Salmonella Saintpaul outbreak associated with cantaloupe consumption, the United Kingdom and Portugal, September to November 2023

Luke J. McGeoch*, Ann Hoban, Clare Sawyer, Hussein Rabie, Anaïs Painset, Lynda Browning, Derek Brown, Caitlin Mccarthy, Andrew Nelson, Ana Firme, Ângela Pista, Joana Moreno, João Vieira Martins, Leonor Silveira, Jorge Machado, