Food poisoning outbreak in Ibadan, Nigeria, due to a new phage type of Salmonella typhimurium

An outbreak of food poisoning in Ibadan, Nigeria, claimed about 20 lives. A new phage type U282 of Salmonella typhimurium, the causative organism, was isolated from a sandwich filling, which yielded 4 X 10(9) viable organisms/g. The sandwiches were prepared in Lagos and kept without refrigeration until consumption next day. There is need for stricter control in the tropical developing countries of private catering agencies which imitate those of the advanced industrial countries.     

Comparison of epidemiological markers for Vibrio parahaemolyticus isolated from food poisoning

Vibrio parahaemolyticus food poisoning, is the most prevalent among bacterial food poisoning in Japan. Study of epidemiologic markers is important in an attempt to trace the source of contamination. The purpose of this study was to compare seven different typing methods (serotyping, plasmid profile, antibiogram, phage susceptibility. TDH production, tdh and trh gene and pulsed-field gel electrophoresis [PFGE]) for V. parahaemolyticus. Outbreaks of V. parahaemolyticus food poisoning which occurred during the 13 years from 1981 to 1993 numbered 43 including 481 cases in Nagano Prefecture. Serovar O4:K8 was the most prlevalent serovar isolated, serovar O2:K3, O4:K63 and O3:K5 followed. Forty one strains of V. parahaemolyticus were used in this study. All of the strains were isolated from 12 food poisoning cases at Nagano Prefectual Research Institute for Health and Pollution. Of the 41 strains, twenty two strains (O4:K8, O4:K63) were sensitive to both phi VP 253 and phi VP 143 phages, six strains (O3:K5) to phage phi VP 143. Thirteen strains (O3:K29, O4:K11, O4:K12 and O5:KUT) were insensitive to both phages. CBPC, CBPC.CEZ and CBPC.CEZ.KM.SM resistant strains was determined in 22 strains out of 41 strains. Five strains of V. parahaemolyticus carried plasmid. Of the 41 strains, thirty nine strains were possessive to tdh gene and productive to TDH. Chromosomal DNA of the isolates from 12 different outbreaks was analysed by PFGE after Not I digestion. PFGE analysis of the digested DNA yielded 11 to 21 DNA fragments. Twelve distinctive fragment patterns were identified in 41 V. parahaemolyticus isolates from 12 different food poisonings. These results showed that the PFGE method is an useful tool to analyse an epidemiological survey for isolates of Vibrio parahaemolyticus food poisoning.     

An outbreak of municipal water-associated food poisoning caused by Salmonella enteritidis]

An outbreak of municipal water-associated food poisoning by Salmonella Enteritidis occurred in Takatoh Town. Nagano prefecture during September 4 to 19, 1989. The major symptoms observed in the 680 patients consisted of diarrhea (70.9%), abdominal pain (51.2%), fever (44.6%), headache (27.9%), nausea (5.9%) and vomiting (5.7%). In the outbreak, S. Enteritidis was the only suspected etiological agent isolated from both patients and municipal water supply. All of the 21 isolates were lysine decarboxylase activity negative. In other respects, the isolates conformed to the general characteristics of Salmonella. All of them were further characterized by phagovar 8 type, uniform drug susceptibilities and carrying 2.7 kb plasmid. Inspite of the evidence that the infection caused by a peculiar strain linked to the strain in municipal water supply used by the patients, it was impossible to determine the exact source of contamination in the water. The outbreak above seems to be the most large-scale among those of Salmonella found poisoning associated with drinking water in Japan.     

Sepsis due to Salmonella Oranienburg--a case report]

A previously healthy 15-year-old female was admitted to our hospital complaining of nausea and vomiting. She did not complain of diarrhea. A physical examination revealed a lower right quadrant abdominal tenderness without rebound or spontaneous pain and a knocking pain of the costovertebral angle. A high fever, knocking pain of costovertebral angle, and urinary findings including Gram's stain, lead us to suspect a urinary tract infection, cefotiam was administered intravenously. Spiking fever with shaking chills continued for three days, and three sets of blood cultures were positive for Salmonella Oranienburg, but her urine culture was negative. Her history was taken again, revealing an intake of a processed squid product. The product was confirmed by the local public health center to be Salmonella Oranienburg. Finally food poisoning by Salmonella Oranienburg with sepsis was diagnosed. With cefotiam she became better and was discharged from the hospital on the 10th hospital day. During admission to the hospital she did not experience any diarrhea, and her stool culture was negative. Epidemics of Salmonella Oranienburg food poisoning are relatively rare in the literature. In Japan, one has arisen as a result of contamination of a processed squid product in March 1999. However, there have been no cases without so-called gastroenteritic symptoms (abdominal pain and diarrhea) who were previously healthy and developed sepsis caused by Salmonella Oranienburg, reported in Japan. Even in previously healthy patients, with an epidemic situation of non-typhoidal salmonellosis, salmonella sepsis must be ruled out. Among such cases, those who present with spiking fever and shaking chills should be given antibiotic therapy after taking appropriate cultures.     

