[Show abstract][Hide abstract] ABSTRACT: During 2008 to 2013, 215 outbreak alerts, also known as ‘urgent inquiries’ (UI), for food- and waterborne diseases were launched in Europe, the majority of them (135; 63%) being related to salmonellosis. For 110 (51%) UI, a potential food vehicle of infection was identified, with vegetables being the most reported category (34; 31%). A total of 28% (n = 60) of the outbreaks reported had an international dimension, involving at least two countries (mean: 4; standard deviation: 2; range: 2–14). Participating countries posted 2,343 messages (initial posts and replies, excluding updates), with a median of 11 messages per urgent inquiry (range: 1–28). Of 60 multicountry UI, 50 involved between two and four countries. The UI allowed early detection of multicountry outbreaks, facilitated the identification of the suspected vehicles and consequently contributed to the timely implementation of control measures. The introduction of an epidemic intelligence information system platform in 2010 has strengthened the role of the Food- and Waterborne Diseases and Zoonoses network in facilitating timely exchange of information between public health authorities of the participating countries.
Full-text · Article · Jul 2015 · Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin
[Show abstract][Hide abstract] ABSTRACT: The Member States of the European Union are following a common strategy on the control of Salmonella and other foodborne pathogens (Anonym, 2003). Within that framework baseline studies on the most relevant animal populations have been carried out. This paper describes the implementation and the results of the baseline studies on Salmonella spp. in slaughter and breeding pigs in Austria. A total of 647 slaughter pigs were sampled in 28 slaughterhouses between October 2006 and September 2007. Samples were taken from the ileocaecal lymphnodes to detect infection in pigs and from the surface of the carcasses to detect contamination. Out of the 617 datasets included in the final analysis, Salmonella prevalences of 2% in lymphnodes and 1.1% on the carcass surface were observed. S. Derby, S. Enteritidis and S. Typhimurium were the three most frequently identified serovars. In an additional study, a total of 252 holdings with breeding pigs has been sampled between January and December combined multiplier herds. Respectively prevalences of 5, 8, 5, 3 and 9.1% were obtained, with S. Typhimurium being the most frequently isolated serovar. Overall, compared to neighbouring Member States a rather low prevalence of Salmonella spp. in pigs was documented for Austria, in particular in slaughter pigs.The serovar distribution seemed to be similar throughout the pig populations, some also being represented in Austrian human isolates. Contamination of feed seems to play a minor role considering the overall low prevalence, but nevertheless has to be taken into account in any future control or monitoring strategy for Salmonella spp. in pigs.
No preview · Article · Feb 2014 · Berliner und Münchener tierärztliche Wochenschrift
[Show abstract][Hide abstract] ABSTRACT: The member states of the European Union (EU) are following a common strategy on the control of Salmonella and other foodborne zoonotic pathogens (Anonym, 2003). In order to establish the prevalence of Salmonella (S.) spp. in turkeys, a baseline survey was organised in between October 2006 and September 2007. In Austria a total of 202 turkey flocks in 104 holdings was included. By doing so, all holdings with fattening turkeys were covered by the sampling scheme, whereas breeding turkey flocks did not exist in the survey period. A prevalence of Salmonella spp. of 17.3% in flocks or 25% of holdings was obtained. A total of nine different serovars were identified, S. Hadar being the most frequently isolated with eleven flocks infected representing 31.4% of all. S. Montevideo and S. Saintpaul were both found in eight flocks, and S. Senftenberg in six flocks. Two flocks were colonized with S. Newport, while one flock each had S. Typhimurium, S. Derby, S. Blockley and a monophasic strain of Salmonella group B. Of the two serovars of highest relevance for human health, S. Typhimurium was detected in only 0.5% of flocks or 1% of holdings tested and S. Enteritidis was not detected at all. Taking into account the high prevalence of the various Salmonella serovars however control measures to prohibit horizontal transmission and entry of Salmonella spp. from the turkey reservoir into the food chain in Austria seem justified.
