Although Listeria monocytogenes is a relatively uncommon cause of food-borne infection in the United States, this species is associated with a disproportionate mortality rate. In recent years, Salmonella and Listeria have been associated with more cases of fatal bacterial food related disease than any other agent, despite the the relative rarity of listeriosis as a disease. [1,2] In fact, case-fatality rates of the most common agent, Salmonella, have not paralleled increases in disease incidence. See graphs 1 and 2.

(See the Graph tool tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps )

References:
1. Berger SA. Infectious Diseases of the United States, 2011. 1030 pp, 464 graphs, 8237 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states
2. Berger SA. Listeriosis: Global Status, 2011. 93 pp, 103 graphs, 487 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/listeriosis-global-status/

Note disussed in Promed

A recent outbreak in Adelaide reminds us that the salmonellosis rates in Australia have been increasing for more than five decades. In contrast, the incidence of this disease in other English-speaking countries has leveled off, or even decreased, since the 1990′s. 1,2 [see graph]

References:
1. Berger S. Infectious Diseases of Australia, 2011, 503 pp. Gideon e-book series, http://www.gideononline.com/ebooks/country/infectious-diseases-of-australia/
2. Berger S. Salmonellosis: Global Status, 2011, 245 pp. Gideon e-book series, http://www.gideononline.com/ebooks/disease/salmonellosis-global-status/

Recent cross-border oubreaks belie the fact that salmonellosis activity in the United Kingdom has actually declined in recent years. In fact, since 1997, reporting rates for England, Scotland and Wales have been similar to the lower figures which had existed in Ireland and Northern Ireland. The following data are extracted from the Gideon e-book series. [1-3]

The following chronlogy of earlier international salmonellosis outbreaks (not including clusters among tourists) is extracted from reference [4]:

Outbreaks involving two or more countries (primary references available on request)
1973 (publication year) – An international outbreak of Salmonella agona infection was reported.
1973 to 1974 – An outbreak (80 cases in the U.S. and 39 in Canada) of Salmonella Eastborne infection was caused by contaminated chocolate.
1982 – An outbreak (245 cases) of Salmonella napoli infection in England and Wales was caused by contaminated chocolate bars imported from Italy.
1991 – An outbreak (400 cases or more) of Salmonella poona infection in the United States and Canada was caused by contaminated American and Central American cantaloupe.
1995 – An outbreak (27 cases in the U.K.) of Salmonella agona infection was caused by a savoury snack imported from Israel.
1995 – An outbreak ( 242 cases, approximate) in the United States and Finland of Salmonella serotype Stanley infection was traced to Alfalfa sprouts.
1996 to 1997 – An outbreak (22 cases) of S. enterica serotype Anatum infection was caused by contaminated dried formula milk – resulting in 13 cases in England, 4 Scotland, 4 France and 1 Belgium.
1997 – An outbreak of S. livingstone infection was reported in Western Europe – several of the cases were acquired abroad, notably in Tunisia.
1997 – An outbreak (24 cases) of Salmonella serogroup Saphra infection in California was associated with imported Mexican cantaloupe.
1997 to 1998 – An outbreak of Salmonella Newport infection associated with contaminated cured ham was reported in the United Kingdom and Finland.
1998 – Outbreaks of Salmonella blockley infection were reported in Germany, Austria, Belgium, Sweden, Finland and the United Kingdom – smoked eel implicated in some countries.
1999 – An outbreak (275 cases) of Salmonella paratyphi B infection was reported among European tourists who visited Turkey during the summer of 1999.
1999 – An outbreak (400 cases or more, 21 hospitalized) of Salmonella muenchen infection from orange juice affected 25 U.S. states and two Canadian provinces (22 cases).
2000 – Outbreaks of Salmonella typhimurium DT204b infection (total 396 cases) which may have been related occurred in Iceland, England and Wales, the Netherlands, Scotland and Germany. Contaminated lettuce was implicated.
2000 to 2001 – An outbreak (168 cases, total) of S. enteritidis phage type 30 infection (157 cases in Canada, 11 in the United States) was caused by contaminated raw almonds.
2000 to 2002 – Outbreaks (148 cases, total) of Salmonella poona infection (47 cases in 2000, 50 in 2001, 58 in 2002) from imported Mexican cantaloupe were reported in multiple American states and Canada.
2001 – Outbreaks of Salmonella typhimurium DT 104 infection caused by a batch of imported Turkish halvah were reported in Australia and Sweden. Contaminated halvah was also identified in Germany, Norway and the United Kingdom.
2001 – An outbreak (99 total cases) of Salmonella Stanley infection in Australia (60 cases) and Canada (33 cases) was associated with contaminated peanuts imported from China.
2001 – An outbreak of Salmonella oranienburg due to contaminated German chocolate affected several European countries.
2001 – An outbreak (303 cases) of Salmonella enteritidis anaerogenic PT 14b infection was reported among Norwegian, Finish and Swedish tourists returning from Crete and Karpathos. The probable source was contaminated poultry.
2001 – An outbreak of Salmonella Schwarzenground infections in Denmark and the United States was traced to contaminated chickens in Thailand.
2003 – Outbreaks of Salmonella Montevideo infection in Australia and New Zealand were caused by contaminated sesame seed products (Tahini and Halva) imported from Egypt and Lebanon.
2004 – Raw almonds contaminated with Salmonella enteritidis were recalled by the manufacturer from China, Taiwan, Democratic Republic of Korea, France, Italy, Japan, Malaysia, Mexico and the United Kingdom.
2004 – Ruccola lettuce contaminated with Salmonella Thompson was identified in Norway, Sweden and the United Kingdom.
2005 – An outbreak (5 cases, total) of Salomonella enterica serotype Thompson infection (3 cases in Canada and 2 in United States) was caused by handling contaminated pet treats.
2005 – An outbreak (48 cases, total) of Salmonella stoubridge infection in Sweden (6 cases), Switzerland (3), Germany (2), Austria (5), United Kingdom (3) and France (27) was caused by unpasteurized French soft cheese.
2005 – An outbreak (178 cases) of Salmonella Goldcoast infection in Majorca affected tourists from Scotland (37), Ireland (6), Sweden (6), Norway (8), Denmark (3), Germany (20) and Finland (4).
2005 – An outbreak (22 cases) of Salmonella typhimurum DT 104 infection in Denmark was caused by raw beef carpacio imported from Italy.
2006 – An outbreak (13 cases) of Salmonella typhimurium infection in Sweden was caused by contaminated salami imported from Italy.
2007 – An outbreak (10 cases) of Salmonella typhimurium infection in Denmark (6 cases) and Norway (4 cases) was caused by imported Spanish sausage.
2007 – An outbreak (63 cases) of Salmonella senftenberg infection in England and Wales (51 cases), Denmark (11) and the Netherlands (2) was ascribed to contaminated basil imported from Israel. Subsequent testing of local batches of basil failed to demonstrate the organism.
2007 – An outbreak (45 cases, total) of Salmonella Weltevreden infections in Norway (19 cases), Denmark (19 cases) and Finland (7 cases) was associated with alfalfa sprouts distributed from Denmark. 2007 – An outbreak (354 cases) of Salmonella paratyphi B variant Java (Salmonella Java) infection in Netherlands (12 cases), Sweden (172), Norway (25), Ireland (9), Hungary (3), Finland (9), Denmark (40) and Austria (2) was ascribed to contaminated baby spinach.
2008 – An outbreak (59 cases) of Salmonella Litchfield infection in 16 American states (50 cases) and Canada (9 cases) was caused by contaminated melon from Honduras.
2008 – An outbreak (141 cases) of Salmonella serotype Agona infection in England (80 cases), Wales (10), Ireland (11) , Northern Ireland (1) , Scotland (31) Sweden (2), France (1) and Finland (1) was ascribed to contaminated commercial sandwiches.
2008 – An outbreak (74 cases) of Salmonella enterica serotype poona infection included 26 cases in Canada and 48 in the United States.
2008 – An outbreak (49 cases) of Salmonella enterica serotype typhimurium U288 infection from contaminated pork products included 37 cases (4 fatal) in Denmark, 10 in Norway and 2 in Sweden.
2008 to 2010 – An outbreak (400 cases) of Salmonella typhimurium DT 191a infections in England, Wales, Northern Ireland and Ireland was related to pet reptiles which were fed with contaminated frozen mice. Subsequent outbreak cases (34) were reported in multiple American states in 2010.
2009 – An outbreak (137 cases) of Salmonella oranienburg infection included 38 cases in the United Kingdom, 85 in the United States, 7 in Canada and 7 in Scotland.
2009 – An outbreak (124 cases in the United States and 12 in Canada) of Salmonella enterica serotype typhimurium infections was ascribed to possible contamination of shredded lettuce.
2010 – An outbreak (14 cases) of Salmonella urbana infection included cases in in Finland, the Czech Republic and Latvia.