Isolation of influenza A H1N2 viruses from an outbreak in Yokohama City during the 2001-2002 influenza season in Japan

Emergence of Influenza A H1N2 viruses was documented worldwide during the 2001-2002 influenza season. In Japan, H1N2 viruses were isolated from two students of a junior high school in an influenza outbreak in Yokohama City, February 2001. Genetic and antigenic analyses demonstrated that the H1N2 viruses isolated in Japan shared common features with those isolated in other countries.     

Beijing family and other genotypes of Mycobacterium tuberculosis isolates in Okayama district

OBJECTIVE: The purpose of this study is to investigate the distribution of Mycobacterium tuberculosis genotypes, such as Beijing family and other genotypes in Okayama district, and to examine the relation between these genotype strains and prevalent strains. METHODS: The 142 M. tuberculosis strains isolated in Okayama City from January 2000 to December 2002 were subjected to IS6110-RFLP and spoligotyping for the population-based study. In addition, 13 strains having 1 to 5 IS6110 copies isolated in Okayama Prefecture excluding Okayama City were also subjected to spoligotyping. RESULTS: A total of 103 (72.5%) of 142 strains belonged to Beijing family. Furthermore, 3 of 4 groups of prevalent strains belonged to the family. Twenty one strains out of 39 rest strains could be classified into 10 shared types (STs) of 259 STs in the worldwide spoligotype database. In addition, 15 out of 26 strains from inside and outside of Okayama City having 1 to 5 IS6110 copies showed common unique spoligotype. Moreover, the age of majority patients who were infected with M. tuberculosis of the Beijing family or other genotypes were older than 60 years. CONCLUSION: It was suggested that Beijing family had been the main infection source, and the spread of strains of Beijing family and other genotypes occurred considerably in old times, and the unique genotype strains remained for a long time as peculiar strains.     

Recovery and its evaluation of Shigella bacilli or Salmonella from healthy food handlers in Tokyo (1961-1997)]

Since 1961, recovery of Shigella bachilli from healthy food handlers in Tokyo has been carrying out, and detection of Salmonella carriers has also been adding from 1980. Recovery rate of Shigella has decreased from 0.28% (589 cases) in 1961 to 0.01% (9 cases) in 1969, and 7 cases between 1971 and 1975 and only 3 carriers since 1976 have been detected. On the other hand, Salmonella has been detected from about 9,000 cases (0.07%) during 18 years. The isolates were typed into 150 serovars, in which the most frequent one was S. Enteritidis, following S. Litchfield, S. Thompson, S. Hadar, S. Typhimurium, S. Infantis, S. Tennessee, S. Montevideo, S. Agona and S. Braenderup. These serovars except S. Agona caused in 90% of 1,650 Salmonella food poisoning outbreaks which had occurred between 1980 and 1996. Recovery of S. Enteritidis from healthy subjects increased year by year since 1989, and this tendency was well consistent with the increase of food poisoning outbreak caused by this serovar. These results indicate that the recovery of carrier with enteropathogen from food handlars is significant as preventive measures or food hygiene.     

