Outbreaks of Shigella sonnei infections in Denmark and Australia linked to consumption of imported raw baby corn

H. C. Lewis; S. Ethelberg; K. E.P. Olsen; E. M. Nielsen; M. Lisby; S. B. Madsen; J. Boel; R. Stafford; M. Kirk; H. V. Smith; S. Tikumrum; A. Wisetrojana; A. Bangtrakulnonth; J. Vithayarungruangsri; P. Siriarayaporn; K. Ungchusak; J. Bishop; K. Mølbak

doi:10.1017/S0950268808001829

Outbreaks of Shigella sonnei infections in Denmark and Australia linked to consumption of imported raw baby corn

H. C. Lewis, S. Ethelberg, K. E.P. Olsen, E. M. Nielsen, M. Lisby, S. B. Madsen, J. Boel, R. Stafford, M. Kirk, H. V. Smith, S. Tikumrum, A. Wisetrojana, A. Bangtrakulnonth, J. Vithayarungruangsri, P. Siriarayaporn, K. Ungchusak, J. Bishop, K. Mølbak^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

43 Citations (Scopus)

Abstract

We investigated an outbreak of Shigella sonnei infections in Denmark and Australia associated with imported baby corn from one packing shed in Thailand. We reviewed nationwide surveillance and undertook case finding, food trace-back and microbiological investigation of human, food and environmental samples. A recall of baby corn and sugar snaps was based on descriptive epidemiological evidence. In Denmark, we undertook a retrospective cohort study in one workplace. In total, 215 cases were laboratory-confirmed in Denmark, and 12 in Australia. In a multivariable analysis, baby corn was the only independent risk factor. Antibiotic resistance and PFGE outbreak profiles in Denmark and Australia were indistinguishable, linking the outbreaks. Although we did not detect S. sonnei in baby corn, we isolated high levels of other enteric pathogens. We identified a packing shed in Thailand that supplied baby corn to Denmark and Australia, and uncovered unhygienic practices in the supply chain. This outbreak highlights the importance of international communication in linking outbreaks and pinpointing the source.

Original language	English
Pages (from-to)	326-334
Number of pages	9
Journal	Epidemiology and Infection
Volume	137
Issue number	3
DOIs	https://doi.org/10.1017/S0950268808001829
Publication status	Published - 2009

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Lewis, H. C., Ethelberg, S., Olsen, K. E. P., Nielsen, E. M., Lisby, M., Madsen, S. B., Boel, J., Stafford, R., Kirk, M., Smith, H. V., Tikumrum, S., Wisetrojana, A., Bangtrakulnonth, A., Vithayarungruangsri, J., Siriarayaporn, P., Ungchusak, K., Bishop, J., & Mølbak, K. (2009). Outbreaks of Shigella sonnei infections in Denmark and Australia linked to consumption of imported raw baby corn. Epidemiology and Infection, 137(3), 326-334. https://doi.org/10.1017/S0950268808001829

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title = "Outbreaks of Shigella sonnei infections in Denmark and Australia linked to consumption of imported raw baby corn",

abstract = "We investigated an outbreak of Shigella sonnei infections in Denmark and Australia associated with imported baby corn from one packing shed in Thailand. We reviewed nationwide surveillance and undertook case finding, food trace-back and microbiological investigation of human, food and environmental samples. A recall of baby corn and sugar snaps was based on descriptive epidemiological evidence. In Denmark, we undertook a retrospective cohort study in one workplace. In total, 215 cases were laboratory-confirmed in Denmark, and 12 in Australia. In a multivariable analysis, baby corn was the only independent risk factor. Antibiotic resistance and PFGE outbreak profiles in Denmark and Australia were indistinguishable, linking the outbreaks. Although we did not detect S. sonnei in baby corn, we isolated high levels of other enteric pathogens. We identified a packing shed in Thailand that supplied baby corn to Denmark and Australia, and uncovered unhygienic practices in the supply chain. This outbreak highlights the importance of international communication in linking outbreaks and pinpointing the source.",

