沙门氏菌谱系相关研究论文

嘿嘿，首要发表的论文吧，期刊jama的 不过倒是不知道你能不能看懂了Outbreak of Salmonella Serotype TyphimuriumInfection Associated with Eating Raw GroundBeef\p=m-\Wisconsin,1994MMWR. 1995;U:905-9091 figure omittedDESPITE previously publicized out¬breaks of illness associated with and rec¬ommendations to avoid eating undercookedmeat, some persons continue toeat undercooked or raw meat. This re¬port summarizes the investigation of anoutbreak of Salmonella serotype Typhimuriumgastrointestinal illness inWisconsin associated with eating con¬taminated raw ground beef during the1994 winter holiday December 29, 1994, physicians ina group medical practice in DodgeCounty (1994 estimated population:79 360), Wisconsin, reported to the Pub¬lic Health Unit of the Dodge CountyHuman Services and Health Department(DCHSHD) that during December 27-29 they had treated 17 patients withacute gastrointestinal illness character¬ized by diarrhea and abdominal least 14 patients reported havingeaten raw ground beef that was eitherplain or seasoned with onions and anherb mix during the 72 hours beforeillness onset. Stool samples for culturewere obtained from 11 patients; Salmo¬nella serotype Typhimurium that didnot ferment tartrate was isolated fromseven specimens. Based on these reportsand findings, the DCHSHD issued a phy¬sician alert and press release that en¬couraged affected residents to reporttheir illnesses and physicians to obtainstool cultures from case-patients. In ad¬dition, DCHSHD and the Bureau of Pub¬lic Health, Wisconsin Division of Health(WDOH), initiated an investigation ofthis outbreak. A probable case of Sal¬monella infection was defined as diar¬rhea or abdominal cramps with onsetduring December 22, 1994-January 4,1995, in a resident ofor a visitor to DodgeCounty or any of the four contiguouscounties. A confirmed case was definedas a stool culture positive for tartratenegativeSalmonella and WDOH identified 107confirmed and 51 probable case-patients;ofthese, 17 (16%) were hospitalized. Pre¬dominant manifestations of illness in¬cluded diarrhea (98%), abdominal cramps(88%), chills (77%), body aches (71%),fever (65%), nausea (60%), and bloodystools (43%). The ages of ill personsranged from 2 years to 90 years; 62%were assess potential risk factors forillness, DCHSHD andWDOH conducteda case-control study including 40 casepatientswho were randomly selectedfrom the persons with a stool specimenculture positive for tartrate-negativeSalmonella Typhimurium and 40 con¬trols who were identified by random tele¬phone digit dialing. The mean ages ofcases and controls were similar (43 yearsfor cases; 47 years for controls). Of 40case-patients, 35 (88%) reported havingeaten raw ground beef during Decem¬ber 22-January 4, compared with eight(20%) of40 controls (odds ratio [OR]=28;95% confidence interval [CI]=7-117).Among the 35 who ate raw ground beef,34 (97%) had purchased the beef fromone butcher shop, compared with three(37%) of the eight controls (OR=56; 95%CI=4-1881). Knowledge of previous re¬ports of outbreaks related to eating rawor undercooked beef was less among illpersons than among controls (26 [65%]of 40 case-patients compared with 30[75%] of 40 controls [OR=; 95%CI=]). However, 22 (85%) of the26 case-patients who reported beingaware of previous outbreaks associatedwith consumption of raw ground beefcontinued this behavior compared withseven (23%) of the 30 controls with knowl¬edge of previous outbreaks (OR=;95% CI=).DCHSHD and WDOH obtained fromcase-patients six leftover samples ofrawground beef that had been purchased atthe butcher shop on five dates duringDecember 21-29 and served in differenthomes. These samples were cultured forSalmonella sp.; all grew tartrate-negativeSalmonella Typhimurium. On De¬cember 30, 1994, staffofthe Meat Safetyand Inspection Bureau (MSIB), Wiscon¬sin Department of Agriculture, Trade,and Consumer Protection (WDATCP),informed the proprietor of the butchershop of a potential problem with con¬sumption of raw ground beef from theshop and the need to properly label meatproducts. During the winter holiday sea¬son, the butcher