TY - JOUR T1 - Multidisciplinary investigation of a multicountry outbreak of Salmonella Stanley infections associated with turkey meat in the European Union, August 2011 to January 201334078 JF - Euro.Surveill Y1 - 2014 A1 - Kinross,P. A1 - L. van Alphen A1 - J. Martinez Urtaza A1 - M. Struelens A1 - Takkinen,J. A1 - Coulombier,D. A1 - Makela,P. A1 - Sophie Bertrand A1 - Wesley Mattheus A1 - Schmid,D. A1 - Kanitz,E. A1 - Rucker,V. A1 - Krisztalovics,K. A1 - Paszti,J. A1 - Szogyenyi,Z. A1 - Lancz,Z. A1 - Rabsch,W. A1 - Pfefferkorn,B. A1 - Hiller,P. A1 - Mooijman,K. A1 - Gossner,C. KW - 2012 KW - a KW - Adult KW - an KW - analysi KW - analysis KW - Animal KW - Animals KW - article KW - AS KW - Case KW - classification KW - Cluster Analysis KW - Communicable Disease Control KW - Control KW - Countries KW - disease KW - Disease Outbreaks KW - Diseases KW - ecdc KW - electronic KW - Electrophoresis KW - environmental KW - epidemic KW - EPIDEMIOLOGICAL KW - epidemiology KW - EU KW - Europe KW - European KW - European Union KW - evidence KW - feed KW - Female KW - food KW - Food Microbiology KW - Food Safety KW - health KW - Human KW - Humans KW - im KW - incidence KW - INFECTION KW - infections KW - INFORMATION KW - Information system KW - International KW - investigation KW - IS KW - isolation & purification KW - journal KW - Male KW - Meat KW - microbiology KW - Molecular Typing KW - Monitoring KW - national KW - ON KW - ORIGIN KW - outbreak KW - Population Surveillance KW - prevention KW - prevention & control KW - production KW - profile KW - public KW - public health KW - Public-health KW - routine KW - S KW - SAFETY KW - Salmonella KW - Salmonella enterica KW - Salmonella Infections KW - sampling KW - SB - IM KW - Serotyping KW - Sweden KW - System KW - Transmission KW - Turkey KW - Turkeys KW - veterinary AB - Between August 2011 and January 2013, an outbreak of Salmonella enterica serovar Stanley (S. Stanley) infections affected 10 European Union (EU) countries, with a total of 710 cases recorded. Following an urgent inquiry in the Epidemic Intelligence Information System for food- and waterborne diseases (EPIS-FWD) on 29 June 2012, an international investigation was initiated including EU and national agencies for public health, veterinary health and food safety. Two of three local outbreak investigations undertaken by affected countries in 2012 identified turkey meat as a vehicle of infection. Furthermore, routine EU monitoring of animal sources showed that over 95% (n=298) of the 311 S. Stanley isolates reported from animal sampling in 2011 originated from the turkey food production chain. In 2004-10, none had this origin. Pulsed-field gel electrophoresis (PFGE) profile analysis of outbreak isolates and historical S. Stanley human isolates revealed that the outbreak isolates had a novel PFGE profile that emerged in Europe in 2011. An indistinguishable PFGE profile was identified in 346 of 464 human, food, feed, environmental and animal isolates from 16 EU countries: 102 of 112 non-human isolates tested were from the turkey production chain. On the basis of epidemiological and microbiological evidence, turkey meat was considered the primary source of human infection, following contamination early in the animal production chain VL - 19 CP - 19 U1 - 34078 ER -