Abstract
In June 2008 an outbreak of gastroenteritis was registered in Sunny Beach resort situated on the Black Sea coast in Bulgaria, affecting 14 employees of a hotel, five of whom tested positive for Salmonella Enteritidis. During June-July 2008 four sporadic S. Enteritidis cases were also reported and two of them were foreign tourists. In the same period S. Enteritidis cases connected with travel to Bulgaria were reported to the European Centre for Disease Prevention and Control (ECDC) from Finland, United Kingdom, Sweden, Germany and Norway. We describe a study performed to find out relatedness between Bulgarian and Finnish S. Enteritidis isolates using phage typing (PT) and pulse-field gel electrophoresis (PFGE). Fifteen S. Enteritidis isolates from Bulgaria and 195 from Finland (including 28 from travellers to Bulgaria) were phage typed. Within Bulgarian isolates four different PTs were found and PT6c with eight strains was predominant. Nineteen out of 28 strains isolated from the Finns visiting Bulgaria belonged also to PT6c. PFGE typing (with one enzyme) of all S. Enteritidis PT6c strains (8 Bulgarian and 19 Finnish isolates) showed indistinguishable PFGE profile. The typing results thus demonstrated a link between Bulgarian and Finnish S. Enteritidis isolates. We conclude that S. Enteritidis PT6c was the cause of salmonella outbreak in Sunny Beach and was exported to Finland, and likely to the United Kingdom, Norway, Sweden and Germany.
Highlights
Salmonella has long been recognised as an important food-borne pathogen which can cause symptoms in humans ranging from self-limited enteric infections to enteric fever
Enteritidis isolates potentially associated with an outbreak occurring in Bulgaria, we initiated an investigation of those strains by phage typing and pulse-field gel electrophoresis (PFGE)
The 15 Bulgarian strains and the 19 Finnish PT6c isolates were analysed for genetic relatedness by PFGE using XbaI according to the Centers for Disease Control and Prevention (CDC) PulseNet protocol [3]
Summary
Background Salmonella has long been recognised as an important food-borne pathogen which can cause symptoms in humans ranging from self-limited enteric infections to enteric fever. Enteritidis cases: 28 of them were connected to a trip to Bulgaria, including 19 that were of the phage type PT6c. Sweden: On 10 July 2008 Sweden reported to ECDC 29 Salmonella cases among travellers returning from Bulgaria during June and July. One of these travellers had stayed in hotel at Nessebar from 23 to 30 May 2008 and had symptoms of salmonellosis starting from 28 May. More information about the other case was not available. O rg Norway reported a total of 76 salmonellosis cases in 2008 linked with travelling to Bulgaria, of which 48 isolates had been identified as S. Enteritidis isolates potentially associated with an outbreak occurring in Bulgaria, we initiated an investigation of those strains by phage typing and PFGE
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