引起食物中毒副溶血性弧菌的病原学鉴定

目的分离食物中毒患者粪便及食物加工工具样本中的病原菌,对分离菌株进行表型和毒力基因鉴定。方法采用TCBS平板法分离食物中毒样本中的病原菌。采用细菌系统鉴定方法,确定所分离的副溶血性弧菌(Vibrio parahaemolyticus,Vp)生化反应特性和血清型。采用PCR检测Vp分离株的种属特异基因、直接耐热溶血素毒力基因(tdh)和直接耐热相关溶血素毒力基因(trh)。采用K-B纸片法检测Vp分离株对14种抗生素的敏感性。结果从1例携带者和3例病人粪便标本中分离出4株Vp,从2份食物加工工具样本中分离出2株Vp。6株Vp分离株均属于含Vp种属特异基因的O1∶K56血清型,tdh基因阳性但trh基因阴性。6株Vp分离株生物学性状和药敏试验结果一致。结论tdh+/trh-O1∶K56血清型Vp是引起本次食物中毒的病原菌。     

A case of cervical abscess caused by Salmonella enteritidis after intestinal infection

Salmonella Enteritidis often causes food poisoning. In this study, an extremely rare case of cervical abscess caused by S. Enteritidis is reported. In January 2003, a 44-year-old man visited our hospital with swelling of the left submandibular region. He had been suffering from a severe diabetic condition but had neglected to seek medical attention. An incision was made at the abscess to drain the pus from which only S. Enteritidis was isolated. This finding led to the discovery that he had suffered from an episode of food poisoning 6 months earlier. However, the organism was not isolated from the stool. The patient recovered with the administration of panipenem/betamipron and gatifloxacin. The S. Enteritidis strain isolated from the pus obtained from this case and that detected from the samples originating from the other patients during the episode of food poisoning 6 months earlier were examined by using pulse-field gel electrophoresis (PFGE). The PFGE patterns of the strains were almost identical. The molecular epidemiological analysis by PFGE was useful in estimating the infection route. In an immuno-compromised host such as those suffering from diabetes mellitus, one must be reminded that unusual bacteria (including S. Enteritidis) may cause a cervical abscess.     

上海市汤卜逊沙门菌流行特征分析

目的研究上海市汤卜逊沙门菌暴发菌株的流行特征。方法调查和收集本地区在全球沙门菌监测(GSS)腹泻病例中分离的汤卜逊沙门菌散发和暴发病例的菌株,并经过系统表型鉴定和耐药性分析;脉冲凝胶电泳(PFGE)选用:XbaⅠ限制性内切酶,聚类软件选用BioNumerics4.0软件。结果2007年GSS分离汤卜逊沙门菌22株,在上海市非伤寒沙门菌型的确诊腹泻病例中排第3位,2007年黄浦区中心医院报告的8株集聚性腹泻病例分离的汤卜逊沙门菌对四环素、奥格门丁、氨苄西林、氯霉素、萘啶酸、磺胺异恶唑6种抗生素的耐药率均为100%,耐药谱明显高于其他散发病例菌株。20株腹泻株和2株食品被PFGE图谱分为15个带型,其中8株暴发菌株显示单一PFGE图谱,其余14个PFGE带型的菌株均仅有1株,分别来自汤卜逊沙门菌散发菌株(12株)和食品株(2株),菌株间的遗传相似度不高。结论2007年10月上海市黄浦区某工地发生的1起暴发病例是由在遗传上完全相同的汤卜逊沙门菌的多重耐药克隆株引起的,PFGE技术可以通过菌株之间的分子同源性关系来证实监测病例中存在的局部暴发病例。     

Excretion of enterotoxin-producing Clostridium perfringens in feces by patients during and after diarrhea

The excretion in the feces of Clostridium perfringens producing enterotoxin by 48 patients in 3 cases of food poisoning was studied during the illness and 1 and 3 months after the onset. Patients in the first outbreak excreted such strains mostly in the form of spores. In the second outbreak, spores and viable count cells were excreted in nearly equal numbers, and about 50% of the spores were enterotoxigenic. In the third outbreak, the strains were detected both as spores and as viable count cells during the illness. In all three groups, most fecal samples contained at least 10(3) spores per gram. About 1 month after the onset of the illness, (long after recovery from symptoms), 12 colonies producing enterotoxin were detected from five of the 22 samples of feces obtained from subjects in the three groups. There were few C. perfringens organisms, mostly spores, in the feces. Enterotoxin was not detected in the feces. About 3 months after onset, colonies producing enterotoxin could not be detected from feces of 11 of the subjects in the first group. We conclude that persons affected by C. perfringens food poisoning might contaminate food for at least 1 month after the onset.     

