RESUMEN
INTRODUCTION: Salmonella foodborne disease during pregnancy causes a significant fetal loss in domestic livestock and preterm birth, chorioamnionitis and miscarriage in humans. These complications could be associated with alterations in placental structure. This study was aimed to determine how a low dose of Salmonella Enteritidis during late gestation affects placental histomorphometric in mice. METHODS: We used a self-limiting enterocolitis murine model. BALB/c pregnant animals received a low dose of Salmonella Enteritidis (3-4 x 102 CFU/mouse) on gestational day (GD) 15. At day 3 post infection bacterial loads, serum cytokines expression and placental histomorphometrics parameters were analyzed. RESULTS: We found that a sub-lethal infection with Salmonella induced a significant drop in fetal weight -to-placental weight-ratio and an increase in the placental coefficient. After bacterial inoculation maternal organs were colonized, inducing placental morphometric alterations, including increased placental thickness, reduced surface area, and diminished major and minor diameters. Also, foci of necrosis accompanied by acute leukocyte infiltration in decidual zone, reduction of vascular spaces and vascular congestion in labyrinth zone, were also evident in placentas from infected females on GD 18. Our data shows that placentas from infected mothers are phenotypically different from control ones. Furthermore, expression of IFN-gamma and IL-6 was up regulated in response to Salmonella in maternal serum. DISCUSSION: Our findings demonstrate that a low dose of Salmonella during late gestation alters the placental morphometry leading to negative consequences on pregnancy outcome such as significant reduction in fetal body weight.
Asunto(s)
Placenta/patología , Complicaciones Infecciosas del Embarazo/patología , Infecciones por Salmonella/patología , Salmonella enteritidis/fisiología , Animales , Corioamnionitis/microbiología , Corioamnionitis/patología , Modelos Animales de Enfermedad , Femenino , Retardo del Crecimiento Fetal/etiología , Retardo del Crecimiento Fetal/patología , Masculino , Ratones , Ratones Endogámicos BALB C , Placenta/microbiología , Enfermedades Placentarias/microbiología , Enfermedades Placentarias/patología , Embarazo , Complicaciones Infecciosas del Embarazo/microbiología , Intoxicación Alimentaria por Salmonella/complicaciones , Intoxicación Alimentaria por Salmonella/patología , Infecciones por Salmonella/complicaciones , Síndrome de Respuesta Inflamatoria Sistémica/complicaciones , Síndrome de Respuesta Inflamatoria Sistémica/microbiología , Síndrome de Respuesta Inflamatoria Sistémica/patologíaRESUMEN
OBJECTIVES: The main objective of this study was to derive cost estimates of five major foodborne illnesses (campylobacteriosis, salmonellosis, enterohemorrhagic Escherichia coli (EHEC), yersiniosis and shigellosis) in Sweden. These estimates provide a necessary contribution to perform future cost-benefit analyses aimed at reducing the burden of foodborne disease. A secondary aim was to obtain estimates of the true number of cases that occur in the community, thus providing necessary ground for calculating costs. METHODS: The true number of cases for each foodborne illness was simulated by multiplying the reported number of cases by sequential multipliers, one for each potential source of information loss about a case. This assessment of the true number of cases was then used to estimate the number of cases of sequelae for each illness. An incidence-based analysis was then used to calculate direct medical and non-medical costs, as well as indirect costs. Data for estimating the true number of cases for each illness were primarily based on an expert panel, while the derivation of costs mainly utilized national registries, databases and published literature. RESULTS: The estimated number of cases was between 7- and 11-fold higher than the reported number of cases, indicating the importance of taking information loss into account when calculating costs. By far the most common pathogen of the five was campylobacter, with an estimated 101,719 (90% credibility interval [CI] 59,640-158,025) human cases occurring annually. For salmonella, 19,678 (90% CI 8394-40,456) cases were estimated to occur each year, while the other three pathogens were less common, with a yearly incidence of approximately 2500-5500 cases each. The total cost for the five pathogens (including sequelae) amounted to 142 million annually. Campylobacter was the most costly pathogen, representing 69% of the total costs. Salmonellosis and EHEC constituted 18 and 9% of these costs, respectively, while yersiniosis and shigellosis represented approximately 2% each. Costs for sequelae were significant and accounted for approximately 50% of the total costs. CONCLUSIONS: Our simulations indicated that campylobacter infection was more common and more costly than salmonella, EHEC, yersinia and shigella combined. Estimated costs for all illnesses were highly influenced by (1) considering potential information losses about cases in the population (which increased costs 7- to 11-fold), and (2) taking account of post-infection sequelae (which doubled the costs).
