Enteritidis pandemic was first noted in the late s and has been attributed to contaminated eggs The proportion of Salmonella infections associated with this serotype seems to have increased over time. Typhimurium has been 1 of the 2 most frequent serotypes in humans since 8. Since S. Typhimurium are so common, additional subtyping methods, including phage typing, antimicrobial susceptibility testing, and pulsed-field gel electrophoresis PFGE , are needed to identify clusters of infection from the same source.
WHO Global Salm-Surv includes antimicrobial susceptibility testing training in all regional courses and has introduced phage typing in the Eastern European region course. The country databank could include data from such subtyping efforts. Typhi is a pathogen of concern in the developing world, especially Asia However, in our analyses, S.
Typhi was the ninth most frequent serotype in Asia in The Asian countries that contributed to the country databank did not include many of the developing countries in south-central and Southeast Asia, where S. Typhi is still highly prevalent. Typhi was the sixth most frequent serotype globally in and was decreasing in relative importance 8. That trend seems to have continued; S. Typhi ranked 14th globally in Typhi has no animal reservoir, which makes it susceptible to improvements in hygiene and sanitation seen in many regions of the world, such as Latin America and the Caribbean.
The distribution of nonhuman serotypes is more heterogeneous than that of human serotypes. The same serotypes appear among the top 5 in human and nonhuman sources, although in a different order. Enteritidis is only the third most common serotype among nonhuman sources. In , it was not reported at all among the 10 most common nonhuman serotypes from North America. This finding partly reflects the capacity of S.
Enteritidis to contaminate eggs in low numbers and the difficulty of isolating it from food or the environment. Moreover, in North America, few samples from eggs are submitted for routine testing. For example, in the United States, routine testing of eggs is not required, whereas routine testing for salmonellae is required of meat and poultry plants.
As eggs are frequently used in foods that do not undergo heat treatment e. The country databank contains far fewer nonhuman than human serotypes, possibly because more participating laboratories are human national reference laboratories, fewer countries have formal nonhuman surveillance, and some countries may be less likely to share nonhuman data because of trade concerns.
In and , 15 of 22 countries reported nonhuman isolates by source. Food serotypes were reported from most countries 11 in and 12 in , followed by animal serotypes 7 countries in and 10 in Weltevreden from the environment, feed, animals, food, and humans in Southeast Asia is an example of how the country databank can be used to track Salmonella serotypes along the food chain. Many serotypes are restricted to a single region of the world.
This finding may reflect an ecologic niche or a local food source that is not exported. A number of such examples have been reported in the past, such as S. Tilene in imported African pygmy hedgehogs in the United States and Canada 14 — The country databank is uniquely placed to allow countries to observe this phenomenon. Investigators have reported infections of S. Javiana associated with exposure to wild amphibians in a confined area in the southeastern United States According to the country databank, S.
Javiana is only reported among the 15 most common serotypes in the United States. Weltevreden was largely restricted to Southeast Asia. A survey of Southeast Asian laboratories showed that items most frequently associated with this serotype include seafood, water, and Asian vegetables In the same region, S.
Rissen has increased in both human and nonhuman sources The country databank allows countries to become aware that a common serotype in their country may be rare elsewhere in the world, leading to hypothesis generation in outbreaks and studies to understand the sources of disease. Countries that report a large number of isolates to the country databank, such as North American and European countries, typically do not report rare serotypes because these would not rank in their top 15, thus limiting the ability to track rare serotypes in these countries.
Countries with fewer resources may lack complete antisera kits necessary to identify certain serotypes, which would lead to underreporting. For example, although we assume that S. Enteritidis human infections occur globally, a number of countries in Asia, Africa, and Latin America and the Caribbean did not report this serotype in their top 10 Table 2. Lack of resources can also cause misclassification of serotypes. For example, S. Paratyphi B was reported to be among the most common serotypes in Latin America and the Caribbean.
However, some countries in the region lack the capacity to differentiate between S. Paratyphi B and S. Paratyphi B tartrate var. In general, industrialized countries are more likely to regularly contribute to the country databank and to report more isolates.
