Risk factors for Salmonella Enteritidis and Typhimurium (DT104 and non-DT104) infections in The Netherlands: predominant roles for raw eggs in Enteritidis and sandboxes in Typhimurium infections
Open accessAbstract
Since 1996 Salmonella Typhimurium DT104 salmonellosis has increased in The Netherlands. This prompted a case-control study of risk factors for salmonellosis to inform transmission routes for this phage type. Cases were laboratory-confirmed patients with a Salmonella infection and controls were selected from population registries by frequency matching for age, sex, degree of urbanization and season. Cases and controls received a questionnaire on risk factors. Of the 1171 cases, 573 (49%) responded: 245 S. Enteritidis and 232 S. Typhimurium cases (both DT104 and non-DT104), of which 58 were DT104. Of the 10250 controls, 3409 (33%) responded. Use of H2 antagonists [odds ratio (OR) 4·4, 95% CI 1·6–12·2] and proton pump inhibitors (OR 4·2, 95% CI 2·2–7·9), consumption of raw eggs (OR 3·1, 95% CI 1·3–7·4) and products containing raw eggs (OR 1·8, 95% CI 1·1–3·0) were associated with endemic S. Enteritidis infection. Risk factors for endemic S. Typhimurium infection were use of proton pump inhibitors (OR 8·3, 95% CI 4·3–15·9), occupational exposure to raw meat (OR 3·0, 95% CI 1·1–7·9), playing in a sandbox (for children aged 4–12 years) (OR 2·4, 95% CI 1·6–3·7), consumption of undercooked meat (OR 2·2, 95% CI 1·1–4·1) and use of antibiotics (OR 1·9, 95% CI 1·0–3·4). Use of proton pump inhibitors (OR 11·2, 95% CI 3·9–31·9) and playing in a sandbox (OR 4·4, 95% CI 1·8–10·7) were the only risk factors for S. Typhimurium DT104 salmonellosis. This study confirms known risk factors for salmonellosis. However, playing in a sandbox was a predominant new risk factor for S. Typhimurium salmonellosis in children [population attributable risk (PAR) 14%], and especially for S. Typhimurium DT104 (PAR 32%).
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Playing in a sandbox is found to be a predominant risk factor for S. Typhimurium salmonellosis in children aged 4-12 years; this can be the result of fecal contamination of the sand by dogs and cats that have been fed raw meat.
“Playing in a sandbox is also found to be a predominant risk factor for S. Typhimurium salmonellosis in children aged 4–12 years [217]. This can be the result of fecal contamination of the sand by dogs and cats that have been fed raw meat (see Section 5.1.1.).”
From A One Health Perspective on the Human-Companion Animal Relationship with Emphasis on Zoonotic Aspects. (2020) · cites this paper as [217]
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- Authors
- DOORDUYN, Y., VAN DEN BRANDHOF, W. E., VAN DUYNHOVEN, Y. T. H. P., WANNET, W. J. B., & VAN PELT, W.
- Affiliations
- National Institute for Public Health and the Environment (NL)
- Venue
- Epidemiology and Infection
- Publisher
- Cambridge University Press (CUP)
- Published
- 2005-11-21
- Volume
- 134
- Issue
- 3
- Pages
- 617-626
- ISSN
- 0950-2688 (ISSN-L)
- 1469-4409
- PMC
- PMC2870426
- OpenAlex
- W2087172643
- Cited by
- 183
- References
- 2
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 5 · 2022: 5 · 2021: 3 · 2020: 7 · 2019: 8 · 2018: 8 · 2017: 14 · 2016: 8 · 2015: 14 · 2014: 15 · 2013: 18 · 2012: 11
- FWCI
- 16.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epidemiology and Infection (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Rivm (National Institute for Public Health and the Environment) (submittedVersion)
- Funders
- National Institutes of Health
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biotechnology › Listeria monocytogenes in Food Safety
- Life Sciences › Agricultural and Biological Sciences › Food Science › Food Safety and Hygiene
- Keywords
- Salmonella Enteritidis, Salmonella typhimurium, DT104, salmonellosis, risk factors, raw eggs, proton pump inhibitors, H2 receptor antagonists, undercooked meat, antibiotic use, children, transmission routes, Netherlands, foodborne transmission, zoonotic transmission
- MeSH terms
- Adolescent, Adult, Aged, Child, Child, Preschool, Eggs, Female, Humans, Infant, Infant, Newborn, Male, Meat, Middle Aged, Risk Factors, Salmonella enteritidis, Salmonella Food Poisoning, Salmonella Infections, Salmonella typhimurium, Silicon Dioxide, Soil Microbiology, Case-Control Studies, Occupational Exposure
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