Asunto(s)
Costo de Enfermedad , Enfermedades Transmitidas por los Alimentos/economía , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/economía , Infecciones por Campylobacter/epidemiología , Disentería Bacilar/complicaciones , Disentería Bacilar/economía , Disentería Bacilar/epidemiología , Infecciones por Escherichia coli/complicaciones , Infecciones por Escherichia coli/economía , Infecciones por Escherichia coli/epidemiología , Femenino , Enfermedades Transmitidas por los Alimentos/complicaciones , Enfermedades Transmitidas por los Alimentos/epidemiología , Costos de la Atención en Salud/estadística & datos numéricos , Humanos , Incidencia , Masculino , Modelos Económicos , Intoxicación Alimentaria por Salmonella/complicaciones , Intoxicación Alimentaria por Salmonella/economía , Intoxicación Alimentaria por Salmonella/epidemiología , Suecia/epidemiología , Yersiniosis/complicaciones , Yersiniosis/economía , Yersiniosis/epidemiologíaRESUMEN
Intestinal inflammation is the central pathological feature of colitis and the inflammatory bowel diseases. These syndromes arise from unidentified environmental factors. We found that recurrent nonlethal gastric infections of Gram-negative Salmonella enterica Typhimurium (ST), a major source of human food poisoning, caused inflammation of murine intestinal tissue, predominantly the colon, which persisted after pathogen clearance and irreversibly escalated in severity with repeated infections. ST progressively disabled a host mechanism of protection by inducing endogenous neuraminidase activity, which accelerated the molecular aging and clearance of intestinal alkaline phosphatase (IAP). Disease was linked to a Toll-like receptor 4 (TLR4)-dependent mechanism of IAP desialylation with accumulation of the IAP substrate and TLR4 ligand, lipopolysaccharide-phosphate. The administration of IAP or the antiviral neuraminidase inhibitor zanamivir was therapeutic by maintaining IAP abundance and function.
Asunto(s)
Fosfatasa Alcalina/deficiencia , Colon/microbiología , Enfermedades Inflamatorias del Intestino/microbiología , Intoxicación Alimentaria por Salmonella/complicaciones , Salmonella typhimurium , Receptor Toll-Like 4/metabolismo , Fosfatasa Alcalina/administración & dosificación , Animales , Colon/inmunología , Colon/patología , Inhibidores Enzimáticos/administración & dosificación , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Enfermedades Inflamatorias del Intestino/enzimología , Enfermedades Inflamatorias del Intestino/patología , Lipopolisacáridos/inmunología , Ratones , Ratones Endogámicos C57BL , Neuraminidasa/antagonistas & inhibidores , Recurrencia , Sialiltransferasas/genética , Sialiltransferasas/metabolismo , Receptor Toll-Like 4/genética , Zanamivir/administración & dosificación , beta-Galactosida alfa-2,3-SialiltransferasaRESUMEN
INTRODUCTION: In neonatal units, Salmonella infections have been attributed to food-borne sources and person to person transmission. METHODS: The outbreak described is the first reported by Salmonella enterica serotype Newport in a neonatal facility in Spain. RESULTS: The index case was an 8-day premature newborn that developed clinical sepsis with positive blood cultures. The outbreak source was the mother of the index case. CONCLUSIONS: It is essential to improve infection control measures taking into account the parents, as they can be an important source of infection
INTRODUCCIÓN: En unidades de neonatología, las infecciones por Salmonella han sido atribuidas a fuentes alimentarias y a transmisión de persona a persona. MÉTODOS: El brote descrito es el primero ocasionado por Salmonella enterica serotipo Newport en una unidad neonatal en España. RESULTADOS: El caso índice era un recién nacido prematuro que desarrolló sepsis clínica con hemocultivos positivos. La fuente del brote fue la madre del caso índice. CONCLUSIONES: Al implementar medidas de control de la infección nosocomial se debe tener en cuenta a los padres ya que pueden constituir una fuente importante de infección