Serovars and epidemiological properties of Salmonella isolated from patients with sporadic diarrhea in Yamanashi prefecture during the last 22 years (1985-2006)

We studied the serovars, yearly and monthly frequency of isolates, and drug susceptibility of 3,028 strains of Salmonella isolated from patients with sporadic diarrhea during April 1985 to December 2006 in Yamanashi Prefecture. Results are as follows : 1) Isolates were serologically classified into 72 different serovars. Predominant serovars were S. Enteritidis (59.3%), S. Typhimurium (10.5%), S. Oranienburg (2.9%), S. Hadar (2.4%), S. Litchfield (2.3%), and S. Infantis (2.0%). 2) Serovars of S. Haifa, S. Schleissheim, S. Livingstone, S. Mikawasima, S. Manhattan, S. Muenchen, S. Emek, S. Dublin, S. Javiana, S. Miami, S. Miyazaki, S. Weltevreden, S. Orion, S. Give, S. Aberdeen, S. Surat and S. Orientalis were isolated from human sources for the first time since 1995 in Yamanashi Prefecture. 3) Yearly frequency of isolation was 305 strains (10.1%) for 1996, 283 strains (9.3%) for 1999, 273 strains (9.0%) for 2000, 238 strains (7.9%) for 1989 and 228 strains (7.5%) for 1997. 4) Monthly frequency of isolation was 567 strains (18.7%) for August, 471 strains (15.6%) for September, 430 strains (14.2%) for July, 340 strains (11.2%) for October and 266 strains (8.8%) for June. 5) Predominant ages of patients from whom Salmonella strains were isolated were 2 years for 199 strains (6.6%), 1 year for 192 strains (6.4%), 3 years for 169 strains (5.6%), 4 years for 161 strains (5.3%), and under 1 year for 110 strains (3.6%). 6) The rate of isolation from males was higher at 56.3% than for females at 43.7%. 7) The isolation frequency of drug-resistant strains was 64.8% in 1985-2006. The most predominant resistance pattern was SM single resistance because of the increase in S. Enteritidis. 8) The number of resistant strains of was 1,435 of 1,780 strains (80.6%) for S. Enteritidis, and 214 of 322 strains (66.5%) for S. Typhimurium, 1 of 87 strains (1.1%) for S. Oranienburg and 73 of 73 strains (100%) for S. Hadar. 9) The serovar S. Typhimurium had much multiple drug resistance strains, being resistant ever to fluoroquinolone.     

Isolation of enteroaggregative escherichia coli (EAggEC) from patients with diarrheal disease in an outbreak case of overseas tour

Twenty four patients out of 78 Cambodia tourists (31%) suffered from diarrhea and/or abdominal pain. Though the stools of 20 patients were examined in some local health centers and institutes, well-known pathogens were detected in only a low level and the cause of the outbreak remained unclear. We suspected the enteroaggregative Escherichia coli (EAggEC) as a cause of this outbreak. We examined E. coli strains isolated from stools of 8 patients (Okayama:7, Aichi:1) at first by the PCR method targeted both the aggR and the astA genes related to the virulence factors of EAggEC. As a result, the E. coli strains with positive aggR and/or astA genes were isolated from 8 patients. And the E. coli strains with positive both aggR gene and clump formation isolated from 3 patients adhered aggregatively to HEp-2 cells and accordingly identified as EAggEC. The plasmid profiles, PFGE patterns and drug resistance patterns of these EAggECs agreed completely. From these results, we concluded that at least 3 patients were infected with EAggEC of the same origin. Though we could not examine all samples from 20 patients, it is possible that the still uncommon EAggEC might be a cause of the outbreak. The E. coli strains with positive aggR gene did not always aggregatively adhered to HEp-2 cells. So we recommend to perform stepwise EAggEC screening tests by the PCR and the clump formation, and final confirmation test by the aggregative adhesion to HEp-2 cells.     

The control of renin release

An outbreak of histoplasmosis occurred in early May 1970 at a junior high school in Delaware, Ohio; clinical illness occurred in 384 (40 per cent) of the students and faculty, with probably an equal number of subclinical cases. The mode of spread was airborne and was shown epidemiologically to be related to activities on Earth Day, April 22, 1970, when the courtyard in the center of the school, an old bird roost, was raked and swept. Contamination of the entire school building with courtyard air occurred via the school's forced air ventilation system with intakes in the courtyard. Soil samples from the courtyard were positive for Histoplasma capsulatum, but random samples from other areas around the building were negative. In two persons in the building only on April 22, the typical illness developed. Features of the outbreak have important implications for clinicians and public health officials.     

