporadic campylobacteriosis, especially the routes of transmission, is to a great extent unclear. Poultry easily become colonised with Campylobacter spp., being symptom-less intestinal carriers. Earlier it was estimated that internationally between 50% and 80% of the cases could be attributed to chicken as a reservoir. In a Norwegian surveillance programme all broiler flocks under 50 days of age were tested for Campylobacter spp. The aim of the current study was to identify simultaneous local space-time clusters each year from 2002 to 2007 for human cases of campylobacteriosis and for broiler flocks testing positive for Campylobacter spp. using a multivariate spatial scan statistic method. A cluster occurring simultaneously in humans and broilers could indicate the presence of common factors associated with the dissemination of Campylobacter spp. for both humans and broilers.
Local space-time clusters of humans and broilers positive for Campylobacter spp. occurring simultaneously were identified in all investigated years. All clusters but one were identified from May to August. Some municipalities were included in clusters all years.
The simultaneous occurrence of clusters of humans and broilers positive for Campylobacter spp. combined with the knowledge that poultry meat has a nation-wide distribution indicates that campylobacteriosis cases might also be caused by other risk factors than consumption and handling of poultry meat.Broiler farms that are positive could contaminate the environment with further spread to new broiler farms or to humans living in the area and local environmental factors, such as climate, might influence the spread of Campylobacter spp. in an area. Further studies to clarify the role of such factors are needed.
Cites: Appl Environ Microbiol. 2004 Dec;70(12):7474-8015574950
The Norwegian Action Plan against Campylobacter in broilers was implemented in May 2001 with the objective of reducing human exposure to Campylobacter through Norwegian broilers. From each flock, samples collected at the farm about one week prior to slaughter, and then again at the slaughter plant, are examined for the presence of Campylobacter. All farmers with positive flocks are followed up with bio-security advice. Sampling of broiler products at retail level is also included in the Action Plan. The aim of this study was to evaluate the existing sampling and culturing methods of the Norwegian Action Plan against Campylobacter in broilers. The material collected was pooled faecal samples, pooled cloacae samples and caecae samples from individuals. The highest number of positives, from culturing of the pooled faecal samples, the pooled cloacae swabs and the caecae swabs from individuals, were obtained at incubation temperature 41.5 degrees C. When comparing the results at incubation temperature 37 and 41.5 degrees C, the faecal samples from the farms demonstrated a high concordance, with a kappa value of 0.88. The results from culturing cloacae swabs and caecae samples from slaughter plant level at two temperatures did not agree very well with a kappa value of 0.21 and moderate value of 0.57, respectively, but were both disconcordant at a level of 0.05. Modelling farm level data indicated that if increasing the number of pooled samples per flock from two (in existing regime) to three, the flock sensitivity increases from 89% to 95%. Modelling of slaughter plant data indicated that three pooled cloacae swabs are needed to identify 90% of the positive flocks. The results from the modelling of caecae data indicated that samples from seven individuals are sufficient to identify 90% of the positive flocks and caecae samples could thus be an alternative to cloacae sampling at slaughter plant level.
Population data and apparent prevalence data from the Salmonella surveillance and control program in pigs (NSSCP) from 1998 and 1999 were used in a simulation model to evaluate the efficacy of the program. The model consists of three parts: modelling of individual prevalence at the abattoir (abattoir part), modelling of the number of sampled herds of different sizes when carcasses are randomly sampled at the abattoir (sampling strategy part) and finally, modelling of the within herd prevalence (within herd part). A total of 136,550 sows and 2,866,550 finishing pigs slaughtered, 4446 herds and 11 herds positive for Salmonella in 1994/1995-2000 were included in the abattoir part, sampling strategy part and the within herd part of the model, respectively. The abattoir part showed an average estimated prevalence of Salmonella in sows and finishing pigs of (median) 0.4% (5-95 percentiles = 0.03-2%) and 0.1% (0.04-0.2%) respectively. The estimated number of infected sow carcasses that entered the market was 502 (37-2157) while the estimated number of finishing pig carcasses was 2919 (1218-5771). The probability of being sampled for the 10% smallest herds was (mean) 1.9% (1.6-2.2), to 25% (24.7-26.5%) for the 10% largest herds. The within herd prevalence was estimated to be from 1% to 4% for Norwegian pig herds. The conclusions drawn from this evaluation are that the NSSCP does not have any significant consumer protection effect, and that the documentation could be done more effectively using the herd rather than the individual animal as the unit of sampling. Sampling should focus on the larger herds supplying most of the meat on the market and on herds that produce breeding sows and piglets and thus can contribute to the spread of Salmonella among herds.