Asunto(s)
Humanos , Recién Nacido , Salmonella/patogenicidad , Intoxicación Alimentaria por Salmonella/complicaciones , Infecciones por Salmonella/transmisión , Enfermedades Intestinales/microbiología , Transmisión Vertical de Enfermedad Infecciosa , Brotes de Enfermedades/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Portador Sano/epidemiología , Unidades de Cuidado Intensivo Neonatal/organización & administraciónAsunto(s)
Fiebre de Origen Desconocido/etiología , Microbiología de Alimentos , Carne/microbiología , Intoxicación Alimentaria por Salmonella/microbiología , Salmonella enterica/aislamiento & purificación , Tortugas/microbiología , Adulto , Animales , Guinea Ecuatorial/etnología , Heces/microbiología , Humanos , Malaria Falciparum/complicaciones , Masculino , Intoxicación Alimentaria por Salmonella/complicaciones , Salmonella enterica/clasificación , España , Sífilis/complicacionesAsunto(s)
Antibacterianos/uso terapéutico , Cefalosporinas/uso terapéutico , Dolor en el Pecho/etiología , Fluoroquinolonas/uso terapéutico , Intoxicación Alimentaria por Salmonella/complicaciones , Intoxicación Alimentaria por Salmonella/tratamiento farmacológico , Enfermedad Aguda , Adulto , Humanos , Masculino , Resultado del TratamientoAsunto(s)
Diarrea/complicaciones , Miocarditis/etiología , Intoxicación Alimentaria por Salmonella/complicaciones , Salmonella enteritidis/aislamiento & purificación , Enfermedad Aguda , Adolescente , Técnicas de Diagnóstico Cardiovascular , Diarrea/microbiología , Heces/microbiología , Humanos , Inmunocompetencia , Masculino , Miocarditis/diagnóstico , Miocarditis/microbiología , Intoxicación Alimentaria por Salmonella/microbiologíaRESUMEN
BACKGROUND: In most patients, infection with a non-typhoid Salmonella species usually results in self-limiting gastroenteritis. Severe complications such as bacteraemia and extra-abdominal infections are most often attributed to typhoid subspecies like S. typhi and S. paratyphi. In this article, we present the case of a healthy patient with non-typhoid salmonellosis who nevertheless developed severe complications. CASE DESCRIPTION: A 63-year-old man with an unremarkable medical history presented at the emergency department with abdominal complaints suggestive of gastroenteritis. Cultures of faeces and blood yielded S. typhimurium. The infection was complicated by many intra-abdominal abscesses, abdominal sepsis and an intestinal perforation requiring multiple interventions. The patient has been symptom-free for half a year now. CONCLUSION: Severe complications related to infection with non-typhoid S. typhimurium are rare. The incidence of salmonellosis has risen over the past few years, however; the risk of severe complications has therefore also increased.
Asunto(s)
Perforación Intestinal/diagnóstico , Infecciones por Salmonella/complicaciones , Infecciones por Salmonella/diagnóstico , Salmonella typhimurium/aislamiento & purificación , Absceso Abdominal/diagnóstico , Absceso Abdominal/microbiología , Bacteriemia/diagnóstico , Bacteriemia/microbiología , Diagnóstico Diferencial , Humanos , Perforación Intestinal/microbiología , Masculino , Persona de Mediana Edad , Intoxicación Alimentaria por Salmonella/complicaciones , Intoxicación Alimentaria por Salmonella/diagnósticoRESUMEN
A 63-year-old woman presented with 24 hours of dysarthria, confusion, and appendicular ataxia preceded by watery diarrhea, without fever, nausea, vomiting, meningeal signs, recent travel, or antibiotic use. She had type II diabetes and gastroesophageal reflux disease (on proton pump inhibitor). She had consumed inadequately cooked beef stew left at room temperature for 24 hours. Blood cultures were positive for Salmonella typhimurium. CSF showed 15 nucleated cells, 72% monocytoid; remainder of CSF was normal. MRI was consistent with cerebellitis (figure). At 3 months, after 3 weeks of IV ceftriaxone, she remained dysarthric with bilateral dysmetria.