No preview · Article · Nov 2013 · Berliner und Münchener tierärztliche Wochenschrift
[Show abstract][Hide abstract] ABSTRACT: We report on an outbreak caused by Salmonella enteritidis phage type 4 (PT4) among 143 participants at a soccer camp in Austria in August 2010. The outbreak affected 34 persons, including 24 epidemiologically related cases and 10 laboratory-confirmed cases. Food-specific cohort analyses revealed spaetzle (homemade noodles) (relative risks (RR): 2.68; 95% CI: 1.13-6.45), hamburger (RR: 2.70; 95% CI: 1.13-6.45) and potato salad (RR: 2.91; 95% CI: 1.69-5.02) as the most biologically plausible infection sources. Eggs used as ingredients were considered to be the vehicle of infection for the outbreak strain. The sole egg producer supplying the hotel that housed the soccer camp participants with table eggs operated two flocks. One flock had been epidemiologically and microbiologically related to a previous S. enteritidis PT4 outbreak affecting the same Austrian province in the four months preceding the August outbreak. We hypothesize that eggs from this flock, already condemned for industrial use only, were falsely declared table eggs and sold among eggs from the non-banned flock causing the subsequent outbreak. In Austria, the illegal distribution of eggs designated for industrial use (i.e., false declaration of these eggs as table eggs) has been previously documented. Our findings underscore the potential of proper epidemiological outbreak investigation to identify the pitfalls of regulatory responses in risk management.
[Show abstract][Hide abstract] ABSTRACT: We describe two linked cases of botulinum toxin intoxication to provide the clinician with a better idea about how
botulism cases may present since early diagnosis and treatment are crucial in botulism. Botulinum toxin is the strongest neurotoxin known.
Methods: We review the available literature, the compiled clinical data, and observations.
Results: After a slow onset of clinical signs a married couple living in Vienna presented with dysphagia, difficulties in accommodation, inability to sweat, urinary and stool retention, dizziness, and nausea. They suffered intoxication with botulinum toxin type B. Botulism is a rarely occurring disease in Austria. In the last 21 years there were only twelve reported cases.
Conclusion: Both patients went to a general practitioner as well as several specialists before they were sent to and correctly diagnosed at our outpatient department. To avoid long delays between intoxication and diagnosis we think it is crucial to advert to the complex symptoms a nonsevere intoxication with botulinum toxin can produce, especially since intoxications have become rare occurrences in the industrialized societies due to the high quality of industrial food production.
[Show abstract][Hide abstract] ABSTRACT: Salmonellosis is one of the most important food-borne diseases worldwide. For outbreak investigation and infection control,
accurate and fast subtyping methods are essential. A triplex gene-scanning assay was developed and evaluated for serotype-specific
subtyping of Salmonella enterica isolates based on specific single-nucleotide polymorphisms in fragments of fljB, gyrB, and ycfQ. Simultaneous gene scanning of fljB, gyrB, and ycfQ by high-resolution melting-curve analysis of 417 Salmonella isolates comprising 46 different serotypes allowed the unequivocal, simple, and fast identification of 37 serotypes. Identical
melting-curve profiles were obtained in some cases from Salmonella enterica serotype Enteritidis and Salmonella enterica serotype Dublin, in all cases from Salmonella enterica serotype Ohio and Salmonella enterica serotype Rissen, from Salmonella enterica serotype Mbandaka and Salmonella enterica serotype Kentucky, and from Salmonella enterica serotype Bredeney, Salmonella enterica serotype Give, and Salmonella enterica serotype Schwarzengrund. To differentiate the most frequent Salmonella serotype, Enteritidis, from some S. Dublin isolates, an additional single PCR assay was developed for specific identification of S. Enteritidis. The closed-tube triplex high-resolution melting-curve assay developed, in combination with an S. Enteritidis-specific PCR, represents an improved protocol for accurate, cost-effective, simple, and fast subtyping of 39
Salmonella serotypes. These 39 serotypes represent more than 94% of all human and more than 85% of all nonhuman Salmonella isolates (including isolates from veterinary, food, and environmental samples) obtained in the years 2008 and 2009 in Austria.
Full-text · Article · Feb 2012 · Applied and Environmental Microbiology
[Show abstract][Hide abstract] ABSTRACT: We report on a salmonellosis-outbreak due to Salmonella Enteritidis phage type 14b resistant to nalidixic acid (S. Enteritidis PT14b Nx) among residents and employees of a student residence in Austria, September 2010. The outbreak was described and analysed by a retrospective cohort study, and microbiological environmental investigations were conducted to identify the outbreak source(s) and the reservoir of the outbreak strain. A total of 66 persons fulfilled the outbreak case definition including 14 laboratory-confirmed cases. Food specific cohort-analyses by day revealed that consumption of potato salad (RR: 1.65, 95%CI: 1.35–2.01, p=0.001) and a cheese-sausage cold plate (RR: 2.24, 95%CI: 1.29–3.88, p=0.002) on 14 September was associated with being an outbreak case. We hypothesised that cross-contamination with S. Enteritidis PT14b Nx positive eggs had occurred during preparation of the potato salad and cold plate as a result of preparing in parallel egg-containing breaded cutlets on 14 September. A traced laying hen holding in eastern Austria was identified as the sole source of the consumable eggs in the student residence. By applying the legally mandated sampling method for epidemiological-related laying hen farms (one pooled dust sample à 150g, two paired boot swabs cultured separately), the outbreak strain could not be detected. Our findings, that legally required sampling methods for laying hen farms failed to detect the causative pathogen in a laying hen holding, despite an epidemiological link, underline the request stated by the European Food Safety Authority Panel on Biological Hazards for a more sensitive sampling plan in epidemiologically-associated laying hen flocks.
