National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne, Waterborne and Environmental Diseases, Program Office for Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, USA.
N Engl J Med. 2011 Aug 18;365(7):601-10. doi: 10.1056/NEJMoa1011208.
Contaminated food ingredients can affect multiple products, each distributed through various channels and consumed in multiple settings. Beginning in November 2008, we investigated a nationwide outbreak of salmonella infections.
A case was defined as laboratory-confirmed infection with the outbreak strain of Salmonella Typhimurium occurring between September 1, 2008, and April 20, 2009. We conducted two case-control studies, product "trace-back," and environmental investigations.
Among 714 case patients identified in 46 states, 166 (23%) were hospitalized and 9 (1%) died. In study 1, illness was associated with eating any peanut butter (matched odds ratio, 2.5; 95% confidence interval [CI], 1.3 to 5.3), peanut butter-containing products (matched odds ratio, 2.2; 95% CI, 1.1 to 4.7), and frozen chicken products (matched odds ratio, 4.6; 95% CI, 1.7 to 14.7). Investigations of focal clusters and single cases associated with nine institutions identified a single institutional brand of peanut butter (here called brand X) distributed to all facilities. In study 2, illness was associated with eating peanut butter outside the home (matched odds ratio, 3.9; 95% CI, 1.6 to 10.0) and two brands of peanut butter crackers (brand A: matched odds ratio, 17.2; 95% CI, 6.9 to 51.5; brand B: matched odds ratio, 3.6; 95% CI, 1.3 to 9.8). Both cracker brands were made from brand X peanut paste. The outbreak strain was isolated from brand X peanut butter, brand A crackers, and 15 other products. A total of 3918 peanut butter-containing products were recalled between January 10 and April 29, 2009.
Contaminated peanut butter and peanut products caused a nationwide salmonellosis outbreak. Ingredient-driven outbreaks are challenging to detect and may lead to widespread contamination of numerous food products.
受污染的食品成分可能会影响多种产品，每种产品通过不同的渠道分销，并在不同的环境中消费。从 2008 年 11 月开始，我们调查了一起全国范围的沙门氏菌感染爆发事件。
病例的定义为在 2008 年 9 月 1 日至 2009 年 4 月 20 日期间实验室确认感染暴发菌株鼠伤寒沙门氏菌的病例。我们进行了两项病例对照研究、产品“追溯”和环境调查。
在 46 个州确定的 714 例病例患者中，166 例（23%）住院，9 例（1%）死亡。在研究 1 中，患病与食用任何花生酱（匹配比值比，2.5；95%置信区间[CI]，1.3 至 5.3）、含花生酱的产品（匹配比值比，2.2；95%CI，1.1 至 4.7）和冷冻鸡肉产品（匹配比值比，4.6；95%CI，1.7 至 14.7）有关。对九个机构的焦点集群和单个病例的调查确定了一种单一的机构品牌花生酱（此处称为品牌 X），分发给所有设施。在研究 2 中，患病与在家外食用花生酱（匹配比值比，3.9；95%CI，1.6 至 10.0）和两种花生酱饼干（品牌 A：匹配比值比，17.2；95%CI，6.9 至 51.5；品牌 B：匹配比值比，3.6；95%CI，1.3 至 9.8）有关。这两种饼干品牌均由品牌 X 花生酱制成。暴发菌株从品牌 X 花生酱、品牌 A 饼干和其他 15 种产品中分离出来。2009 年 1 月 10 日至 4 月 29 日期间，召回了 3918 种含花生酱产品。
受污染的花生酱和花生制品导致了这起全国范围的沙门氏菌病爆发。由成分驱动的爆发难以检测，可能导致大量食品受到污染。