Asunto(s)
Enfermedades Cerebelosas/diagnóstico , Enfermedades Cerebelosas/microbiología , Intoxicación Alimentaria por Salmonella/diagnóstico , Salmonella typhimurium/aislamiento & purificación , Enfermedad Aguda , Enfermedades Cerebelosas/etiología , Femenino , Humanos , Persona de Mediana Edad , Intoxicación Alimentaria por Salmonella/complicacionesRESUMEN
Myocarditis typically presents with non-specific clinical symptoms, and can easily be missed in the absence of a high index of clinical suspicion. Myocarditis caused by bacterial pathogens is rare in immunocompetent individuals, more commonly seen following viral infection. Although more classically associated with typhoid fever and gastroenteritis, Salmonella species are a rare cause of myocarditis. We report a case of Salmonella enteritidis-induced myocarditis after gastrointestinal infection in a 16 year-old girl, and discuss the diagnostic tools currently utilised to ascertain the diagnosis.
Asunto(s)
Miocarditis/diagnóstico , Infecciones por Salmonella/diagnóstico , Salmonella enteritidis , Adolescente , Ceftriaxona/uso terapéutico , Diagnóstico Diferencial , Quimioterapia Combinada , Ecocardiografía , Electrocardiografía , Femenino , Estudios de Seguimiento , Gastroenteritis/complicaciones , Gastroenteritis/diagnóstico , Gastroenteritis/tratamiento farmacológico , Humanos , Miocarditis/tratamiento farmacológico , Edema Pulmonar/diagnóstico , Edema Pulmonar/tratamiento farmacológico , Intoxicación Alimentaria por Salmonella/complicaciones , Intoxicación Alimentaria por Salmonella/diagnóstico , Intoxicación Alimentaria por Salmonella/tratamiento farmacológico , Infecciones por Salmonella/tratamiento farmacológico , Taquicardia/diagnóstico , Taquicardia/tratamiento farmacológicoRESUMEN
Salmonella is an important foodborne pathogen, with eggs and egg-containing foods being frequently implicated in causing outbreaks of disease. In April 2012, an investigation was commenced after a number of cases of salmonellosis were linked to a Canberra café. The investigation sought to identify the cause of illness and to introduce public health measures to prevent further disease. A case control study was undertaken using the café's booking list to identify potential cases and controls. A structured questionnaire was developed using the café's menu, with information collected via telephone interview or email. A case was defined as any person who ate at the implicated café on 25 April 2012 and subsequently developed gastroenteritis. A total of 20 cases and 22 controls were recruited into the study. All 20 cases had faecal cultures positive for Salmonella Typhimurium phage type 135a (STm 135a). Eating eggs Benedict (odds ratio 63.00, 95% confidence interval 6.08-2771.66 P > 0.001) was significantly associated with illness. While no microbiological evidence of STm 135a was obtained from foods sampled from the café, STm 135a was recovered from swabs taken from the kitchen environment. This report illustrates an ongoing trend in Australia, where raw and minimally cooked egg-containing foods are identified as the responsible vehicles in a high proportion of foodborne Salmonella outbreaks.
Asunto(s)
Brotes de Enfermedades , Gastroenteritis/epidemiología , Intoxicación Alimentaria por Salmonella/epidemiología , Salmonella typhimurium , Adulto , Australia/epidemiología , Estudios de Casos y Controles , Huevos/microbiología , Femenino , Gastroenteritis/microbiología , Humanos , Masculino , Persona de Mediana Edad , Intoxicación Alimentaria por Salmonella/complicaciones , Intoxicación Alimentaria por Salmonella/microbiología , Adulto JovenRESUMEN
Described case report speaks in favour of the relation between childhood sexual abuse with the development of conversion disorder. Following Salmonella poisoning, adolescent, at the age of 16, develops series of severe somatic symptoms. Results of diagnostic procedures excluded organic foundation of the symptoms; diagnosis of conversion disorder is established. Soon, patient's problems stop abruptly and spontaneously, and the aetiology of the mental disorder remains unexplained. Six years later, adolescent reveals for the first time data about the childhood sexual abuse during the forensic evaluation (within the court process related to the request for compensation for the complications which occurred following the Salmonella infection). During the forensic evaluation, we had insight into the previous medical history, while an interview, psychological and psychiatric exploration was conducted with the examinee. Data about the sexual abuse retrospectively explain the dynamics of the development of conversion disorder. The described case indicates that sexual abuse of children and adolescents frequently remains unrecognized, which has sequels for treatment and prevention of subsequent consequences for mental health. It is important to emphasize the significance of examining history of abuse during the diagnostic of certain mental disorders. Forensic implications of the case have not been discussed in details for the needs of this report.
