Epidemiology and Infection
- Epidemiology and Infection / Volume 139 / Issue 12 / December 2011, pp 1956-1964
- Copyright © Cambridge University Press 2011
- DOI: http://dx.doi.org/10.1017/S0950268810003110 (About DOI), Published online: 01 February 2011
Gastrointestinal infections
Shigellosis outbreak linked to canteen-food consumption in a public institution: a matched case-control study
I. GUTIÉRREZ GARITANOa1a2, M. NARANJOa3 c1, A. FORIERa4, R. HENDRIKSa5, K. DE SCHRIJVERa6, S. BERTRANDa3a7, K. DIERICKa3, E. ROBESYNa8 and S. QUOILINa2
a1 European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
a2 Operational Directorate for Surveillance and Public Health, Scientific Institute of Public Health, Brussels, Belgium
a3 Operational Directorate for Transmissible and Infectious Diseases, Scientific Institute of Public Health, Brussels, Belgium
a4 Infectious Disease Control Unit, Department of Public Health Surveillance, Flemish Agency for Care and Health, Limburg, Belgium
a5 Infectious Disease Control Unit, Department of Public Health Surveillance, Flemish Agency for Care and Health, Flemish Brabant, Belgium
a6 Infectious Disease Control Unit, Department of Public Health Surveillance, Flemish Agency for Care and Health, Antwerp, Belgium
a7 National Reference Centre for Salmonella and Shigella, Scientific Institute of Public Health, Brussels, Belgium
a8 Infectious Disease Control Unit, Department of Public Health Surveillance, Flemish Agency for Care and Health, Brussels, Belgium
SUMMARY
On 13 November 2009, the authorities of Flemish Brabant, Belgium, received an alert concerning a potential outbreak of Shigella sonnei at a public institution. A study was conducted to assess the extent, discover the source and to implement further measures. We performed a matched case-control study to test an association between shigellosis and canteen-food consumption. Water samples and food handlers' faecal samples were tested. The reference laboratory characterized the retrospectively collected Shigella specimens. We found 52 cases distributed over space (25/35 departments) and time (2 months). We found a matched odds ratio of 3·84 (95% confidence interval 1·02–14·44) for canteen-food consumption. A food handler had travelled to Morocco shortly before detection of the first laboratory-confirmed case. Water samples and food handlers' faecal samples tested negative for Shigella. Confirmed cases presented PFGE profiles, highly similar to archived isolates from Morocco. Foodborne transmission associated with the canteen was strongly suspected.
(Accepted December 15 2010)
(Online publication February 01 2011)
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Correspondence:
c1 Author for correspondence: Dr M. Naranjo Scientific Institute of Public Health, Operational Directorate Transmissible and Infectious Diseases, Juliette Wytsman 14, 1050 Brussels, Belgium. (Email: maria.naranjo@wiv-isp.be)
