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. 2019 Jan;24(3):1700703.
doi: 10.2807/1560-7917.ES.2019.24.3.1700703.

Disentangling a complex nationwide Salmonella Dublin outbreak associated with raw-milk cheese consumption, France, 2015 to 2016

Aymeric Ung  1   2   3 , Amrish Y Baidjoe  3   4   5 , Dieter Van Cauteren  1 , Nizar Fawal  5 , Laetitia Fabre  5 , Caroline Guerrisi  6 , Kostas Danis  1   2 , Anne Morand  7 , Marie-Pierre Donguy  7 , Etienne Lucas  1 , Louise Rossignol  6 , Sophie Lefèvre  5 , Marie-Léone Vignaud  8 , Sabrina Cadel-Six  8 , Renaud Lailler  8 , Nathalie Jourdan-Da Silva  1   9 , Simon Le Hello  5   9
Affiliations

Disentangling a complex nationwide Salmonella Dublin outbreak associated with raw-milk cheese consumption, France, 2015 to 2016

Aymeric Ung et al. Euro Surveill. 2019 Jan.

Abstract

On 18 January 2016, the French National Reference Centre for Salmonella reported to Santé publique France an excess of Salmonella enterica serotype Dublin (S. Dublin) infections. We investigated to identify the source of infection and implement control measures. Whole genome sequencing (WGS) and multilocus variable-number tandem repeat analysis (MLVA) were performed to identify microbiological clusters and links among cases, animal and food sources. Clusters were defined as isolates with less than 15 single nucleotide polymorphisms determined by WGS and/or with identical MLVA pattern. We compared different clusters of cases with other cases (case-case study) and controls recruited from a web-based cohort (case-control study) in terms of food consumption. We interviewed 63/83 (76%) cases; 2,914 controls completed a questionnaire. Both studies' findings indicated that successive S. Dublin outbreaks from different sources had occurred between November 2015 and March 2016. In the case-control study, cases of distinct WGS clusters were more likely to have consumed Morbier (adjusted odds ratio (aOR): 14; 95% confidence interval (CI): 4.8-42) or Vacherin Mont d'Or (aOR: 27; 95% CI: 6.8-105), two bovine raw-milk cheeses. Based on these results, the Ministry of Agriculture launched a reinforced control plan for processing plants of raw-milk cheeses in the production region, to prevent future outbreaks.

Keywords: France; Salmonella Dublin; WGS; cheese; outbreaks; raw-milk.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Flowchart of human and non-human Salmonella Dublin isolatesa subtyped and included in the study, France, 2015–2016 (n = 289)
Figure 2
Figure 2
Number of cases by reporteda date of onset of symptomsb, Salmonella Dublin outbreak, France, November 2015–March 2016 (n = 83b)
Figure 3
Figure 3
Phylogenetic analysis of all the subtyped human and non-human Salmonella Dublin isolates included in the study that were whole genome sequenced, France, 2015–2016a (n = 289)
See this image and copyright information in PMC

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