Asunto(s)
Abuso Sexual Infantil/psicología , Trastornos de Conversión/etiología , Trastornos de Conversión/psicología , Niño , Electrocardiografía , Femenino , Humanos , Intoxicación Alimentaria por Salmonella/complicaciones , Adulto JovenRESUMEN
The authors propose to consider infectious diseases as mass clinical conditions in both normative-legal and medical contexts. Peculiarities of commission and comprehensive inspections carried out in situations of massive infectious morbidity among servicemen are illustrated by examples of the work of state forensic medical organizations and investigative authorities of the Russian Defense Ministry.
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Transmisión de Enfermedad Infecciosa/legislación & jurisprudencia , Medicina Militar/legislación & jurisprudencia , Personal Militar , Infecciones por Salmonella , Precauciones Universales/legislación & jurisprudencia , Testimonio de Experto/legislación & jurisprudencia , Testimonio de Experto/métodos , Fómites/microbiología , Medicina Legal , Humanos , Control de Infecciones/legislación & jurisprudencia , Control de Infecciones/normas , Morbilidad , Salmonella/patogenicidad , Intoxicación Alimentaria por Salmonella/complicaciones , Infecciones por Salmonella/epidemiología , Infecciones por Salmonella/etiología , Infecciones por Salmonella/prevención & control , Infecciones por Salmonella/transmisiónRESUMEN
Osteomyelitis is an inflammation of the bone caused by infecting organisms. We present here the first case of osteomyelitis of the distal femur caused by Salmonella typhimurium in a patient with Crohn's disease. The infection was successfully treated with a combination of antibiotics and surgical treatment.
Asunto(s)
Corticoesteroides/efectos adversos , Corticoesteroides/uso terapéutico , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/tratamiento farmacológico , Fémur , Infecciones Oportunistas/diagnóstico , Osteomielitis/diagnóstico , Infecciones por Salmonella/diagnóstico , Salmonella typhimurium , Antibacterianos/uso terapéutico , Ceftriaxona/uso terapéutico , Terapia Combinada , Fémur/cirugía , Humanos , Infusiones Intravenosas , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Osteomielitis/cirugía , Cuidados Posoperatorios , Complicaciones Posoperatorias/diagnóstico , Cintigrafía , Intoxicación Alimentaria por Salmonella/complicaciones , Intoxicación Alimentaria por Salmonella/diagnóstico , Infecciones por Salmonella/cirugíaRESUMEN
OBJECTIVE: In 2005 a large outbreak of Salmonella hadar occurred in Spain following the consumption of commercial precooked roast chicken. We estimated the incidence and risk factors for reactive arthritis (ReA) and other musculoskeletal sequelae in the patients of this outbreak in 2 health departments of Castellon province. METHODS: A prospective cohort study of the patients and their families was carried out. Clinical infection with Salmonella was considered as the exposure factor. The cohort was studied for ReA symptoms using a telephone questionnaire. Telephone interviews or medical examinations of subjects with musculoskeletal symptoms were conducted by a rheumatologist. Robust Poisson regression models were used in the analysis. RESULTS: From the cohort of 262 people, 248 (94.7%) participated in the telephone survey, 155 with clinical salmonellosis (infected), 78 noninfected, and 15 with some symptoms but not clinical salmonellosis. One hundred one infected patients (65%) reported musculoskeletal symptoms, compared to 19 noninfected (24%) (adjusted relative risk = 2.60, 95% CI 1.73-3.90). Of the infected group, 16 ReA (incidence 10%, 95% CI 6.0-16.2), 7 enthesopathies, and 2 arthralgias were detected, and zero in the noninfected group. The risk factors for ReA were age, weight loss, and duration of diarrhea. Antibiotic treatment for the infection protected against symptoms of peripheral or axial arthritis (adjusted relative risk = 0.73, 95% CI 0.55-0.98). CONCLUSION: The incidence of ReA and musculoskeletal symptoms after the infection was high. The use of antibiotics for S. hadar infection offered some protection against musculoskeletal symptoms.
