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Risk factors for Salmonella Typhimurium DT104 and non-DT104 infection: a Canadian multi-provincial case-control study

Published online by Cambridge University Press:  12 May 2004

K. DORÉ ,
J. BUXTON ,
B. HENRY ,
F. POLLARI ,
D. MIDDLETON ,
M. FYFE ,
R. AHMED ,
P. MICHEL ,
A. KING  and
C. TINGA
...Show all authors
K. DORÉ
Affiliation:
Foodborne, Waterborne and Zoonotic Infections Division, Centre for Infectious Disease Prevention and Control, Population and Public Health Branch, Health Canada, Guelph, Ontario, Canada
J. BUXTON
Affiliation:
Field Epidemiology Training Program, Centre for Infectious Disease Prevention and Control, Population and Public Health Branch, Health Canada, Ottawa, Ontario, Canada
B. HENRY
Affiliation:
Toronto Public Health, Toronto, Ontario, Canada
F. POLLARI
Affiliation:
Foodborne, Waterborne and Zoonotic Infections Division, Centre for Infectious Disease Prevention and Control, Population and Public Health Branch, Health Canada, Guelph, Ontario, Canada
D. MIDDLETON
Affiliation:
Ontario Ministry of Health and Long Term Care, Disease Control Service, Public Health Branch, Toronto, Ontario, Canada
M. FYFE
Affiliation:
British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
R. AHMED
Affiliation:
National Laboratory for Enteric Pathogens, Health Canada, Winnipeg, Manitoba, Canada
P. MICHEL
Affiliation:
Laboratory for Foodborne Zoonoses, St-Hyacinthe, Quebec, Canada
A. KING
Affiliation:
Bureau of Immunization, Centre for Infectious Disease Prevention and Control, Population and Public Health Branch, Health Canada, Ottawa, Ontario, Canada
C. TINGA
Affiliation:
Foodborne, Waterborne and Zoonotic Infections Division, Centre for Infectious Disease Prevention and Control, Population and Public Health Branch, Health Canada, Guelph, Ontario, Canada
J. B. WILSON
Affiliation:
Foodborne, Waterborne and Zoonotic Infections Division, Centre for Infectious Disease Prevention and Control, Population and Public Health Branch, Health Canada, Guelph, Ontario, Canada Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Abstract

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To identify risk factors for sporadic Salmonella Typhimurium definitive phage-type 104 (DT104) and non-DT104 diarrhoeal illness in Canada, we conducted a matched case-control study between 1999 and 2000. Cases were matched 1[ratio ]1 on age and province of residence. Multivariate analysis suggested that recent antibiotic use [odds ratio (OR) 5·2, 95% confidence interval (CI) 1·8–15·3], living on a livestock farm (OR 4·9, 95% CI 1·9–18·9), and recent travel outside Canada (OR 4·1, 95% CI 1·2–13·8) are independent risk factors for DT104 illness. Similar analyses suggested that recent travel outside North America is a sizable risk factor for non-DT104 illness (OR 66·8, 95% CI 6·7–665·3). No food exposure was a risk factor in either analysis. Educating health-care providers and the public about appropriate antibiotic use and antimicrobial resistance is important. Appropriate administration of antibiotics to livestock, particularly cattle, and hygienic measures such as handwashing after contact with farm animals may reduce risk. Travel represents an important and probably underestimated risk factor for sporadic illness with S. Typhimurium. Improved national surveillance and detailed investigation of travel-related illness are required.

Type
Research Article
Information
Epidemiology & Infection , Volume 132 , Issue 3 , June 2004 , pp. 485 - 493
Copyright
© 2004 Cambridge University Press