Serovar-distribution, drug-resistance, and DNA analysis of Salmonella strains isolated from sporadic diarrhea cases or healthy cases in Tama, Tokyo (1991-2000)]

Serovar-distribution and drug-resistance of a total of 421 Salmonella strains, which were 98 stains from sporadic diarrhea cases and 323 strains from healthy cases between 1991 and 2000 in Tama, Tokyo were investigated. In serological typing tests, the strains tested were classified into 26 different kinds of serovar in diarrhea cases, 58 in food handlers, and 25 in individuals for health care. Salmonella serovar Enteritidis (S. Enteritidis) was the most predominant serovar in three cases. Following, S. Typhimurium and S. Infantis in diarrhea cases, S. Hadar, S. Montevideo and S. Thompson in food handlers, or S. Typhimurium, S. Lichfield and S. Oranienburg in healthy individuals were frequent. The drug-resistance test using 9 drugs (CP, TC, SM, KM, ABPC, SXT, NA, FOM, and NFLX) showed that 57.1% of the strains from diarrhea cases and 36.8% from the healthy cases were resistant to one or the other of the drugs examined. Drug-resistance patterns of those showed 13 types in diarrhea cases and 25 types in healthy cases. Out of them, strains which showed a predominant and common pattern in both cases were SM resistant-S. Enteritidis and CP.TC.SM.ABPC resistant-S. Typhimurium. In addition, the latter strains were also resistant to sulfiso-xzole (SU). In DNA analysis by RAPD method of their strains, common DNA finger-prints were observed in both cases through out the investigation period.     

Biochemical and molecular characterization of Salmonella ser. enteritidis phage type 1 isolated from food poisoning outbreaks in Tokyo]

Since the first outbreak in 1990, the incidence of Salmonella ser. Enteritidis (S. Enteritidis) phage type (PT) 1 food poisoning has gradually increased in Tokyo and has reached approximately 30% of the total S. Enteritidis outbreaks reported. To characterise these S. Enteritidis PT1 food poisoning, a total of 198 strains obtained from 44 outbreaks between 1990 and 1996 were examined for antimicrobial resistance, acid producibility from glycols (propylene and ethylene glycol) and plasmid DNA profiles. The 44 PT1 outbreaks analysed were further subdivided into 11 types by epidemiological markers. The most common patterns were type A (plasmid profile carrying only one plasmid (60 kb). SM and TC resistance and non producibility from glycols), and type B (plasmid profile carrying two plasmids (60 and 20 kb), SM resistance and no producibility from glycols) and were responsible for 21 (47.7%) and 15 (34.1%) outbreaks, respectively. In 11 of 44 outbreaks, strains carrying identical epidemiological markers were isolated both from patients and vehicle foods, environments, and/or food-handlers. Similar to PT4 and PT34 outbreaks reported in Japan, egg and egg-related foods were also suspected in 8 of these 11 outbreaks. Of interest, chicken which were not pointed out in PT4 and PT 34 outbreaks was also suspected as a vehicle of transmission in two outbreaks.     

ST6型金黄色葡萄球菌食物中毒菌株的毒力因子分析

目的检测食物中毒优势型ST6型菌株的毒力基因特征,为食品安全风险评估、食源性病原菌的监测和致病性研究提供依据。方法选取深圳地区7次食物中毒收集的32株ST6型菌株进行全基因组测序,利用VFDB数据库进行毒力因子分析,并通过序列比对进行SEA亚型分析。结果第1-4起食物中毒ST6菌株携带的毒力因子谱完全相同;第5-7起食物中毒中,同一起食物中毒的暴发菌株携带的毒力因子一致,而非暴发菌株与暴发菌株携带的毒力因子不完全一致。在32株ST6型菌中,与粘附、酶和Ⅶ型分泌系统相关的毒力基因具有较高的携带率,α-溶血素(hly/hla)、β-溶血素(hlb)、δ-溶血素(hld)、γ-溶血素基因(hlgA、hlgB、hlgC)、肠毒素A基因(sea)和表皮剥脱毒素A基因(eta)的携带率均为100%,双组分白细胞毒素LukDE基因(lukD和lukE)的携带率为96.8%。所有菌株携带的肠毒素A均为SEA1亚型。结论32株ST6型食物中毒相关菌株携带多个毒力因子基因,以cna、sea、eta、lukD、lukE毒力基因携带率较高,编码的毒力因子可能对ST6型菌株的致病性产生影响。