Human Salmonella infections linked to contaminated dry dog and cat food, 2006-2008.Pediatrics. September 2010;126(3):477-83.1 National Center for Zoonotic, Vectorborne, and Enteric Diseases, Division of Foodborne, Bacterial, and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. cbartonbehravesh@cdc.gov
AbstractOBJECTIVE: Human Salmonella infections associated with dry pet food have not been previously reported. We investigated such an outbreak of Salmonella Schwarzengrund and primarily affecting young children. PATIENTS AND METHODS: Two multistate case-control studies were conducted to determine the source and mode of infections among case-patients with the outbreak strain. Study 1 evaluated household exposures to animals and pet foods, and study 2 examined risk factors for transmission among infant case-patients. Environmental investigations were conducted. RESULTS: Seventy-nine case-patients in 21 states were identified; 48% were children aged 2 years or younger. Case-households were significantly more likely than control households to report dog contact (matched odds ratio [mOR]: 3.6) and to have recently purchased manufacturer X brands of dry pet food (mOR: 6.9). Illness among infant case-patients was significantly associated with feeding pets in the kitchen (OR: 4.4). The outbreak strain was isolated from opened bags of dry dog food produced at plant X, fecal specimens from dogs that ate manufacturer X dry dog food, and an environmental sample and unopened bags of dog and cat foods from plant X. More than 23 000 tons of pet foods were recalled. After additional outbreak-linked illnesses were identified during 2008, the company recalled 105 brands of dry pet food and permanently closed plant X. CONCLUSIONS: Dry dog and cat foods manufactured at plant X were linked to human illness for a 3-year period. This outbreak highlights the importance of proper handling and storage of pet foods in the home to prevent human illness, especially among young children.
Companion NotesTwo, case-control studies determining the source of Salmonella infections in humans - 2 studies of a multi-state outbreak that occurred over 3 years - human salmonellosis not previously reported associated with dry dog and cat foods
Study design - introduction on human salmonellosis due to Salmonella enterica - estimated to cause 1.4 million illnesses and 400 deaths each year in USA - infections usually due to consumption of contaminated food products - especially animal origin foods - direct and indirect contact with animals can also result in infection - S enterica serotype Schwarzengrund is an uncommon cause of disease - causing about 0.4% of salmonellosis cases per year (reported laboratory-confirmed infections) - study population: affected people identified from 1/1/06-10/31/08 - 79 patients in 21 states infected with S enterica serotype Schwarzengrund - symptoms reported by 43 ill persons - pyrexia, 26 patients - bloody diarrhea, 15 - hospitalization, 12 for a median of 4 days - 48% were children 2 years of age or younger (58% were girls) - public health labs performed pulsed-field gel electrophoresis (PFGE) - PFGE patterns electronically submitted to PulseNet (PN) - PN is molecular sub-typing network for foodborne disease surveillance - PN identified a multistate outbreak of Salmonella Schwarzengrund in 07 - procedure: - outbreak strain isolated from the following in ‘07 - 5 of 13 dog fecal specimens - 2 of 22 dry dog food specimens from 9 Pennsylvania case-households - food was of 2 brands made at one Pennsylvania facility (plant X) - outbreak strain isolated from 1 of 144 swabs from plant X - swab was from the enrobing/flavoring room - structured questionnaires were used for the 2 multi-state case-control studies - study 1: investigate possible exposures to dogs and dry pet foods - this study employed all affected patients identified from 1/1/06-10/31/08 - case-households compared to those with nobody ill (control households) - study 2: investigate possible risk factors for infection within households - this study employed Pennsylvania children aged 2 years or younger - 2 controls recruited for each case-patient based on geography
Results - case-households significantly more likely to report the following (bivariate analysis) (as compared to control households) - dog contact (matched odds ratio [mOR]: 3.6) - recently purchased manufacturer X brands dry pet food (mOR: 6.9) - illness among infants significantly associated with: - feeding pets in kitchen (OR: 4.4) - primary caregiver had contact with pet treats (OR: 4.3) - child attended day care (OR: 3.8) - illness among infants not significantly associated with: - child placed dry pet food in mouth - child touched dry pet food - child had access to pet food bowls - outbreak strain isolated from the following: - opened bags of dry dog food produced at plant X - fecal specimens from dogs that ate manufacturer X dry dog food - environmental sample from plant X - unopened bags of dog and cat food from plant X - over 23,000 tons of pet foods recalled - company X recalled 105 brands of dry pet food and permanently closed the plant - another outbreak-linked illness identified in 2008
“This study found that illness was associated with feeding pets in the kitchen. This finding suggests that cross-contamination in the kitchen is an important source of human illness. No association was found between illness and children placing petfood in their mouths.”
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