Full-text · Article · Aug 2011 · Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin
[Show abstract][Hide abstract] ABSTRACT: In Austria an EU-wide baseline survey on the prevalence of Salmonella spp. in broilers organized by the EU commission was conducted from October 2005 to September 2006. The aim of this study was to produce comparable data on the prevalence of Salmonella in broiler flocks and holdings for all member states and for the EU-Commission to set EU-wide targets for the control of Salmonella in the broiler populations. A randomised sampling plan was designed according to EU-commission parameters (p = 50%; CI = 95%, a = 5%). Sampling was carried out regularly throughout the whole year. On every farm one flock was sampled with five pairs of boot swabs and analysed in the lab according to appendix D of ISO 6579 (2002). In Austria, 363 flocks on farms consisting of at least 5000 broilers each were tested. 28 flocks (7.7%) showed infections with Salmonella spp., eight flocks (2.2%) had either S. Enteritidis (six flocks) or S. Typhimurium (two flocks). In detail, S. Enteritidis (1.7%), S. Typhimurium (0.6%), S. Montevideo (4.1%), S. Infantis 0.6%, S. Senftenberg, S. Tennessee and S. Virchow (0.3% each) have been found. Data indicated that the risk of vertical transmission of Salmonella spp. to broiler flocks has almost been kept at bay; however, the risk of horizontal transmission still needs attention. Contamination of feeding stuff, possible persistence, spreading between barns of a farm as well as introduction of Salmonella spp. through individuals or materials are important factors for future control strategies.
No preview · Article · Jan 2011 · Berliner und Münchener tierärztliche Wochenschrift
[Show abstract][Hide abstract] ABSTRACT: Diversity Arrays Technology (DArT) was applied to differentiate between S. enterica serovar Enteritidis and Typhimurium strains, respectively. Ten and eleven, mainly phage and plasmid-related markers were identified for serovars Enteritidis and Typhimurium. In combination, these markers can be used for subtyping among and within phage types.
No preview · Article · Oct 2009 · Journal of microbiological methods
[Show abstract][Hide abstract] ABSTRACT: Multidrug-resistant Salmonella serovar Concord infections have been reported from children adopted from Ethiopia. We interviewed patients, characterized the isolates, and gathered information about adoptions from Ethiopia to assess public health implications.
Information about Salmonella Concord cases and adoptions were provided from Austria, Denmark, England (and Wales), Ireland, the Netherlands and the United States. Patients from Denmark and the United States were interviewed to determine the orphanages of origin; orphanages in Ethiopia were visited. Isolates were subtyped by pulsed-field gel electrophoresis and antimicrobial susceptibility; specific antimicrobial resistance genes were characterized.
Salmonella Concord was isolated from 78 persons from 2003 to 2007. Adoption status was known for 44 patients <or=3 years of age; 98% were adopted from Ethiopia. The children adopted from Ethiopia were from several orphanages; visited orphanages had poor hygiene and sanitation and frequent use of antimicrobial agents. The number of children adopted from Ethiopia in the participating countries increased 527% from 221 in 2003 to 1385 in 2007. Sixty-four Salmonella Concord isolates yielded 53 pulsed-field gel electrophoresis patterns including 6 patterns with >2 indistinguishable isolates; one isolate from an Ethiopia adoptee. Antimicrobial susceptibility was performed on 43 isolates; 81% were multidrug-resistant (>or=3 agents). Multidrug-resistant isolates were from Ethiopian adoptees and were resistant to third and fourth generation cephalosporins and 14% had decreased susceptibility to ciprofloxacin.
Improved hygiene and sanitation and more appropriate use of antimicrobial agents are needed in orphanages in Ethiopia. Culturing of stool specimens of children adopted from Ethiopia and appropriate hygiene may prevent further disease transmission.
