Quantifying the Contribution of Animal-food Sources to Human Salmonellosis in Denmark in 1999

A risk assessment model quantifying the impmiance of the major animal-food sources was developed. For modelling purposes, we combined Bayesian inference and Monte Carlo simulation. The principle was to compare the registered number of human cases caused by different Salmonella sero- and phage types with the prevalence of these types in the different sources, weighted by the amount of food source consumed. A prior distribution was included to account for the presumed differences between serotypes and food sources with respect to causing human salmonellosis. A Poisson likelihood function was used for the probability of observing the actual number of human cases given the prevalence in the sources. Based on the posterior distribution, the number of human cases attributable to each food source was estimated. The described method may prove to be an alternative to the traditional stable-to-table risk assessment, which often involves making a large number of assumptions

The Routine Use of Antibiotics to Promote Animal Growth Does Little to Benefit Protein Undernutrition in the Developing World

Some persons argue that the routine addition of antibiotics to animal feed will help alleviate protein undernutrition in developing countries by increasing meat production. In contrast, we estimate that, if all routine antibiotic use in animal feed were ceased, there would be negligible effects in these countries. Poultry and pork production are unlikely to decrease by more than 2%. Average daily protein supply would decrease by no more than 0.1 g per person (or 0.2% of total protein intake). Eliminating the routine use of in-feed antibiotics will improve human and animal health, by reducing the development and spread of antibiotic-resistant bacteri

Increasing Quinolone Resistance in Salmonella enterica serotype Enteritidis

Until recently, Salmonella enterica serotype Enteritidis has remained sensitive to most antibiotics. However, national surveillance data from Denmark show that quinolone resistance in S. Enteritidis has increased from 0.8% in 1995 to 8.5% in 2000. These data support concerns that the current use of quinolone in food animals leads to increasing resistance in S. Enteritidis and that action should be taken to limit such use

Antimicrobial Growth Promoters and Salmonella spp., Campylobacter spp. in Poultry and Swine, Denmark

The use of antimicrobial growth promoters in Danish food animal production was discontinued in 1998. Contrary to concerns that pathogen load would increase; we found a significant decrease in Salmonella in broilers before and after slaughter of swine and pork and no change in the prevalence of Campylobacter in broilers

Salmonella Control Programs in Denmark

We describe Salmonella control programs of broiler chickens, layer hens, and pigs in Denmark. Major reductions in the incidence of foodborne human salmonellosis have occurred by integrated control of farms and food processing plants. Disease control has been achieved by monitoring the herds and flocks, eliminating infected animals, and diversifying animals (animals and products are processed differently depending on Salmonella status) and animal food products according to the determined risk. In 2001, the Danish society saved U.S.$25.5 million by controlling Salmonella. The total annual Salmonella control costs in year 2001 were U.S.$14.1 million (U.S.$0.075/kg of pork and U.S.$0.02/kg of broiler or egg). These costs are paid almost exclusively by the industry. The control principles described are applicable to most industrialized countries with modern intensive farming systems

Fresh Chicken as Main Risk Factor for Campylobacteriosis, Denmark

Increased consumption of fresh poultry in Denmark has contributed substantially to the increasing incidence of human campylobacteriosis

Web-based Surveillance and Global Salmonella Distribution, 2000–2002

Surveillance improves control of Salmonella infections

Danish Integrated Antimicrobial Resistance Monitoring and Research Program

This program has led to changes in the use of antimicrobial agents in Denmark and other countries

International travel and the risk of hospitalization with non-typhoidal Salmonella bacteremia. A Danish population-based cohort study, 1999-2008

<p>Abstract</p> <p>Background</p> <p>Information is sparse regarding the association between international travel and hospitalization with non-typhoidal <it>Salmonella </it>bacteremia. The aim of this study was to determine the proportion, risk factors and outcomes of travel-related non-typhoidal <it>Salmonella </it>bacteremia.</p> <p>Methods</p> <p>We conducted a 10-year population-based cohort study of all patients hospitalized with non-typhoidal <it>Salmonella </it>bacteremia in three Danish counties (population 1.6 million). We used denominator data on Danish travellers to assess the risk per 100,000 travellers according to age and travel destination. We used patients contemporaneously diagnosed with travel-related <it>Salmonella </it>gastroenteritis as reference patients to estimate the relative risk of presenting with travel-related bacteremia as compared with gastroenteritis. To evaluate clinical outcomes, we compared patients with travel-related bacteremia and patients with domestically acquired bacteremia in terms of length of hospital stay, number of extraintestinal focal infections and mortality after 30 and 90 days.</p> <p>Results</p> <p>We identified 311 patients hospitalized with non-typhoidal <it>Salmonella </it>bacteremia of whom 76 (24.4%) had a history of international travel. The risk of travel-related bacteremia per traveller was highest in the age groups 15-24 years (0.8/100,000 travellers) and 65 years and above (1.2/100,000 travellers). The sex- and age-adjusted relative risk of presenting with bacteremia was associated with travel to Sub-Saharan Africa (odds ratio 18.4; 95% confidence interval [6.9-49.5]), the Middle East (10.6; [2.1-53.2]) and South East Asia (4.0; [2.2-7.5]). We found high-risk countries in the same three regions when estimating the risk per traveller according to travel destination. Patients hospitalized with travel-related bacteremia had better clinical outcomes than patients with domestically acquired bacteremia, they had a shorter length of hospital stay (8 vs. 11 days), less extraintestinal focal infections (5 vs. 31 patients) and a lower risk of death within both 30 days (relative risk 0.2; [0.1-0.7]) and 90 days (0.3; [0.1-0.7]). A healthy traveller effect was a plausible explanation for the observed differences in outcomes.</p> <p>Conclusions</p> <p>International travel is a notable risk factor for being hospitalized with non-typhoidal <it>Salmonella </it>bacteremia and the risk differs between age groups and travel destinations. Healthy travellers hospitalized with bacteremia are less likely to have poor outcomes than patients with domestically acquired bacteremia.</p