Imported Salmonella Enteritidis cases: a multiphage outbreak among Austrian vacationers in Turkey, 2008.

An outbreak of Salmonella Enteritidis infection among high school graduates was associated with the 2008 three-week Summer Splash event in Turkey. A similar outbreak, caused by Salmonella Enteritidis PT6, affected 70 of 2879 graduates attending the 2007 Summer Splash event. A total of 103 cases of Salmonella Enteritidis were identified by passive and active case finding among the 8914 participants of the 2008 event. A case series investigation was performed. The cases originated from eight of the nine Austrian provinces. Among 59 laboratory-confirmed S. Enteritidis cases, the most commonly identified phage type was PT21 (72.9%), followed by PT6 (18.6%), PT7 and PT3 (3.4% each). To our knowledge, none of the published outbreaks of salmonellosis in the past 10 years has involved multiple phage types. Among the three hotels within the resort complex, the highest number of outbreak cases was identified among the students who stayed at Hotel A (n = 37), followed by Hotel B (n = 33) and Hotel C (n = 32). Eggs and egg-containing products frequently offered at meals in all three hotels were hypothesized as the source of infection. Reliable findings from investigation of imported outbreaks enable the appropriate response measures in the country of origin. As a consequence of the effective programs for reducing salmonella in domestic animals intended for human consumption in Austria, the number of imported cases will gain importance in the coming years, and salmonellosis will increasingly appear as traveler's diarrhoea.