Risk factors for sporadic salmonellosis: a systematic review and meta-analysis

Non-typhoidal Salmonella is an important causative agent of diarrheal illness worldwide. A systematic review and meta-analysis of case-control studies were performed to determine the main risk factors associated with sporadic salmonellosis. Suitable scientific articles published up to 2017 were identified through a systematic literature search and subject to methodological quality assessment. From each study, odds ratios (OR) were extracted or calculated, as well as study characteristics such as population type, design, type of model used and risk factor categorization. Mixed-effects meta-analytical models were adjusted by population type to appropriate data partitions. From 3858 identified references, the quality assessment stage was passed by 62 case-control studies focusing on sporadic salmonellosis which provided 1154 ORs for meta-analysis. The meta-analysis identified host-specifics factors, travel, environmental, animal and food exposures as significant risk factors of salmonellosis in the mixed population. For the mixed population, foods significantly associated with salmonellosis were eggs and egg products, composite foods, and meat (pork, red meats other than beef and poultry meats). In the child population, the main risk factors were found for person-to-person transmission, recent use of gastric anti-acids or antibiotics, contact with pets and farm animals, environmental, and food vehicles. Breastfeeding was found to be a protective factor for children. The food vehicles identified in children comprised dairy (milk formula), produce, meat and eggs products. Untreated drinking water was a risk factor for the children and mixed population. The result of the meta-analysis conducted at the international level is very important in the context of increasing international trade in foodstuffs and changes in food consumption patterns.The authors would like to thank Anses staff and the members of the Anses Working Group on Source Attribution of Foodborne Diseases: Moez Sanaa, Jean Christophe Augustin, Fr´ed´eric Carlin, Alexandre Leclercq, Nicole Pavio, Isabelle Villena, and Laurence Watier. U. Gonzales-Barron and V. Cadavez are grateful to the Foundation for Science and Technology (FCT, Portugal) for financial support through national funds FCT/MCTES to CIMO (UIDB/00690/2020). U. Gonzales- Barron acknowledges the national funding by FCT, P.I., through the institutional scientific employment program contract.info:eu-repo/semantics/publishedVersio

Acute diarrhea in adults consulting a general practitioner in France during winter: incidence, clinical characteristics, management and risk factors

International audienceBackgroundData describing the epidemiology and management of viral acute diarrhea (AD) in adults are scant. The objective of this study was to identify the incidence, clinical characteristics, management and risk factors of winter viral AD in adults.MethodsThe incidence of AD in adults during two consecutive winters (from December 2010 to April 2011 and from December 2011 to April 2012) was estimated from the French Sentinelles network. During these two winters, a subset of Sentinelles general practitioners (GPs) identified and included adult patients who presented with AD and who filled out a questionnaire and returned a stool specimen for virological examination. All stool specimens were tested for astrovirus, group A rotavirus, human enteric adenovirus, and norovirus of genogroup I and genogroup II. Age- and sex-matched controls were included to permit a case¿control analysis with the aim of identifying risk factors for viral AD.ResultsDuring the studied winters, the average incidence of AD in adults was estimated to be 3,158 per 100,000 French adults (95% CI [2,321 ¿ 3,997]). The most reported clinical signs were abdominal pain (91.1%), watery diarrhea (88.5%), and nausea (83.3%). GPs prescribed a treatment in 95% of the patients with AD, and 80% of the working patients with AD could not go to work. Stool examinations were positive for at least one enteric virus in 65% (95% CI [57 ¿ 73]) of patients with AD with a predominance of noroviruses (49%). Having been in contact with a person who has suffered from AD in the last 7 days, whether within or outside the household, and having a job (or being a student) were risk factors significantly associated with acquiring viral AD.ConclusionsDuring the winter, AD of viral origin is a frequent disease in adults, and noroviruses are most often the cause. No preventable risk factor was identified other than contact with a person with AD. Thus, at the present time, reinforcement of education related to hand hygiene remains the only way to reduce the burden of disease

Euro Surveill

In September 2023, a severe outbreak of type B botulism with fifteen cases was linked to consumption of canned sardines at a restaurant in Bordeaux, France, during the Rugby World Cup. The cases were from seven countries. One death was recorded. Outbreak investigation using credit card data, rapid communication between health authorities of the affected countries and broad media communication allowed identification of cases and exposed persons and prevented further severe outcomes

Retour d experience sur l investigation d épidemies de salmonelloses (infections à Salmonella autres que S. Typhi et S. Paratyphi 2005-2010)

Les toxi-infections alimentaires causées par les salmonelles non-typhiques représentent un problème de Santé Publique d importance et ont un poids économique considérable dans le Monde. L essentiel de la transmission des salmonelles passe par la voie alimentaire, son expression épidémiologique correspond à la survenue de cas de gastro-entérite sporadiques, et groupés (toxi-infection alimentaire collective et épidémie communautaire). L investigation d épidémies communautaires de salmonelloses en France repose dans un système de surveillance national qui articule des expertises multidisciplinaires. Les techniques et les dispositifs mis en œuvre lors d investigation d épidémies d infections à Salmonella doivent être régulièrement améliorés afin d anticiper les conséquences pratiques et théoriques de l évolution de l épidémiologie des salmonelloses. L'exercice de réflexion sur les points critiques de trois investigations d épidémies de salmonelloses nationales, ici présenté permet de proposer des pistes d améliorations pratiques et techniques comme: le développement de nouvelles méthodes de génotypage, la réalisation d'enquête pour documenter les consommations alimentaires en population générale et l'utilisation des données enregistrées lors d'achat avec une carte de fidélité en grande distribution.PARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocSudocFranceF

Reptiles à domicile (un risque de salmonellose parfois sévère chez les enfants. Revue bibliographique et investigation en France métropolitaine en 2012)

PARIS-BIUP (751062107) / SudocSudocFranceF

Instauration d'une insulinothérapie dans le diabète de type 2 (données épidémiologiques, étude entred 2001-2003)

LE KREMLIN-B.- PARIS 11-BU Méd (940432101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Les toxi-infections alimentaires collectives en France entre 2006 et 2008

International audienceBetween 2006 and 2008, 3,127 foodborne outbreaks were reported in France to health authorities. They affected 33,404 persons, of which 2,302 were admitted to hospital and 15 deceased.A pathogenic agent was isolated from human or food specimen in 26,5% of these outbreaks.The number of reported outbreaks almost doubled between 2006 and 2008 (period during which the reporting system was reinfoced) compared to the three previous years. This increase is linked to an increase of the outbreaks for which no agent could be confirmed or suspected.Salmonella represented almost half of the confirmed outbreaks, S Typhimurium representing 40% of Salmonella outbreaks. A decrease of the number of Salmonella-related outbreaks since 2001 has been observed.Among suspected outbreaks, staphylococcal enterotoxin- related outbreaks were predominant.Enteric virus-related outbreaks represented 7,4% of all confirmed outbreaks, and 16,2% of all patients in this category.Entre 2006 et 2008, 3 127 foyers de toxi-infections alimentaires collectives (Tiac) ont été déclarés aux autorités sanitaires en France. Elles concernaient 33 404 malades dont 2 302 ont été hospitalisés et 15 sont décédés. Dans 26,5% de ces foyers, un agent pathogène a été isolé dans des échantillons humains ou alimentaires.Le nombre de Tiac déclarées a presque doublé entre 2006 et 2008 – années durant lesquelles un renforcement du système de déclaration a eu lieu – par rapport aux trois années précédentes. Cette augmentation est liée à une augmentation du nombre de foyers dans lesquels aucun agent n’a pu être confirmé ni suspecté.Les salmonelles représentaient presque la moitié des foyers confirmés, S. Typhimurium représentant 40% des foyers confirmés à Salmonella. On peut constater une diminution depuis 2001 du nombre de foyers où Salmonella a été isolée.Parmi les foyers dont l’agent a été suspecté, les Tiac à entérotoxine staphylococcique prédominent.Les Tiac au décours desquelles des virus entériques ont été retrouvés représentaient 7,4% du total des foyers confirmés et 16,2% du nombre de malades de cette catégorie

Escherichia coli O104:H4 south-west France, June 2011

International audienceComment on: Characterisation of the Escherichia coli strain associated with an outbreak of haemolytic uraemic syndrome in Germany, 2011: a microbiological study. [Lancet Infect Dis. 2011

Cas publiés de salmonelloses chez les jeunes enfants secondaires à une exposition aux reptiles : revue bibliographique 1993-2013

International audienceContact with animals including reptiles is a known source for Salmonella transmission. Cases of Salmonella infections transmitted by domestic reptiles have been described in the literature since the 1960s.A review of published cases of salmonellosis in young children secondary to reptiles’ exposure since 1993 was carried out in January 2013 in order to identify the most frequent clinical forms, the Salmonella serotypes involved, and the transmission of Salmonella.The 66 selected articles were 43 case-reports, 14 outbreak investigations, 5 case-control studies and 4 retrospective studies.Isolated cases reported were mostly cases of gastroenteritis (69%), and 31% were infections other than digestive. Serotypes of Salmonella strains were mostly enterica subspecies (I). Turtles were the reptiles the most frequently involved.Le contact avec des animaux, notamment avec les reptiles, est une source connue de transmission de Salmonella. Des cas d’infections à Salmonella transmises par des reptiles domestiques ont été décrits dans la littérature dès les années 1960.Une revue de la littérature scientifique des cas publiés de salmonellose chez les jeunes enfants secondaires à une exposition aux reptiles depuis 1993 a été réalisée en janvier 2013 afin de documenter les formes cliniques les plus fréquentes, les sérotypes de Salmonella impliqués ainsi que le mode de transmission des Salmonella.Les 66 articles retenus concernaient 43 études de cas isolés, 14 investigations d’épidémies, 5 études cas/témoins et 4 études rétrospectives descriptives.Les cas isolés rapportés étaient majoritairement des cas de gastro-entérites (69%) et 31% étaient des cas d’infections autres que digestives. Les sérotypes des souches de Salmonella étaient en majorité de la sous-espèce enterica (I). Les reptiles le plus fréquemment impliqués étaient des tortues