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The relationship between infecting dose and severity of disease in reported outbreaks of salmonella infections

  • J. R. Glynn (a1) and D. J. Bradley (a1)

Summary

The relationship between size of the infecting dose and severity of the resulting disease has been investigated for salmonella infections by reanalysis of data within epidemics for 32 outbreaks, and comparing data between outbreaks for 68 typhoid epidemics and 49 food-poisoning outbreaks due to salmonellas. Attack rate, incubation period, amount of infected food consumed and type of vehicle are used as proxy measures of infecting dose, while case fatality rates for typhoid and case hospitalization rates for food poisoning salmonellas were used to assess severity. Limitations of the data are discussed. Both unweighted and logit analysis models are used.

There is no evidence for a dose-severity relationship for Salmonella typhi, but evidence of a correlation between dose and severity is available from within-epidemic or between-epidemic analysis, or both, for Salmonella typhimurium, S. enteritidis, S. infantis, S. newport, and S. thompson. The presence of such a relationship affects the way in which control interventions should be assessed.

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References

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1.Esrey, SA, Feachem, RG, Hughes, JM. Interventions for the control of diarrhoeal diseases among young children: improving water supplies and excreta disposal facilities. Bull W H O 1985; 63: 757–72.
2.Hornick, RB, Greisman, SE, Woodward, TE et al. , Typhoid fever: pathogenesis and immunologic control. N Engl J Med 1970; 283: 686–91, 739–46.
3.McCullough, NB, Eisele, CW. Experimental human salmonellosis. I. Pathogenicity of strains of Salmonella meleagridis and Salmonella anatum obtained from spray-dried whole egg. J Infect Dis 1951; 88: 278–89.
4.McCullough, NB, Eisele, CW. Experimental human salmonellosis. II. Immunity studies following experimental illness with Salmonella meleagridis and Salmonella anatum. J Immunol 1951; 66: 595608.
5.McCullough, NB, Eisele, CW. Experimental human salmonellosis. III. Pathogenicity of strains of Salmonella newport, Salmonella derby, and Salmonella bareilly obtained from spray-dried whole egg. J Infect Dis 1951; 89: 209–13.
6.McCullough, NB, Eisele, CW. Experimental human salmonellosis. IV. Pathogenicity of strains of Salmonella pullorum obtained from spray-dried whole egg. J Infect Dis 1951; 88: 259–65.
7.Meynell, GG, Meynell, EW. The growth of micro-organisms in vivo with particular reference to the relation between dose and latent period. J Hyg 1958; 56: 323–45.
8.Schutze, H, Gorer, PA, Finlayson, MH. The resistance of four mouse lines to bacterial infection. J Hyg 1936; 36: 3749.
9.Robson, HG, Vas, SJ. Resistance of inbred mice to Salmonella typhimurium. J Infect Dis 1972; 126: 378–86.
10.Hormaeche, CE. Immunity mechanisms in Salmonella infections. PhD thesis, University of Cambridge, 1975.
11.Rao, V, Chauhan, HVS. The pathology and pathogenesis of Salmonella stanley infection in experimental chicks. Res Vet Sci 1987; 42: 287–93.
12.Collins, FM. Salmonellosis in orally infected specific pathogen-free C57B1 mice. Infect Immun 1972; 5: 191–8.
13.Humphrey, TJ, Baskerville, A, Chart, H, Rowe, B, Whitehead, A. Salmonella enteritidis PT4 infection in specific pathogen-free hens: influence of infecting dose. Vet Rec 1991; 129: 482–5.
14.DeJong, H, Ekdahl, MO. Salmonellosis in calves – the effect of dose rate and other factors on transmission. NZ Vet J 1965; 13: 5964.
15.Robinson, RA, Loken, KI. Age susceptibility and excretion of Salmonella typhimurium in calves. J Hyg 1968; 66: 207–16.
16.Wray, C, Sojka, WJ. Experimental Salmonella typhimurium infection in calves. Res Vet Sci 1978; 25: 139–43.
17.Smith, HW, Jones, JET. Observations on experimental oral infection with Salmonella dublin in calves and Salmonella cholerasuis in pigs. J Path Bact 1967; 93: 141–56.
18.Miner, JR. The incubation period of typhoid fever. J Infect Dis 1922; 31: 296301.
19.Bernard, RP. The Zermatt typhoid outbreak in 1963. J Hyg 1965; 63: 537–63.
20.Cumming, JG. An epidemic resulting from the contamination of icecream by a typhoid carrier. JAMA 1917; 68: 1163–5.
21.Mintz, ED, Cartter, M, Zingeser, J, Hadler, J. Dose–response effects in a food-borne outbreak of Salmonella enteritidis, Connecticut. Presented at the Epidemic Intelligence Service Conference, 04 1991.
