Highlights ► Incidence of tick-borne encephalitis (TBE) in Gorenjska region (Slovenia) is 30/100,000. ► The number of subjects protected by vaccination is only 6.8% of the population of Gorenjska. ► ...Charity activities to reduce the price of vaccination increase the vaccination rate.
Background. An outbreak of gastroenteritis of etiologically unspecified origin and an outbreak of Salmonellosis occurred simultaneously in September 2011 in Tržič. The purpose of the investigation of ...both outbreaks was to identify the most probable source and the mode of transmission and to implement preventive measures.
Methods. In two retrospective case-control studies, the association between gastroenteritis of etiologically unspecified origin or Salmonellosis and food from a restaurant or drinking tap water were tested by univariate and multivariate analysis. The subject in the first study was a sick person with salmonellosis, and the subject in the second study was a resident that developed diarrhoea and/ or vomiting. Cases were reported by doctors, and controls were selected from healthy persons who responded to the questionnaire.
Results. A person exposed to food from the restaurant had a 24.8 times higher odds ratio (univariate analysis OR 24.8, 95% CI 7.5 to 82.3, p <0.05; multivariate analysis OR 14.7, 95% CI 3.5 - 61.3, p <0.05) for salmonellosis than non-exposed. A resident exposed to tap water from specific water source had a 3.4 times higher odds ratio (univariate analysis of OR 3.4, 95% CI 2.2 to 5.1 is p <0.05, multivariate analysis of RO 2.9, 95% CI 1, 7 to 5.3, p <0.05), for gastroenteritis of unspecific etiology than non-exposed. The dose response relationship was also statistically significant.
Conclusion. Analytical cases - controls studies confirmed a causal relationship between salmonellosis and food from the specific restaurant and the causal relationship between gastroenteritis of etiologically unspecified origin and drinking tap water from specific water source. Salmonella enteritidis may have entered into the restaurant through tap water
Uvod. Izbruh gastroenteritisa neopredeljene etiologije in izbruh salmoneloze sta bila hkrati v Tržiču septembra 2011. Namen preiskave izbruhov je bil odkriti izvor in poti prenosa okužbe s ciljem, da se sprejmejo ukrepi za prekinitev širjenja. Metode. V dveh retrospektivnih študijah primerov in kontrol je bila z univariatnimi in multivariatnimi analizami testirana povezava med gastroenteritisom neopredeljene etiologije oziroma salmonelozo in uživanjem hrane v gostilni ali pitjem vodovodne vode. Primer v prvi študiji je bil oboleli s salmonelozo, primer v drugi študiji pa je bil vsak občan z drisko in/ali bruhanjem. Primere obolelih so prijavili zdravniki; kontrole so bile izbrane med zdravimi osebami, ki so vrnile izpolnjeni vprašalnik. Rezultati. Osebe, izpostavljene hrani v gostilni, so imele 24,8-krat višje obete za obolevanje za salmonelozo kot neizpostavljeni (univariatna analiza RO 24,8; 95 % IZ 7,5-82,3; p < 0,05; multivariatna analiza RO 14,7; 95% IZ 3,5-61,3, p < 0,05). Občani, ki so pili vodo iz določenega vodnega vira, so imeli 3,4-krat višje obete, da so oboleli za gastroenteritisom neopredeljene etiologije kot neizpostavljeni (univariatna analiza RO 3,4; 95 % IZ je 2,2-5,1; p < 0,05; multivariatni analizi RO 2,9; 95 % IZ 1,7-5,3; p < 0,05). Statistično značilna je bila tudi povezava med obolevanjem in količino popite pitne vode. Zaključki. Z analitičnima študijama primerov in kontrol smo potrdili vzročno povezanost med salmonelozo in prehranjevanjem v določeni gostilni ter povezanost med gastroenteritisom neopredeljene etiologije in pitjem vodovodne vode iz določenega vodnega vira. Mogoč je vnos Salmonelle enteritidis v gostilno prek vodovodne vode
Background: In October 2010 an outbreak of staphylococcal food poisoning occurred in an elementary school with a kindergarten in Gorenjska. Methods: Using a questionnaire we performed a retrospective ...cohortanalytical epidemiological study. We calculated attack rate (AR) and relative risk for each food item. In patients we cultivated stools and vomit. We performed an onsite audit where the food samples, environmental samples, and swabs of the hands of the cooks were taken. We performed medical examination of those employed in the kitchen where specimens were taken for microbiological examination. Staphylococcal enterotoxins were detected with agglutination test SET RPLA (Oxoid) and genotypes determined by the pulsed-field gel electrophoresis (PFGE). Results: Out of 374 exposed 73 subjects got ill. Attack rate in the outbreak was 19,5 %. The most frequent symptoms were vomiting (87,7 %), stomach ache (75,3 %), diarrhea (64,2 %) and nausea ( 59,3 %). The highest relative risk (RR) were found for the meatloaf (RR= 24,2 (95 % CI 12,1-48,5; p<0,001)) and potato salad (RR= 19,4 (95 % CI 10,7 - 35,2; p<0,001)). Enterotoxin A producing S. aureus was isolated from hand of a cook, from potato salad and meatlof, from vomit and stools of patients. These strains had the same antibiotic sensitivity and were genetically closely related (96,3 %). Conclusions: In the article an optimal team approaches of a community epidemiologist and microbiologist in the occasion of outbreak are described. We confirmed epidemiologically related isolates and determined the importance of individual methods.