shop sold both seasonedand unseasoned raw ground beef thathad a warning label regarding safe han¬dling of poultry. On January 2, 1995,inspectors from MSIB examined sani¬tary conditions in the butcher shop, ob¬tained invoices indicating the origin andthe quantity of the meat used to preparethe ground beef, and inspected the rawground beef production method and sell¬ing practice in the butcher from approximately 35 carcassesobtained from three different suppliershad been ground in the shop from De¬cember 21 through January 4. Leftoverproduct was reported to have been dis¬carded each day and not carried over forsale the next day. All parts of the meatgrinder except for the auger housingwere disassembled and individuallycleaned and sanitized at the end of eachday. This type of grinder allowed easydisassembly of the auger and othersmaller parts; the auger housing wasattached to the grinder with nuts andbolts and required a wrench for , the cleaning staff had not re¬ceived instructions regarding removalof the auger housing and had cleanedonly surfaces of the tunnel-like space forthe auger with a from by guest on November 23, 2009Meat remnants were present in theauger housing when the grinder wasdisassembled. Twenty environmentalswabs of the equipment and the areasrelated to the production of the groundbeefwere obtained for bacterial culture;all were negative for Salmonella specimens obtained from all fivebutchers at the shop were cultured; onewas positive for tartrate-negative Sal¬monella Typhimurium. Although thisbutcher denied illness, he had eaten rawground beef at the shop during the out¬break by: PA Frazak, MPH, Public Health Unit,Dodge County Human Svcs and Health Dept; JJKazmierczak, DVM, ME Proctor, PhD, JP Davis, MD,State Epidemiologist for Communicable Diseases, Burof Public Health, Wisconsin Div of Health; J Larson, RLoerke, Meat Safety and Inspection Bur, WisconsinDept of Agriculture, Trade, and Consumer of Bacterial and Mycotic Diseases, National Cen¬ter for Infectious Diseases; Div of Field Epidemiology,Epidemiology Program Office, Editorial Note: The investigationofthis outbreak implicated consumptionof contaminated raw ground beef as thesource of Salmonella infection. Inad¬equate cleaning and sanitization of themeat grinder probably resulted in on¬going contamination ofground beef overmany production days. The outbreak oc¬curred during the winter holiday sea¬son, and some patients reported thatconsumption of raw ground beef duringthese holidays was a practice broughtfrom Europe by their ancestors. Thedecline of cases after the holidays mayhave occurred because ground beeffromthe implicated butcher shop was nolonger consumed raw or because thegrinder was cleaned more thoroughlyafter WDATCP personnel spoke withthe proprietor of the butcher shop onDecember 30. The five persons who be¬came ill but did not report eating rawground beef may not have rememberedeating the raw ground beef, may haveeaten undercooked ground beef or foodthat was contaminated from the rawground beef, or may have become illthrough person-to-person ground beef previously has beenimplicated as a vehicle for transmissionoiSalmonella,12 and undercooked groundbeef is the most frequently recognizedvehicle for Escherichia coli 0157:H7 in¬ The prevalence of Salmonellain beef ranges from 1% for raw beef car¬casses4 to 5%-7% for ground beef ( of Agriculture, Food Safetyand Inspection Service, unpublished data,1994). Prevention measures include warn¬ing consumers of the health risks asso¬ciated with eating raw ground beef andencouraging them to thoroughly cookground beef and to adhere to safefoodhandling guidelines. Safe cooking andhandling labels on raw or partially cookedmeat and poultry are now required bythe . Department of Agriculture(USDA).However, the presence of safefoodhandling labels does not ensure ad¬herence to safe practices. For example,an investigation of risk factors for spo¬radic E. coli 0157:H7 infection indicatedthat of 43 food preparers who reportedreading the safe foodhandling label onmeat packages, 33 (77%) admitted topractices