22.Blaser, MJ, Newman, LS. A review of human salmonellosis. I. Infective dose. Rev Infect Dis 1982; 4: 1096–106.
23.Naylor, GRE. Incubation period and other features of food-borne and water-borne outbreaks of typhoid fever in relation to pathogenesis and genetics of resistance. Lancet 1983; i: 864–6.
24.Sirois, JS. An outbreak of typhoid fever due to raw milk. Canad Pub Health J 1942; 33: 168–73.
25.Taylor, DN, Bopp, C, Birkness, K, Cohen, ML. An outbreak of Salmonellosis associated with a fatality in a healthy child: a large dose and severe illness. Am J Epidemiol 1984; 119: 907–12.
26.Balice, A. Salmonellosis ‘osimo’ 1958. Igiene e San Pubblica 1958; 14: 612–27.
27.Bierschenck, H. Eine Lebensmittelvergiftung durch Salmonella infantis im Speiseeis. Z Gesamte Hyg 1962; 8: 383–7.
28.De Blasi, R, Scotti, G, Alcuni aspetti della epidemiologia delle ‘Salmonellosis’. Riv Ital Igiene 1950; 10: 324–41.
29.Harding, KM. An outbreak of food poisoning following the consumption of infected pork pie. Medical Officer 1966; 115: 159–60.
30.Gomez, Lus R, Gimenez, Martinez A. Epidemia gastroenteritis aguda a Salmonella typhimurium. Med Trop (Madrid) 1965; 41: 549–51.
31.Palmer, SR, Watkeys, JEM, Zamiri, I, et al. Outbreak of Salmonella food poisoning amongst delegates at a medical conference. J R Coll Physicians Lond 1990; 24: 26–9.
32.Miller, AA, Nicol, CGM, Ramsden, F. An outbreak of food poisoning due to Salmonella bovis morbificans (Basenau) in which the vehicle of infection was meat pies. Ministry of Health. Reports on Public Health and Medical Subjects no. 96. London: HMSO, 1955.
33.Brockbank, W, Metcalfe, Brown C, Parker, MT. Outbreak of food-poisoning due to Salmonella aberdeen. Lancet 1950; ii: 873–6.
34.D'aoust, J-Y. Infective dose of Salmonella typhimurium in cheddar cheese. Am J Epidemiol 1985; 122: 717–20.
35.Cook, GT, de Costabadie, LP. Food poisoning associated with infected dried egg. Monthly Bull Minist Health (London) 1947; 6: 177–80.
36.Semple, AB, Turner, GC, Lowry, DMO. Outbreak of food poisoning caused by Salmonella virchow in spit-roasted chicken. Br Med J 1968; 2: 801–3.
37.Möller, A. Breslau-Gruppenerkrankung durch infizierte Hühnereier. Zbl Bakt I Abt Orig 1955; 164: 535–9.
38.Shaw, WV. Report to the Ministry of Health on an epidemic of enteric fever at Bolton-upon-Dearne. Ministry of Health. Reports on Public Health and Medical Subjects no. 12. London: HMSO, 1922.
39.Desranleau, JM. An oubreak of typhoid fever traced to a wedding breakfast. Can J Public Health 1946; 37: 244–8.
40.Lumsden, LL. Outbreak of gastroenteritis and typhoid fever due to drinking water on excursion steamer. Public Health Rep 1912; 27: 1960–71.
41.Bulstrode, HT. Report upon alleged oyster-borne enteric fever and other illness following the Mayoral banquets at Winchester and Southampton, and upon enteric fever occurring simultaneously elsewhere, and also ascribed to oysters. Annual Report of the Medical Officer of the Local Government Board 1902–3. No. 9: 129–89.
42.Mollohan, CS, Reid, G. Typhoid fever in Colorado. National Communicable Disease Center Salmonella Surveillance 1967, no. 63: 4.
43.Horwitz, MA, Pollard, RA, Merson, MH, Martin, SM. A large outbreak of food borne Salmonellosis on the Navajo Nation Indian Reservation, epidemiology and secondary transmission. Am J Public Health 1977; 67: 1071–6.
44.Bille, B, Mellbin, T, Nordbring, F. An extensive outbreak of gastroenteritis caused by Salmonella newport. I. Some observations on 745 known cases. Acta Med Scand 1964; 175: 557–67.
45.Fowinkle, EW, Armes, WH, Barrick, JH, et al. A Salmonella thompson outbreak traced to barbecued pork – Tennessee. Center for Disease Control Salmonella Surveillance 1970, no. 99: 13.