Full-text · Article · Oct 2009 · The Pediatric Infectious Disease Journal
[Show abstract][Hide abstract] ABSTRACT: An outbreak of Salmonella Enteritidis infection among high school graduates was associated with the 2008 three-week Summer Splash event in Turkey. A similar outbreak, caused by Salmonella Enteritidis PT6, affected 70 of 2879 graduates attending the 2007 Summer Splash event. A total of 103 cases of Salmonella Enteritidis were identified by passive and active case finding among the 8914 participants of the 2008 event. A case series investigation was performed. The cases originated from eight of the nine Austrian provinces. Among 59 laboratory-confirmed S. Enteritidis cases, the most commonly identified phage type was PT21 (72.9%), followed by PT6 (18.6%), PT7 and PT3 (3.4% each). To our knowledge, none of the published outbreaks of salmonellosis in the past 10 years has involved multiple phage types. Among the three hotels within the resort complex, the highest number of outbreak cases was identified among the students who stayed at Hotel A (n = 37), followed by Hotel B (n = 33) and Hotel C (n = 32). Eggs and egg-containing products frequently offered at meals in all three hotels were hypothesized as the source of infection. Reliable findings from investigation of imported outbreaks enable the appropriate response measures in the country of origin. As a consequence of the effective programs for reducing salmonella in domestic animals intended for human consumption in Austria, the number of imported cases will gain importance in the coming years, and salmonellosis will increasingly appear as traveler's diarrhoea.
No preview · Article · Mar 2009 · Wiener klinische Wochenschrift
[Show abstract][Hide abstract] ABSTRACT: In April 2008, a general foodborne outbreak of Salmonella Enteritidis phage type 6 affected nine persons (two households in Salzburg and one household in Tyrol; eight microbiologically confirmed cases and one possible case). Epidemiological investigation revealed that all cases had eaten lunch together at a farm. Homemade bread dumpling loaf, prepared with eggs from the farm, was the most likely vehicle for the pathogen. Six eggs were bacteriologically tested and yielded the outbreak strain on the egg shells. The farm's egg laying flock consisted of 12 hens, which were identified as the source of infection by isolating the outbreak strain from samples of hen fecal material and dust. Molecular subtyping using multiple loci variable number of tandem repeats analysis (MLVA) revealed a pattern unique to isolates from the outbreak, different from nine epidemiologically unrelated isolates tested for comparison. The laying hens were culled and no further cases of salmonellosis were associated with the farm. This example demonstrates the considerable potential of outbreak investigation to elucidate the transmission of infection along the food chain and to provide information essential for implementation of targeted measures for prevention of foodborne illness.
No preview · Article · Mar 2009 · Wiener klinische Wochenschrift
[Show abstract][Hide abstract] ABSTRACT: Non-typhoidal Salmonella spp. are a major cause of human gastroenteritis in many parts of the world. Most of these infections are zoonotic and are transmitted from healthy carrier animals to humans through contaminated food. In Austria we are facing an ongoing salmonellosis epidemic that started in 1989. The main cause of the epidemic is a massive increase of infections due to S. enterica subsp. enterica serovar Enteritidis (S. Enteritidis), a serotype prevalent in poultry, particularly in eggs. The introduction of vaccination of laying hens and broilers, together with intensified outbreak investigation efforts, has led to a remarkable decrease of human salmonella isolates. Since 2002 the number of isolates received by the National Reference Center for Salmonella (NRCS) has been reduced by more than 50%. Overall rates of antibiotic resistance in salmonella have remained stable over the past years. In Austria, high levels of resistance to ciprofloxacin and third-generation cephalosporins (cefotaxime) are still extremely rare.
No preview · Article · Mar 2009 · Wiener klinische Wochenschrift
[Show abstract][Hide abstract] ABSTRACT: Adequate identification of Salmonella enterica serovars is a prerequisite for any epidemiological investigation. This is traditionally obtained via a combination of biochemical and serological typing. However, primary strain isolation and traditional serotyping is time-consuming and faster methods would be desirable. A microarray, based on two housekeeping and two virulence marker genes (atpD, gyrB, fliC and fljB), has been developed for the detection and identification of the two species of Salmonella (S. enterica and S. bongori), the five subspecies of S. enterica (II, IIIa, IIIb, IV, VI) and 43 S. enterica ssp. enterica serovars (covering the most prevalent ones in Austria and the UK). A comprehensive set of probes (n = 240), forming 119 probe units, was developed based on the corresponding sequences of 148 Salmonella strains, successfully validated with 57 Salmonella strains and subsequently evaluated with 35 blind samples including isolated serotypes and mixtures of different serotypes. Results demonstrated a strong discriminatory ability of the microarray among Salmonella serovars. Threshold for detection was 1 colony forming unit per 25 g of food sample following overnight (14 h) enrichment.
