Epidemiology and Infection

Re-assessment of risk factors for sporadic Salmonella serotype Enteritidis infections: a case-control study in five FoodNet Sites, 2002–2003

R. MARCUS a1c1 1 , J. K. VARMA a2a3 1 , C. MEDUS a4 1 , E. J. BOOTHE a5 1 , B. J. ANDERSON a6 1 , T. CRUME a7 1 , K. E. FULLERTON a3a8 1 , M. R. MOORE a3 1 , P. L. WHITE a9 1 , E. LYSZKOWICZ a3 1 , A. C. VOETSCH a3 1 and F. J. ANGULO a3 1
a1 Connecticut Emerging Infections Program, New Haven, CT, USA
a2 Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
a3 Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
a4 Minnesota Department of Health, Minneapolis, MN, USA
a5 Tennessee Department of Health, Nashville, TN, USA
a6 New York Department of Health, Albany, NY, USA
a7 Colorado Department of Public Health and Environment, Denver, CO, USA
a8 Atlanta Research and Education Foundation, Atlanta, GA, USA
a9 Food Safety and Inspection Service, USDA, Omaha, NE, USA

Article author query
marcus r   [PubMed][Google Scholar] 
varma jk   [PubMed][Google Scholar] 
medus c   [PubMed][Google Scholar] 
boothe ej   [PubMed][Google Scholar] 
anderson bj   [PubMed][Google Scholar] 
crume t   [PubMed][Google Scholar] 
fullerton ke   [PubMed][Google Scholar] 
moore mr   [PubMed][Google Scholar] 
white pl   [PubMed][Google Scholar] 
lyszkowicz e   [PubMed][Google Scholar] 
voetsch ac   [PubMed][Google Scholar] 
angulo fj   [PubMed][Google Scholar] 


Active surveillance for laboratory-confirmed Salmonella serotype Enteritidis (SE) infection revealed a decline in incidence in the 1990s, followed by an increase starting in 2000. We sought to determine if the fluctuation in SE incidence could be explained by changes in foodborne sources of infection. We conducted a population-based case-control study of sporadic SE infection in five of the Foodborne Diseases Active Surveillance Network (FoodNet) sites during a 12-month period in 2002–2003. A total of 218 cases and 742 controls were enrolled. Sixty-seven (31%) of the 218 case-patients and six (1%) of the 742 controls reported travel outside the United States during the 5 days before the case's illness onset (OR 53, 95% CI 23–125). Eighty-one percent of cases with SE phage type 4 travelled internationally. Among persons who did not travel internationally, eating chicken prepared outside the home and undercooked eggs inside the home were associated with SE infections. Contact with birds and reptiles was also associated with SE infections. This study supports the findings of previous case-control studies and identifies risk factors associated with specific phage types and molecular subtypes.

(Accepted March 31 2006)
(Published Online June 7 2006)

c1 MPH, Connecticut FoodNet, Connecticut Emerging Infections Program, One Church Street, 7th Floor, New Haven, CT 06510, USA. (Email: Ruthanne.Marcus@yale.edu)


1 for the Emerging Infections Program FoodNet Working Group