Asunto(s)
Artritis Reactiva/epidemiología , Brotes de Enfermedades , Contaminación de Alimentos , Miositis/epidemiología , Intoxicación Alimentaria por Salmonella/epidemiología , Salmonella enteritidis/aislamiento & purificación , Animales , Antibacterianos/uso terapéutico , Artritis Reactiva/microbiología , Artritis Reactiva/prevención & control , Pollos , Estudios de Cohortes , Culinaria , Recolección de Datos , Microbiología de Alimentos , Humanos , Masculino , Miositis/microbiología , Miositis/prevención & control , Prohibitinas , Estudios Prospectivos , Intoxicación Alimentaria por Salmonella/complicaciones , Intoxicación Alimentaria por Salmonella/tratamiento farmacológico , Salmonella enteritidis/fisiología , España/epidemiología , Encuestas y Cuestionarios , TeléfonoAsunto(s)
Dolor Abdominal/etiología , Aneurisma Infectado/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Intoxicación Alimentaria por Salmonella/complicaciones , Adulto , Aneurisma Infectado/tratamiento farmacológico , Antibacterianos/administración & dosificación , Hernia Diafragmática/diagnóstico por imagen , Humanos , Masculino , Radiografía , Intoxicación Alimentaria por Salmonella/tratamiento farmacológico , Tomógrafos Computarizados por Rayos X , Resultado del TratamientoRESUMEN
Anaerobic gas-producing clostridial infection is one of most severe complications of mainly gunshot wound of war period, in peace time occurs very seldom. The rare clinical case of anaerobic gas-producing clostridial endogenic infection with fulminant course in patient with salmonellosis produced by group B salmonella typhimurium. The disease was finished with fatal outcome in 8.5 hours after appearance of pain syndrome in right thigh with consequent fulminant development of gas gangrene with arterial hypotension on 4th day after onset of gastroenteric form of medium severity salmonellosis. Clinical, microbiological and postmortem data are represented.
Asunto(s)
Infecciones por Clostridium/complicaciones , Clostridium/aislamiento & purificación , Intoxicación Alimentaria por Salmonella/complicaciones , Salmonella typhimurium/aislamiento & purificación , Anciano , Infecciones por Clostridium/diagnóstico , Infecciones por Clostridium/microbiología , Diagnóstico Diferencial , Resultado Fatal , Humanos , Intestino Delgado/microbiología , Masculino , Intoxicación Alimentaria por Salmonella/diagnóstico , Intoxicación Alimentaria por Salmonella/microbiologíaRESUMEN
OBJECTIVE: In 2005, 592 individuals in Ontario developed acute gastroenteritis, predominantly after consuming bean sprouts contaminated with Salmonella enteritidis. Salmonella is a known trigger of reactive arthritis (ReA). We describe the population affected by the Salmonella outbreak in terms of clinical presentation of self-reported arthritic symptoms and HLA-B27 genotyping. METHODS: Subjects were mailed a questionnaire, which assessed symptoms consistent with ReA. Subsequently, subjects were asked to submit saliva samples, which were analyzed for HLA-B27. Simple descriptive statistics were performed for analysis of survey responses, and the genetic component was analyzed by chi-square or Fisher's exact tests. RESULTS: Most respondents were female (71.3%), with a mean age of 46.0 years. The mean duration of diarrhea symptoms was 16.5 days. 62.5% of respondents reported extraintestinal symptoms that were consistent with ReA. The most commonly reported features were joint pain, swelling or stiffness (46.2%), stiffness > 30 min (35.6%), ocular symptoms (24.0%), and visibly swollen joints (19.2%). Subjects with Salmonella infection had a similar incidence of HLA-B27, regardless of whether they developed symptoms consistent with ReA or not. Notably, HLA-B27 was present more frequently in those who developed Salmonella infection than in healthy controls (OR 3.0). CONCLUSION: The study, one of the largest for a dysenteric outbreak, revealed a high event rate of self-reported symptoms consistent with ReA in those infected with Salmonella. Our results showed that HLA-B27 may have rendered individuals more susceptible to Salmonella infection, but did not contribute to the development of symptoms consistent with ReA after infection. We note that the methods used in this study, including self-report, are not ideal for diagnosis of inflammatory arthritis. However, given the rarity of large outbreaks of Salmonella, the study adds valuable knowledge about the course of ReA.