Everything but the kitchen sink : The use of multiple hypothesis generation methods to investigate an outbreak of Salmonella Enteritidis associated with frozen profiteroles and eclairs

Journal article


Smith, Courtney R., Taylor, Marsha, Manore, Anna J. W., Hexemer, April, Adhikari, Bijay, Alexander, David, Atkinson, Robin, Chui, Linda, Galanis, Eleni, Gaulin, Colette, Griffin, Meghan, Honish, Lance, Kearney, Ashley, Mah, Victor, McCormick, Rachel and Murti, Michelle. (2024). Everything but the kitchen sink : The use of multiple hypothesis generation methods to investigate an outbreak of Salmonella Enteritidis associated with frozen profiteroles and eclairs. Epidemiology and Infection. 152, p. Article e107. https://doi.org/10.1017/S0950268824001067
AuthorsSmith, Courtney R., Taylor, Marsha, Manore, Anna J. W., Hexemer, April, Adhikari, Bijay, Alexander, David, Atkinson, Robin, Chui, Linda, Galanis, Eleni, Gaulin, Colette, Griffin, Meghan, Honish, Lance, Kearney, Ashley, Mah, Victor, McCormick, Rachel and Murti, Michelle
Abstract

In December 2018, an outbreak of Salmonella Enteritidis infections was identified in Canada by whole-genome sequencing (WGS). An investigation was initiated to identify the source of the illnesses, which proved challenging and complex. Microbiological hypothesis generation methods included comparisons of Salmonella isolate sequence data to historical domestic outbreaks and international repositories. Epidemiological hypothesis generation methods included routine case interviews, open-ended centralized re-interviewing, thematic analysis of open-ended interview data, collection of purchase records, a grocery store site visit, analytic comparison to healthy control groups, and case–case analyses. Food safety hypothesis testing methods included food sample collection and analysis, and traceback investigations. Overall, 83 cases were identified across seven provinces, with onset dates from 6 November 2018 to 7 May 2019. Case ages ranged from 1 to 88 years; 60% (50/83) were female; 39% (22/56) were hospitalized; and three deaths were reported. Brand X profiteroles and eclairs imported from Thailand were identified as the source of the outbreak, and eggs from an unregistered facility were hypothesized as the likely cause of contamination. This study aims to describe the outbreak investigation and highlight the multiple hypothesis generation methods that were employed to identify the source.

Keywordsfood-borne infections; outbreaks; salmonellosis
Year2024
JournalEpidemiology and Infection
Journal citation152, p. Article e107
PublisherCambridge University Press
ISSN0950-2688
Digital Object Identifier (DOI)https://doi.org/10.1017/S0950268824001067
PubMed ID39344906
Scopus EID2-s2.0-85205336297
PubMed Central IDPMC11450506
Open accessPublished as ‘gold’ (paid) open access
Page range1-8
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online30 Sep 2024
Publication process dates
Accepted02 Sep 2024
Deposited03 Apr 2025
Additional information

© Public Health Agency of Canada, 2024. Published by Cambridge University Press.

This is an Open Access article, distributed under the terms of the Creative Commons Attribution- NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use and/or adaptation of the article.

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