Institute of Environmental Science and Research Ltd., Wellington, New Zealand.
Foodborne Pathog Dis. 2013 Feb;10(2):159-64. doi: 10.1089/fpd.2012.1282. Epub 2013 Jan 29.
A cluster of salmonellosis cases caused by Salmonella Typhimurium phage type 42 (STM42) emerged in New Zealand in October 2008. STM42 isolates from a wheat-based poultry feed raw material (broll; i.e., product containing wheat flour and particles of grain) had been identified in the 2 months prior to this cluster. Initial investigations indicated that eating uncooked baking mixture was associated with illness. A case-control study was conducted to test the hypothesis that there was an association between STM42 cases and consumption of raw flour or other baking ingredients. Salmonella isolates from human and non-human sources were compared using pulsed-field gel electrophoresis (PFGE) and multiple-locus variable number tandem repeat analysis (MLVA). Environmental investigations included testing flour and other baking ingredients from case homes, unopened bags of flour purchased from retail stores, and inspection of an implicated flour mill. A case-control study of 39 cases and 66 controls found cases had 4.5 times the odds of consuming uncooked baking mixture as controls (95% confidence interval [CI] 1.6-12.5, p-value 0.001). Examination of individual baking ingredients found that, after adjusting for eggs, flour had an odds ratio (OR) of 5.7 (95% CI 1.1-29.1, p-value 0.035). After adjusting for flour, eggs had an OR of 0.8 (95% CI 0.2-3.4, p-value 0.762). PFGE patterns were identical for all STM42 isolates tested; however, MLVA distinguished isolates that were epidemiologically linked to the cluster. STM42 was recovered from flour taken from four cases' homes, two unopened packs purchased from retail stores and packs from three batches of retrieved (recalled) product. This outbreak was associated with the consumption of uncooked baking mixture containing flour contaminated with STM42. The implicated flour mill initiated a voluntary withdrawal from sale of all batches of flour thought to be contaminated. Media releases informed the public about implicated flour brands and the risks of consuming uncooked baking mixture.
2008 年 10 月，新西兰出现了由肠炎沙门氏菌噬菌体 42 型（STM42）引起的一组沙门氏菌病病例。在该群组出现前的 2 个月，从一种基于小麦的家禽饲料原料（即含有小麦面粉和谷物颗粒的产品）中分离出 STM42 分离株。初步调查表明，食用未煮熟的烘焙混合物与疾病有关。进行了病例对照研究，以检验 STM42 病例与食用生面粉或其他烘焙成分之间存在关联的假设。使用脉冲场凝胶电泳（PFGE）和多位点可变数串联重复分析（MLVA）比较了来自人类和非人类来源的沙门氏菌分离株。环境调查包括测试来自病例家庭的面粉和其他烘焙成分、从零售店购买的未开封面粉袋以及对受影响的面粉厂进行检查。对 39 例病例和 66 例对照进行的病例对照研究发现，病例食用未煮熟的烘焙混合物的几率是对照的 4.5 倍（95%置信区间 [CI] 1.6-12.5，p 值 0.001）。检查个别烘焙成分发现，在调整鸡蛋后，面粉的比值比（OR）为 5.7（95%CI 1.1-29.1，p 值 0.035）。在调整面粉后，鸡蛋的 OR 为 0.8（95%CI 0.2-3.4，p 值 0.762）。对所有测试的 STM42 分离株进行 PFGE 模式均相同；然而，MLVA 区分了与该群组具有流行病学联系的分离株。从四个病例家庭、从零售店购买的两个未开封包装和三个批次回收（召回）产品中取出的面粉中分离出 STM42。此次暴发与食用受 STM42 污染的生烘焙混合物有关。受影响的面粉厂自愿停止销售所有批次的面粉，这些面粉被认为受到污染。媒体发布通知公众有关受影响的面粉品牌和食用未煮熟的烘焙混合物的风险。
