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Reportable Infectious Diseases in Maine – 2002 Summary

Enteric Diseases. Reportable Infectious Diseases in Maine, 2002.  Maine Department of Health and Human Services, Bureau of Health, Division of Disease Control. Augusta, Maine.

Salmonellosis

During 2002, 147 cases of culture confirmed Salmonellosis infections were reported in Maine.  This represents a case rate of 12 cases per 100,000 of the Maine population, the same rate as 2001.  The mean number of cases reported from 1998 to 2002 is 148 with a median of 147. 

Demographic information include:

• Geographic Occurrence: All 16 counties reported at least one case of Salmonellosis in 2002. Most of the cases, 46% (n=67) resided in the southern Maine counties of York and Cumberland. 
• Seasonality: Unlike previous years when most cases occurred in the summer months, no seasonal trend was seen in 2002.  This is primarily due to clusters and outbreaks of illness in the winter and fall months.  Only 25% of cases were during the summer months of June through August.
• Gender: Eighty-nine cases or 61% were female.
• Age: Most of the cases, 56% (n=83), were between the ages of 20 and 64 years old.  Thirteen percent were 5 years old and younger, 18% (n=26) were between the ages of 6 and 19 years old, and 13% (n=19) were 65 years old and older.

 2002 Total Number of Salmonella Cases by Month

Serotyping results of Salmonella isolates were conducted for samples submitted to HETL.   The following tables illustrates the most popular serotypes: 

In addition to serotyping, HETL conducted pulse field gel electrophoresis (PFGE) in order to identify any matching patterns among cases and enhance surveillance for outbreaks.  In 2002, five clusters of Salmonella were identified through PFGE testing.  One cluster, described below, involved fifteen cases of Salmonella enteriditis.  A third cluster involved four people who attended a family gathering and had similar food histories.  After thorough investigations of the other 2 clusters, no epidemiological links were identified.

In 2002, Maine investigated an outbreak of Salmonella enteriditis.  The outbreak was first detected in late January when an unexpectedly large number of Salmonella isolates were reported by clinical laboratorians and were sent to the Maine Health and Environmental Testing Laboratory for serotyping.  Fifteen cases met the case definition for this outbreak based on laboratory testing and clinical presentation.  Eleven cases resided in southern Maine (York and Cumberland counties) and 4 in the mid coast region (Waldo, Sagadahoc, and Lincoln counties).  Cases ranged in age from 5-88 years with a mean of 31 and a median of 25 years.  Seventy-three percent of cases were female.  Dates of illness onset ranged from January 13 – January 26^th, with 11 cases clustered during the week of January 20-26.  After conducting a trace back of common foods reported by the cases and a telephone case control study, the epidemiological evidence supported the theory of mung bean sprouts as the source for this outbreak.    This investigation was conducted in collaboration of the US Food and Drug Administration (USDA) and with assistance from the Maine Department of Agriculture. Epidemiological and laboratory assistance was supplied by the CDC Foodborne and Diarrheal Diseases Branch.

Source:

Enteric Diseases. Reportable Infectious Diseases in Maine, 2002.  Maine Department of Health and Human Services, Bureau of Health, Division of Disease Control. Augusta, Maine.