International outbreak investigation of Salmonella Heidelberg associated with in-flight catering

Epidemiol Infect. 2014 Apr;142(4):833-42. doi: 10.1017/S0950268813001714. Epub 2013 Jul 26.

Abstract

Rapid and wide dispersal of passengers after flights makes investigation of flight-related outbreaks challenging. An outbreak of Salmonella Heidelberg was identified in a group of Irish travellers returning from Tanzania. Additional international cases sharing the same flight were identified. Our aim was to determine the source and potential vehicles of infection. Case-finding utilized information exchange using experts' communication networks and national surveillance systems. Demographic, clinical and food history information was collected. Twenty-five additional cases were identified from Ireland, The Netherlands, Norway, USA and Canada. We conducted a case-control study which indicated a significant association between illness and consumption of milk tart (OR 10.2) and an egg dish (OR 6) served on-board the flight. No food consumed before the flight was associated with illness. Cases from countries other than Ireland provided supplementary information that facilitated the identification of likely vehicles of infection. Timely, committed international collaboration is vital in such investigations.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Air Travel*
  • Analysis of Variance
  • Cohort Studies
  • Disease Outbreaks*
  • Food Handling
  • Food Microbiology
  • Humans
  • Internationality
  • Ireland
  • Middle Aged
  • Salmonella Food Poisoning / epidemiology*
  • Salmonella Food Poisoning / microbiology
  • Tanzania
  • Young Adult