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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
Smith, Courtney R. Taylor, Marsha Manore, Anna J. W. Hexemer, April Adhikari, Bijay Alexander, David Atkinson, Robin Chui, Linda Galanis, Eleni Gaulin, Colette
Smith, Courtney R.
Taylor, Marsha
Manore, Anna J. W.
Hexemer, April
Adhikari, Bijay
Alexander, David
Atkinson, Robin
Chui, Linda
Galanis, Eleni
Gaulin, Colette
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.
Keywords
food-borne infections, outbreaks, salmonellosis
Date
2024
Type
Journal article
Journal
Epidemiology and Infection
Book
Volume
152
Issue
Page Range
1-8
Article Number
Article e107
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC-ND 4.0
File Access
Open
Notes
© 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.