Knoblauch Astrid M, Bratschi Martin W, Zuske Meike K, Althaus Denise, Stephan Roger, Hächler Herbert, Baumgartner Andreas, Prager Rita, Rabsch Wolfgang, Altpeter Ekkehardt, Jost Marianne, Mäusezahl Mirjam, Hatz Christoph, Kiefer Sabine
Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland.
Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, Switzerland.
Swiss Med Wkly. 2015 Oct 2;145:w14182. doi: 10.4414/smw.2015.14182. eCollection 2015.
In July 2014, an outbreak of Salmonella enterica ssp. enterica serovar Bovismorbificans was detected in Switzerland. The goal of the outbreak investigation was to rapidly identify and eliminate the contamination source in order to prevent new cases.
A case-case study design was applied comprising reported cases of S. Bovismorbificans and cases of other serovars. A trawling questionnaire was administered by telephone interview. Data were collected for 34 cases (20 S. Bovismorbificans and 14 Salmonella spp.) pertaining to food consumption during the 72 hours prior to symptom onset.
A statistically significant association between an S. Bovismorbificans infection and the consumption of 'salads' (odds ratio [OR] 14.3, 95% confidence interval [CI] 1.47-138.27) as well as the consumption of 'sprouts' (OR 10.6, 95% CI 1.16-97.59) was found. Principal places of consumption of 'salads' and 'sprouts' in outbreak cases were restaurants in southern Germany (80.0%, 95% CI 56.3%-94.3%). Microbiological analysis in Germany identified S. Bovismorbificans on sprouts, and genotype analysis confirmed that Swiss and German cases shared the same outbreak strain. The contaminated products were removed from the market in Germany, preventing an on-going outbreak.
The combination of the applied methods and the collaboration between the two countries proved to be crucial elements of this investigation. A series of sprouts-associated salmonellosis outbreaks underpin the importance of this vegetable as a potential food-borne pathogen carrier.
2014年7月，瑞士检测到肠炎沙门氏菌亚种肠炎牛病亚种疫情。疫情调查的目标是迅速查明并消除污染源，以防止新病例出现。
采用病例对照研究设计，纳入报告的牛病亚种病例和其他血清型病例。通过电话访谈发放一份全面的调查问卷。收集了34例病例（20例牛病亚种病例和14例沙门氏菌属病例）在症状出现前72小时内的食物消费数据。
发现牛病亚种感染与“沙拉”消费（优势比[OR]14.3，95%置信区间[CI]1.47 - 138.27）以及“豆芽”消费（OR 10.6，95% CI 1.16 - 97.59）之间存在统计学显著关联。疫情病例中“沙拉”和“豆芽”的主要消费场所是德国南部的餐馆（80.0%，95% CI 56.3% - 94.3%）。德国的微生物分析在豆芽上检测到牛病亚种，基因分型分析证实瑞士和德国的病例共享同一疫情菌株。受污染产品在德国被撤出市场，防止了疫情的持续蔓延。
所采用方法的结合以及两国之间的合作被证明是本次调查的关键要素。一系列与豆芽相关的沙门氏菌病疫情突显了这种蔬菜作为潜在食源性病原体载体的重要性。