Full-text · Article · Nov 2008 · Microbial Biotechnology
[Show abstract][Hide abstract] ABSTRACT: Salmonella enterica subsp. enterica serovar Enteritidis is a major food-borne pathogen that caused most of Salmonella infections worldwide. S. Enteritidis phage type 4 (PT4) especially presents a real challenge for the classical typing methods. We developed a simple multiple-locus variable-number tandem repeat analysis (MLVA) assay based on three hypervariable variable-number tandem repeat (VNTR) loci for subtyping of Salmonella Enteritidis. Testing an arbitrary chosen strain collection of 110 S. Enteritidis isolates, comprising PTs 4, 8, and 21, the MLVA assay yielded a higher discriminatory power, corresponding to a Simpson's index of diversity (ID) of 0.91, when compared to pulsed-field gel electrophoresis (PFGE) which had a Simpson's ID of 0.41. To simplify interpretation of results, we developed a VNTR allele code based on the repeat unit number. This code can easily be exchanged. In conclusion, MLVA is a promising new tool to investigate outbreaks of S. Enteritidis and constitutes a useful addition to the current phage typing scheme.
No preview · Article · Sep 2008 · International journal of medical microbiology: IJMM
[Show abstract][Hide abstract] ABSTRACT: To establish a community target for reducing the prevalence of salmonella in laying hens, comparable data in member states must be available. Therefore, a special survey was carried out in holdings of laying hens consisting of more than 1,000 hens. Sampling method - 5 pooled faeces samples and 2 dust samples per flock -, procedures for detection and typing of salmonellae, in the respective National Reference Laboratory for Salmonella, had to be performed according to given technical specifications. In Austria 337 flocks were sampled and Salmonella (S.) spp. were detected in 52 flocks (15.4 %). S. Enteritidis (SE) was the most frequently identified serotype, isolated out of 32 flocks (9.5 %), S.Typhimurium (ST) from 4 flocks (1.2 %) and other serotypes isolated from 18 flocks (5.3 %). The analysis In terms of production types revealed Salmonella spp. in 33 cage flocks (34.4 %) compared to 19 out of 241 non-cage flocks (7.9 %) tested, thereof 11 barn flocks (15.3 %), 7 free range standard flocks (7.0 %) and 1 free range organic flock (1.4 %). 70.4 % of all isolated salmonella serovars were SE (n = 157), 5.4 % ST (n = 12) and 24.2 % non SE and ST. The SE and ST prevalence in holdings of laying hens in Austria of 10.7 % implicates that the goal must be a reduction of 20 % of SE and ST (prevalence of 8.6 %) by 2008.
No preview · Article · Nov 2007 · Archiv für lebensmittelhygiene
[Show abstract][Hide abstract] ABSTRACT: Salmonella enterica subsp. enterica is one of the main causative agents of food-borne disease in man, and can also be the cause of serious systemic illness. Organisms belonging to this genus have traditionally been classified on the basis of the antigenic properties of the cell-surface lipopolysaccharide and of the phase 1 and phase 2 flagellar proteins. Primary isolation, biochemical identification, and serotyping are laborious and time consuming. Molecular identification based on suitable marker genes could be an attractive alternative to conventional bacteriological and serological methods. We have assessed the applicability of two housekeeping genes, gyrB, atpD, in combination with the flagellin genes fliC and fljB in multilocus sequence typing of Salmonella. Sequencing and comparative analysis of sequence data was performed on multiple strains from Austria, the United Kingdom, and Switzerland, representing all subspecies and 22 of the more prevalent non-typhoid S. enterica subsp. enterica serovars. A combination of these four marker genes allowed for a clear differentiation of all the strains analysed, indicating their applicability in molecular typing. The term MLST-v, for multilocus sequence typing based on virulence genes, is proposed to distinguish this approach from MLST based solely on housekeeping genes. An assortative recombination of the fliC gene was found in seven of the analysed serovars indicating multiple phylogenetic origin of these serovars.
No preview · Article · May 2007 · Journal of Microbiological Methods