46.Janeway, CM, Goldfield, M, Attman, R, et al. Foodborne outbreak of gastroenteritis possibly of multiple bacterial etiology. Am J Epidemiol 1971; 94: 135–41.
47.Holmes, M, Runte, V, Goldblatt, EL. Fatal case of Salmonella enteritidis infection. National Communicable Disease Center Salmonella Surveillance 1967, no. 67: 6.
48. Anonymous. Update: Salmonella enteritidis infection and grade A shell eggs – United States. MMWR 1988; 37: 490–6.
49.Hauser, GH, Treuting, WL, Brieffelh, LA. An outbreak of food poisoning due to a new etiological agent – Salmonella berta. Public Health Rep 1945; 60: 1138–42.
50.Scott, HH. Some notable epidemics. London: Edward Arnold & Co, 1934.
51.Stallybrass, CO. The principles of epidemiology and the process of infection. London: George Routledge and Son Ltd, 1931.
52.Greenwood, M. Epidemics and crowd-diseases. London: Williams and Norgate Ltd, 1935.
53.Ledingham, JCG. Report to the Local Government Board on the enteric fever ‘carrier’, being a review of current knowledge on this subject. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 43. London: HMSO, 1910.
54.Bracken, HM, Bass, FH, Westbrook, FF. The Mankato typhoid fever epidemic of 1908. J Infect Dis 1911; 9: 410–74.
55.Johnstone, RW. Report to the Local Government Board upon outbreaks of enteric fever in Conway Rural District, Conway Urban District, and Llandudno Urban District, during 1908 and 1909. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 28. London: HMSO, 1910.
56.Carnwath, T. Report to the Local Government Board upon an outbreak of enteric fever at Oakenshaw, in the urban district of Willington. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 59. London: HMSO, 1912.
57.Grover, AL. An outbreak of typhoid fever in Cedar Falls, Iowa. J Infect Dis 1912; 10: 388408.
58.Wheaton, SW. Report to the Local Government Board on enteric fever at Strood, in Rochester Borough, in 1912. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 79. London: HMSO, 1913.
59.Macewen, HA. Report to the Local Government Board on an outbreak of enteric fever in Ringwood, 1912. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 74. London: HMSO, 1912.
60.Hutchinson, JR. Report to the Local Government Board on an outbreak of enteric fever in the Borough of Colne (Lancashire), 1913. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 84. London: HMSO, 1913.
61.Jordan, EO, Irons, EE. The Rockford (Ill.) typhoid epidemic. J Infect Dis 1912; 11: 2143.
62.Ridlon, JR. Investigation of typhoid fever at Texarkana, Ark. – Tex. (Milk outbreak). Public Health Rep 1912; 27: 219–27.
63.Manby, EP. Report to the Local Government Board upon an outbreak of enteric fever in the Urban District of Kenilworth. Reports to the Local Government Board on Public Health and Medical Subjects. New Series no. 92. London: HMSO, 1914.
64.Jordan, EO, Irons, EE. The Quincy (Illinois) typhoid epidemic. J Infect Dis 1913; 13: 1629.
65.Sawyer, WA. Ninety-three persons infected by a typhoid carrier at a public dinner. JAMA 1914; 18: 1537–42.
66.Geiger, JC. A milk borne epidemic of typhoid fever due to the use of polluted water. JAMA 1917; 68: 978–9.
67.Geiger, JC, MacMillan, A, Gillespie, CG. A waterborne epidemic of typhoid fever. JAMA 1917; 68: 1681–3.
68. Anonymous. A water-borne typhoid fever epidemic. Lancet 1921; i: 548–9.
69.Bundesen, HN. Typhoid epidemic in Chicago apparently due to oysters. JAMA 1925; 84: 641–50.
70.Lumsden, LL. An outbreak of typhoid fever caused by a milkborne infection. Public Health Rep 1925; 40: 1302–15.
71.Ramsey, GH, Benning, CH, Orr, PF. An epidemic of typhoid fever following a church dinner. Am J Public Health 1926; 16: 1011–6.
72.Murata, S. On a prevalence of typhoid fever in Shizuoka Prefecture. J Pub Health Assoc Japan 1926; 2 (10): 16.
73. Anonymous. Epidemiology of typhoid fever in the Royal Navy. Lancet 1928; ii: 393.
74.Dean, AS. The Olean City epidemic of typhoid fever in 1928. Am J Public Health 1931; 21: 390402.
75.Lessa, G, Surto de febre typhoide de origem hydrica. Brasil-Med 1930; 44: 1155–61.
76.Miner, HE, Forsbeck, FC. An outbreak of typhoid fever traced to a chicken salad infected by a carrier. N Engl J Med 1929; 200: 440–1.