1. Berger SA. Infectious Diseases of the United Kingdom, 956 pp. 2010. Gideon e-book series. http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-kingdom/
2. Berger SA. Infectious Diseases of Ireland and Northern Ireland, 433 pp. 2010. Gideon e-book series. http://www.gideononline.com/ebooks/country/infectious-diseases-of-ireland-and-northern-ireland/
3. Berger SA. Salmonellosis: Global Status, 237 pp. 2010. Gideon e-book series. http://www.gideononline.com/ebooks/disease/salmonellosis-global-status/
4. Berger SA. Infectious Diseases of the World, 929 pp. 2010. Gideon e-book series. http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-world/

An ongoing outbreak in Denmark belies the fact that salmonellosis rates in Scandinavia have remained fairly constant during the past decade. In the attached graph rates for the United States are added for comparison. Some additional background data on salmonellosis in Denmark – source www.GideonOnline.com (more…)

A recent outbreak of suspected salmonellosis among British travelers at a hotel in Italy highlights the risk for such infections among tourists, expatriates and similar groups in transit through foreign countries. The following chronology of similar episodes is abstracted from GIDEON:

1976 – An outbreak (550 cases) of Salmonella typhimurium infection affecting 4 international air flights (Las Palmas-Helsinki, Las Palmas-Honover) was caused by contaminated mayonnaise prepared in Spain.
1985 – An outbreak (168 cases) of Salmonella minnesota infection was reported at a Filipino workers’ camp in Saudi Arabia. (more…)

Following up on the latest outbreak of salmonellosis in Constanta, Romania, using the GIDEON graph function, Steve analyzes the reported rates of salmonellosis in Romania and surrounding countries. As reported by ProMED:

The recent outbreak in Constanta belies the fact that Romania has consistently reported the lowest rates of salmonellosis in this region of Europe for at least 20 years. See graph.

ProMED published another note from GIDEON related to Salmonellosis in Germany. Here’s an abstract:

Salmonellosis accounts for 14 percent of all reported infectious disease and 98 percent of all zoonoses in Germany. 55 percent of infections are acquired from meat and poultry.

Recent incidence data are displayed at and are contrasted with those of the United States at