Outbreak Investigation
Outbreak of Salmonella Enteritidis Infection Linked to Tiramisu Cakes Contaminated by Liquid Eggs in Taiwan, 2014
DOI: 10.6525/TEB.201805_34(9).0002Yi-Chen Tsai1*, Wan-Chin Chen2, Ying-Shu Liao3, Chien-Shun Chiou3,Pei-Chen Chen4, Yu-Chieh Chien5, Hung-Wei Kuo1
2018 Vol.34 NO.9
Correspondence Author： Yi-Chen Tsai1*
- 1Epidemic Intelligence Center, Centers for Disease Control,Ministry of Health and Welfare, Taiwan
- 2Office of Preventive Medicine, Centers for Disease Control, Ministry of Health and Welfare, Taiwan
- 3Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan
- 4Taipei Regional Center, Centers for Disease Control, Ministry of Health and Welfare, Taiwan
- 5National Yang-Ming University, Taipei, Taiwan
Abstract：
Taiwan CDC identified a cluster of Salmonella enterica serovar Enteritidis in northern Taiwan on May 15, 2014, which had an indistinguishable, novel pulsed-field gel electrophoresis (PFGE) subtyping pattern. We conducted a case-control study using structured hypothesis-generating interviews, and environmental and trace-back investigations. We defined confirmed cases as patients with culture-confirmed of S. Enteritidis (SEX.238) infection and whose illness onset were during April–May, 2014. The presumptive control cases were recruited from a pilot survey in September 2013 to February 2014 for locally-acquired hepatitis A patients using the similar questionnaire. We identified 6 confirmed cases in 3 households. Illness was significantly associated with tiramisu cakes consumption from bakery X (P <0.01). Bacterial culture of liquid egg yolk used for tiramisu cakes, which were prepared manually without pasteurization, yielded salmonella spp. We identified tiramisu cakes as a vehicle for S. Enteritidis (SEX.238) outbreak. We recommended bakers should use pasteurized liquid eggs for lightly cooked egg-associated products.