77.Garrido-Morales, E, Costa, Mandry O. Typhoid fever spread by water from a cistern contaminated by a carrier. J Preventive Med 1931; 5: 351–5.
78. Anonymous. Typhoid in Yorkshire. Lancet 1932; ii: 1029–30.
79.Magliano, G. Epidemia circoscritta di febbre tifoide di origine idrica. Ann d'igiene 1935; 45: 727. In: Bull Hyg 1935; 10: 437.
80.Gomez, Jimenez F. Un brote epidémico de fiebre tifoidea en Erla. Rev Sanid Hig Pública (Madr) 1934; 9 (1): 108–18.
81.Leeder, FS. An outbreak of milk-borne typhoid fever. Canad Pub Health J 1932; 23: 503–6.
82.Ritchie, J, Armstrong, E. A waterborne epidemic of typhoid fever. J Hyg 1932; 32: 417–20.
83.Shaw, WV. Report on an outbreak of enteric fever in the Malton Urban District. Ministry of Health. Reports on Public Health and Medical Subjects no. 69. London: HMSO. 1933.
84.Morris, ES. An outbreak of typhoid fever at a Religious Convention probably caused by a ‘carrier’. Rep Director General Public Health, New South Wales, for Year 1933: 4751. In: Bull Hyg 1935; 10: 777.
85.Hornung, H. Eine Trunkwasser-Typhusepidemie in Swarzwald. Arch Hyg Bakt 1934; 113: 158–69.
86. Anonymous. Sequel to a pilgrimage. Lancet 1935; ii: 452.
87.Johnson, GE. Epidemiological features of a typhoid fever outbreak in West Philadelphia following a supper. Am J Public Health 1936; 26: 913–17.
88. Anonymous. Typhoid after camping. Lancet 1936; ii: 654.
89.Watson, Smith S. The 1936 outbreak of typhoid fever at Poole, Bournemouth and Christchurch. Bournemouth: Pardy and Son Ltd, 1942.
90.Roelcke, K. Eine Gruppenerkrankung an Typhus durch Speiseeis. Z Hyg Infektionskr 1937; 119: 549–57.
91.Lembecke, PA, von Haesseler, P. An epidemic of typhoid fever attributed to salad contaminated by a chronic typhoid carrier. Am J Public Health 1936; 28: 1212–16.
92.Holden, OM. The Croydon typhoid outbreak. Public Health 1939; 52: 135–46.
93.Caudill, FW. Small college suffers outbreak of water-borne typhoid fever. Water Works Engineering 1937; 90: 106. In: Bull Hyg 1938; 13:106.
94.Landau, D. Notes on a milk-borne typhoid outbreak. S Afr Med J 1938; 12: 463–5.
95.Old, HN, Gill, SL. A typhoid fever epidemic caused by carrier ‘bootlegging’ oysters. Am J Public Health 1940; 30: 633–40.
96.Constam, ZF, Steiner, H. Ueber eine Typhus-epidemie mit Vorkrankheit. Schweiz Med Woch 1945; 75: 573–8. In: Bull Hyg 1945; 20: 723–4.
97.Galea, J. The typhoid epidemic of 1943 in Malta. Lux Press, 1944. In: Bull Hyg 1944; 19: 927–8.
98.Jordan, J, Everley, Jones H. Typhoid fever in immunised personnel. Lancet 1945; ii: 333–5.
99.Marmion, DE, Naylor, GRE, Stewart, IO. Second attacks of typhoid fever. J Hyg 1953; 51: 260–7.
100.Neill, WA, Martin, JD, Belden, EA., Trotter, WY. A widespread epidemic of typhoid fever traced to a common exposure. N Engl J Med 1958; 259: 667–72.
101.Caraway, CT, Bruce, JM. Typhoid fever epidemic following a wedding reception. Public Health Rep 1961; 76: 427–30.
102.Mallory, A, Belden, EA, Brachman, PS. The current status of typhoid fever in the United States and a description of an outbreak. J Infect Dis 1969; 119: 673–6.
103.Taylor, A, Santiago, A, Gonzalez-Cortes, A, Gangarosa, EJ. Outbreak of typhoid fever in Trinidad in 1971 traced to a commercial icecream product. Am J Epidemiol 1974; 100: 150–7.
104.Hanson, SM, Bender, G, Schrack, WD, Goldenson, RH. S. typhi – Coatsville Pennsylvania. Center for Disease Control Salmonella Surveillance 1972, no. 113: 34.
105.Hornick, RB, Woodward, TE. Appraisal of typhoid vaccine in experimentally infected human subjects. Trans Am Clin Climatol Assoc 1966; 78: 70–8.
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