RESUMEN
During the winter of 2000 to 2001, an outbreak due to Salmonella Enteritidis (SE) phage type 30 (PT30), a rare strain, was detected in Canada. The ensuing investigation involved Canadian and American public health and food regulatory agencies and an academic research laboratory. Enhanced laboratory surveillance, including phage typing and pulsed-field gel electrophoresis, was used to identify cases. Case questionnaires were administered to collect information about food and environmental exposures. A case-control study with 16 matched case-control pairs was conducted to test the hypothesis of an association between raw whole almond consumption and infection. Almond samples were collected from case homes, retail outlets, and the implicated processor, and environmental samples were collected from processing equipment and associated farms for microbiological testing. One hundred sixty-eight laboratory-confirmed cases of SE PT30 infection (157 in Canada, 11 in the United States) were identified between October 2000 and July 2001. The case-control study identified raw whole almonds as the source of infection (odds ration, 21.1; 95% confidence interval, 3.6 to infinity). SE PT30 was detected in raw whole natural almonds collected from home, retail, distribution, and warehouse sources and from environmental swabs of processing equipment and associated farmers' orchards. The frequent and prolonged recovery of this specific organism from a large agricultural area was an unexpected finding and may indicate significant diffuse contamination on these farms. Identification of almonds as the source of a foodborne outbreak is a previously undocumented finding, leading to a North American recall of this product and a review of current industry practices.
Asunto(s)
Brotes de Enfermedades , Prunus/microbiología , Intoxicación Alimentaria por Salmonella/epidemiología , Fagos de Salmonella/clasificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Tipificación de Bacteriófagos , Canadá/epidemiología , Estudios de Casos y Controles , Niño , Preescolar , Intervalos de Confianza , Contaminación de Equipos , Femenino , Contaminación de Alimentos , Industria de Alimentos/normas , Humanos , Lactante , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Factores de Riesgo , Fagos de Salmonella/aislamiento & purificación , Salmonella enteritidis/aislamiento & purificaciónRESUMEN
The Public Health Agency of Canada (the Agency) has an important role to play in collaboration with its provincial/territorial partners to advance preparedness for emerging and re-emerging high-consequence infectious diseases. During the 2014 Ebola outbreak, the Agency established Ebola Virus Disease (EVD) Rapid Response Teams that were available to any requesting provincial/territorial jurisdiction with a laboratory confirmed case of EVD. Working with provincial and territorial officials, a Rapid Response Team Concept of Operations was developed which outlined the process for Rapid Response Team engagement as well as the suite of technical expertise available. The Concept of Operations was refined further following a series of face-to-face advance planning meetings with individual provincial and territorial jurisdictions. This led to a consensus agreement that the Agency's Rapid Response Team should be available to support management of both confirmed and suspected EVD cases. There was also unanimous support from provincial and territorial jurisdictions that the concept and operationalization of the Agency's Rapid Response Team should be broadened to provide surge-capacity support to the provinces and territories to include any event with significant public health consequences. The Agency will continue to engage with domestic and international partners regarding best practices to maintain a highly skilled and nimble Rapid Response Team that is operationally ready to support both domestic and international public health emergencies.