The results are therefore biased towards the industrialized world. However, the country databank lacks data from many Western European countries. Twenty-four European countries report human Salmonella serotype results annually to Enter-net, a European-based surveillance network for gastrointestinal infections, as compared to only 14 reporting to WHO Global Salm-Surv from to A review of recent Enter-net data confirms that S. Enteritidis from to Ian Fisher, pers. A recent agreement between WHO Global Salm-Surv and Enter-net will lead to routine electronic sharing of data between the 2 systems to improve efficiency and representativeness Henrik Wegener, pers.
Serotypes reported by a region are not necessarily circulating locally and may have been imported through travel or traded foods. Intraregional comparisons are limited by the fact that case definitions and surveillance systems vary between countries. The country databank does not collect the source of isolation. Some countries may report salmonellae isolated from both blood and stool and others from stool only. The low number of isolates and countries reporting nonhuman data and the pooling of food, animal, environmental, and feed sources hamper further analysis of nonhuman data.
Some regional results may not be representative, since some regions have few countries reporting data to the country databank e. Some countries may not submit data to the country databank because of concern regarding international trading of food.
Others do not have the supplies or training necessary to conduct serotyping. All participating countries were initially provided with antisera to conduct serotyping. WHO Global Salm-Surv established an external quality assurance system EQAS in to assess the accuracy of serotyping and antimicrobial susceptibility testing among member national reference laboratories. The increased reporting of certain serotypes during the study period may be due to capacity improvement and increased participation in the country databank as well as real changes in the epidemiologic features of salmonellae.
Montevideo was first reported in Africa in In , Tunisia participated in the country databank for the first time and reported S. Montevideo in its top 15 increased participation.
Oceania started reporting S. Sushi made from frozen raw tuna is linked to 62 cases of Salmonella this year. Here are some of the biggest foodborne illness outbreaks since A Consumer Reports team looked for five types of bacteria that have been found on beef, including E. Most packages of ground beef in the grocery store contain at least one type of bacteria that could make you sick, according to their survey. The Food and Drug Administration has issued a ban on some cilantro imported from Mexico after an investigation to determine the cause of hundreds of reported intestinal illnesses in the United States dating back to People infected with the parasite Cyclospora cayetanensis experienced watery diarrhea, nausea, bloating and cramping.
Click here for tips on how to keep your food safe. Worst foodborne illness outbreaks — Raw milk can contain germs such as E. Chicken — In , Foster Farms chicken infected people in 29 states with a multidrug-resistant strain of Salmonella, according to the CDC. A total of cases were reported, and 71 people were hospitalized, according to the CDC.
Severe hepatitis cases can cause liver damage. The blend's pomegranate seeds came from a company in Turkey, which was the source of contamination. Cantaloupe — Cantaloupes tainted with salmonella infected more than people across 24 states in October Three people in Kentucky died and 94 were hospitalized.
Investigators determined Chamberlain Farms Produce Inc. Cantaloupe — In September , listeria in cantaloupes left 30 people dead in what was the deadliest U. The outbreak killed one person and sickened more than Eggs — In summer , more than 1, people were reportedly sickened by salmonella found in eggs produced by Iowa's Hillandale Farms , which voluntarily recalled about a half-billion eggs nationwide.
Celery — Authorities shut down a processing plant in Texas in October after four deaths were tied to listeria-infected celery produced at the site.
At least people were hospitalized, and the infection may have contributed to two deaths, according to the CDC. Walmart stores in four states recalled jars of serrano peppers as a result.
Peanut butter — Nine people died from salmonella-infected peanut butter between September and April The Peanut Corp. More than people were infected and hospitalized. Spinach — In the summer of , more than people became infected with E.
Investigators traced the prepackaged spinach back to Natural Selection Foods and baby spinach sold under the Dole brand name. Five deaths were linked to the outbreak. Tomatoes — During and , four large outbreaks of salmonella infections hit 21 states in the United States. Tainted tomatoes being served in restaurants were found to be the cause. All authors made substantial contributions to preparation and submission of manuscript. The funding sources had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Typhimurium outbreak by day of symptom onset. The branch where the outbreak strains are located was marked in blue color, and 11 of the self-test strains were marked in red color.
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