specifically discouraged on investigation in Dodge County un¬derscores that knowledge of health risksis not consistently associated with desir¬able changes in behavior. Despite publichealth warnings and publicity about re¬lated outbreaks, some consumers inDodge County and elsewhere have con¬tinued to eat raw or undercooked foods ofanimal origin. For example, a telephonesurvey of a national sample of adults con¬ducted by the Center for Food Safetyand Applied Nutrition, Food and DrugAdministration (FDA), during December1992-February 1993 indicated that 53%consumed raw eggs; 23%, undercookedhamburgers; 17%, raw clams or oysters;8%, raw sushi or ceviche; and 5%, steaktartare (raw hamburger meat).6Consumer advisories can be more ef¬fective if targeted to specific cultural orethnic groups with such high-risk di¬etary practices, and WDATCP is plan¬ning two press releases this winter holi¬day period to warn consumers of therisks associated with eating raw addition to consumer advisories,interventions to reduce the risks asso¬ciated with the consumption of groundbeef include the needs for (1) producersof ground beef to emphasize employeeeducation and training on the recom¬mended methods of cleaning and sani¬tizing meat-grinding equipment; (2)manufacturers to design meat-grindingequipment that is easily accessible forcleaning and sanitization; and (3) stateregulatory and inspection authorities toadopt and enforce FDA's Food Codemodel requirements, which offer spe¬cific recommendations for handling,cooking, and storing raw meat; cleaningand sanitizing equipment and utensils;designing and constructing equipment;and advising consumers about the risksassociated with consumption of raw orundercooked food of animal TheUSDA's Food Safety and Inspection Ser¬vice also has proposed changes in themeat and poultry inspection system toimprove assessment and control of microbialpathogens in raw meat and poul¬ Consumers can obtain more infor¬mation on safe meat handling from theUSDA's Meat and Poultry Hotline (tele¬phone [800] 535-4555).References1. Fontaine RE, Arnon S, Martin WT, et al. Raw hamburger:an interstate common source of human J Epidemiol 1978;107:. CDC. Salmonella Typhimurium\p=m-\Minnesota,Wisconsin,Michigan. MMWR 1972;21:411 . Griffin PM. Escherichia coli O157:H7 and other enterohemorrhagicEscherichia coli. In: Blaser MJ,Smith PD, Ravdin JI, Greenberg HG, Guerrant RL,eds. Infections of the gastrointestinal tract. New York:Raven Press, Ltd, . Food Safety and Inspection Service, US Departmentof Agriculture. Nationwide beef microbiological baseline data collection program: steers and heifers(October 1992-September 1993). Washington, DC: USDepartment of Agriculture, January . Mead PS, Finelli L, Spitalny K, et al. Risk factors forsporadic infection with Escherichia coli O157:H7 [Abstract].In: 44th Annual Epidemic Intelligence ServiceConference, March 27-31, 1995. Atlanta, Georgia: USDepartment of Health and Human Services, PublicHealth Service, CDC, . Klontz KC, Timbo B, Fein S, Levy A. Prevalence ofselected food consumption and preparation behaviorsassociated with increased risks of food-borne of Food Protection 1995;58:. Public Health Service. Food code, 1995. Washington,DC: US Department of Health and Human Services,Public Health Service, Food and Drug Administration,. Food Safety and Inspection Service, US Department ofAgriculture. Pathogen reduction: hazard analysis andcritical control point (HACCP) systems; proposed Register 1995;60:: Influenza Activity\p=m-\UnitedStates,1995-96 SeasonMMWR. 1996;U:937-939INFLUENZA activity in the UnitedStates increased steadily from late Oc¬tober through mid-December 1995. Thisreport summarizes influenza surveillancedata from October 1 through December16, October 1-December 16, influ¬enza viruses were isolated in 45 statesand the District of Columbia. Of the 296influenza virus isolates reported by WorldHealth Organization (WHO) collaborat¬ing laboratories in the United States, 293() were type A and three ()were type B. Of the type A isolates, 140Downloaded from by guest on November 23, 2009