keywords = "Cohort study, Foodborne, International, Outbreak, Shigella",

author = "Lewis, {H. C.} and S. Ethelberg and Olsen, {K. E.P.} and Nielsen, {E. M.} and M. Lisby and Madsen, {S. B.} and J. Boel and R. Stafford and M. Kirk and Smith, {H. V.} and S. Tikumrum and A. Wisetrojana and A. Bangtrakulnonth and J. Vithayarungruangsri and P. Siriarayaporn and K. Ungchusak and J. Bishop and K. M{\o}lbak",

year = "2009",

doi = "10.1017/S0950268808001829",

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Lewis, HC, Ethelberg, S, Olsen, KEP, Nielsen, EM, Lisby, M, Madsen, SB, Boel, J, Stafford, R, Kirk, M, Smith, HV, Tikumrum, S, Wisetrojana, A, Bangtrakulnonth, A, Vithayarungruangsri, J, Siriarayaporn, P, Ungchusak, K, Bishop, J & Mølbak, K 2009, 'Outbreaks of Shigella sonnei infections in Denmark and Australia linked to consumption of imported raw baby corn', Epidemiology and Infection, vol. 137, no. 3, pp. 326-334. https://doi.org/10.1017/S0950268808001829

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T1 - Outbreaks of Shigella sonnei infections in Denmark and Australia linked to consumption of imported raw baby corn

AU - Lewis, H. C.

AU - Ethelberg, S.

AU - Olsen, K. E.P.

AU - Nielsen, E. M.

AU - Lisby, M.

AU - Madsen, S. B.

AU - Boel, J.

AU - Stafford, R.

AU - Kirk, M.

AU - Smith, H. V.

AU - Tikumrum, S.

AU - Wisetrojana, A.

AU - Bangtrakulnonth, A.

AU - Vithayarungruangsri, J.

AU - Siriarayaporn, P.

AU - Ungchusak, K.

AU - Bishop, J.

AU - Mølbak, K.

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N2 - We investigated an outbreak of Shigella sonnei infections in Denmark and Australia associated with imported baby corn from one packing shed in Thailand. We reviewed nationwide surveillance and undertook case finding, food trace-back and microbiological investigation of human, food and environmental samples. A recall of baby corn and sugar snaps was based on descriptive epidemiological evidence. In Denmark, we undertook a retrospective cohort study in one workplace. In total, 215 cases were laboratory-confirmed in Denmark, and 12 in Australia. In a multivariable analysis, baby corn was the only independent risk factor. Antibiotic resistance and PFGE outbreak profiles in Denmark and Australia were indistinguishable, linking the outbreaks. Although we did not detect S. sonnei in baby corn, we isolated high levels of other enteric pathogens. We identified a packing shed in Thailand that supplied baby corn to Denmark and Australia, and uncovered unhygienic practices in the supply chain. This outbreak highlights the importance of international communication in linking outbreaks and pinpointing the source.

AB - We investigated an outbreak of Shigella sonnei infections in Denmark and Australia associated with imported baby corn from one packing shed in Thailand. We reviewed nationwide surveillance and undertook case finding, food trace-back and microbiological investigation of human, food and environmental samples. A recall of baby corn and sugar snaps was based on descriptive epidemiological evidence. In Denmark, we undertook a retrospective cohort study in one workplace. In total, 215 cases were laboratory-confirmed in Denmark, and 12 in Australia. In a multivariable analysis, baby corn was the only independent risk factor. Antibiotic resistance and PFGE outbreak profiles in Denmark and Australia were indistinguishable, linking the outbreaks. Although we did not detect S. sonnei in baby corn, we isolated high levels of other enteric pathogens. We identified a packing shed in Thailand that supplied baby corn to Denmark and Australia, and uncovered unhygienic practices in the supply chain. This outbreak highlights the importance of international communication in linking outbreaks and pinpointing the source.

KW - Cohort study

KW - Foodborne

KW - International

KW - Outbreak

KW - Shigella

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DO - 10.1017/S0950268808001829

M3 - Review article

SN - 0950-2688

VL - 137

SP - 326

EP - 334

JO - Epidemiology and Infection

JF - Epidemiology and Infection

IS - 3

ER -

Outbreaks of Shigella sonnei infections in Denmark and Australia linked to consumption of imported raw baby corn

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