In May/June 2005 an outbreak of diarrhoeal illness occurred among company employees in Copenhagen. Cases were reported from seven of eight companies that received food from the same catering kitchen. Stool specimens from three patients from two companies were positive for Campylobacter jejuni. We performed a retrospective cohort study among employees exposed to canteen food in the three largest companies to identify the source of the outbreak and to prevent further spread. Using self-administered questionnaires we collected information on disease, days of canteen food eaten and food items consumed. The catering kitchen was inspected and food samples were taken. Questionnaires were returned by 295/348 (85%) employees. Of 247 employees who ate canteen food, 79 were cases, and the attack rate (AR) was 32%. Consuming canteen food on 25 May was associated with illness (AR 75/204, RR=3.2, 95%CI 1.3-8.2). Consumption of chicken salad on this day, but not other types of food, was associated with illness (AR=43/97, RR=2.3, 95%CI 1.3-4.1). Interviews with kitchen staff indicated the likelihood of cross-contamination from raw chicken to the chicken salad during storage. This is the first recognised major Campylobacter outbreak associated with contaminated chicken documented in Denmark. It is plausible that food handling practices contributed to transmission, and awareness of safe food handling and storage has since been raised among kitchen staff. The low number of positive specimens accrued in this outbreak suggests a general underascertainment of adult cases in the laboratory reporting system by a factor of 20.
Erratum In: Euro Surveill. 2006 May;11(5):1 p following 139
A large outbreak of enterohaemorrhagic Escherichia coli (EHEC) infections occurred in southern Sweden during autumn 2002. A matched case-control study was performed and indicated an association between consumption of fermented sausage and EHEC infection (odds ratio 5.4, P
An outbreak of listeriosis in Sweden, consisting of nine cases, was investigated by means of molecular typing of strains from patients and strains isolated from suspected foodstuffs, together with interviews of the patients. Listeria monocytogenes was isolated from six of the patients, and all isolates were of the same clonal type. This clonal type was also isolated from a "gravad" rainbow trout, made by producer Y, found in the refrigerator of one of the patients. Unopened packages obtained from producer Y were also found to contain the same clonal type of L. monocytogenes. Based on the interview results and the bacteriological typing, we suspect that at least six of the nine cases were caused by gravad or cold-smoked rainbow trout made by producer Y. To our knowledge, this is the first rainbow trout-borne outbreak of listeriosis ever reported.
In November-December 2008, Norway and Denmark independently identified outbreaks of Salmonella Typhimurium infections characterised in the multiple-locus variable number of tandem repeats analysis (MLVA) by a distinct profile. Outbreak investigations were initiated independently in the two countries. In Denmark, a total of 37 cases were identified, and multiple findings of the outbreak strain in pork and pigs within the same supply chain led to the identification of pork in various forms as the source. In Norway, ten cases were identified, and the outbreak investigation quickly indicated meat bought in Sweden as the probable source and the Swedish authorities were alerted. Investigations in Sweden identified four human cases and two isolates from minced meat with the distinct profile. Subsequent trace-back of the meat showed that it most likely originated from Denmark. Through international alert from Norway on 19 December, it became clear that the Danish and Norwegian outbreak strains were identical and, later on, that the source of the outbreaks in all three countries could be traced back to Danish pork. MLVA was instrumental in linking the outbreaks in the different countries and tracing the source. This outbreak illustrates that good international communication channels, early alerting mechanisms, inter-sectoral collaboration between public health and food safety authorities and harmonised molecular typing tools are important for effective identification and management of cross-border outbreaks. Differences in legal requirements for food safety in neighbouring countries may be a challenge in terms of communication with consumers in areas where cross-border shopping is common.
An outbreak of Salmonella typhimurium infection, affecting 170 people in Funen, Denmark, was detected in late summer 1996. To detect risk factors for S. typhimurium infection and test the hypothesis that pork originating from a local slaughterhouse was the source, a matched case-control study of 47 cases and 89 controls was conducted. No single food item could be associated with S. typhimurium infection. However, of 29 cases, 24 (83%) had consumed pork which could be traced to the slaughterhouse. In comparison, 25 (46%) of 54 controls had consumed pork of the same origin (odds ratio: 6.7; 95% confidence interval: 1.8-23.5; p = 0.003). The results showed that consumption of pork from the concerned slaughterhouse was strongly associated with S. typhimurium infection.
Between April and June 2010, a small national outbreak of Salmonella Typhimurium with a particular multilocus variable-number tandem repeat analysis (MLVA) type was identified in Denmark through laboratory-based surveillance. The outbreak involved twenty cases, primarily living within the greater Copenhagen area. Half of the cases were children aged ten years or younger and 12 were male; three cases were hospitalised.A matched case-control study showed a strong link between illness and eating a particular salami product containing pork and venison, matched odds ratio(mOR):150, confidence interval (CI): 19?1,600. The salami had been produced in Germany. Microbiological confirmation in food samples was sought but not obtained. Danish consumers were notified that they should return or dispose of any packages from the suspected salami batch. Because the salami product had potentially been sold in other European countries, the European Centre for Disease Prevention and Control urgent enquiry and Rapid Alert System for Food and Feed systems were used to highlight the possibility of outbreaks in these countries. Case-control studies area strong tool in some outbreak investigations and evidence from such studies may give sufficient information to recall a food product.