Uvod. Izbruh gastroenteritisa neopredeljene etiologije in izbruh salmoneloze sta bila hkrati v Tržiču septembra 2011. Namen preiskave izbruhov je bil odkriti izvor in poti prenosa okužbe s ciljem, da ...se sprejmejo ukrepi za prekinitev širjenja. Metode. V dveh retrospektivnih študijah primerov in kontrol je bila z univariatnimi in multivariatnimi analizami testirana povezava med gastroenteritisom neopredeljene etiologije oziroma salmonelozo in uživanjem hrane v gostilni ali pitjem vodovodne vode. Primer v prvi študiji je bil oboleli s salmonelozo, primer v drugi študiji pa je bil vsak občan z drisko in/ali bruhanjem. Primere obolelih so prijavili zdravniki; kontrole so bile izbrane med zdravimi osebami, ki so vrnile izpolnjeni vprašalnik. Rezultati. Osebe, izpostavljene hrani v gostilni, so imele 24,8-krat višje obete za obolevanje za salmonelozo kot neizpostavljeni (univariatna analiza RO 24,8; 95 % IZ 7,5-82,3; p < 0,05; multivariatna analiza RO 14,7; 95% IZ 3,5-61,3, p < 0,05). Občani, ki so pili vodo iz določenega vodnega vira, so imeli 3,4-krat višje obete, da so oboleli za gastroenteritisom neopredeljene etiologije kot neizpostavljeni (univariatna analiza RO 3,4; 95 % IZ je 2,2-5,1; p < 0,05; multivariatni analizi RO 2,9; 95 % IZ 1,7-5,3; p < 0,05). Statistično značilna je bila tudi povezava med obolevanjem in količino popite pitne vode. Zaključki. Z analitičnima študijama primerov in kontrol smo potrdili vzročno povezanost med salmonelozo in prehranjevanjem v določeni gostilni ter povezanost med gastroenteritisom neopredeljene etiologije in pitjem vodovodne vode iz določenega vodnega vira. Mogoč je vnos Salmonelle enteritidis v gostilno prek vodovodne vode
An outbreak of gastroenteritis of etiologically unspecified origin and an outbreak of Salmonellosis occurred simultaneously in September 2011 in Tržič. The purpose of the investigation of both ...outbreaks was to identify the most probable source and the mode of transmission and to implement preventive measures.
In two retrospective case-control studies, the association between gastroenteritis of etiologically unspecified origin or Salmonellosis and food from a restaurant or drinking tap water were tested by univariate and multivariate analysis. The subject in the first study was a sick person with salmonellosis, and the subject in the second study was a resident that developed diarrhoea and/ or vomiting. Cases were reported by doctors, and controls were selected from healthy persons who responded to the questionnaire.
A person exposed to food from the restaurant had a 24.8 times higher odds ratio (univariate analysis OR 24.8, 95% CI 7.5 to 82.3, p <0.05; multivariate analysis OR 14.7, 95% CI 3.5 - 61.3, p <0.05) for salmonellosis than non-exposed. A resident exposed to tap water from specific water source had a 3.4 times higher odds ratio (univariate analysis of OR 3.4, 95% CI 2.2 to 5.1 is p <0.05, multivariate analysis of RO 2.9, 95% CI 1, 7 to 5.3, p <0.05), for gastroenteritis of unspecific etiology than non-exposed. The dose response relationship was also statistically significant.
Analytical cases - controls studies confirmed a causal relationship between salmonellosis and food from the specific restaurant and the causal relationship between gastroenteritis of etiologically unspecified origin and drinking tap water from specific water source. Salmonella enteritidis may have entered into the restaurant through tap water.
Salmonella is an important zoonotic pathogen in animals and humans. In the European Union, Salmonella enterica subspecies enterica serovar Enteritidis (serovar Enteritidis) is one of the serovars ...most frequently associated with human illness. The most important food vehicles responsible for the infection are eggs and egg products. We describe two serovar Enteritidis outbreaks on account of consump
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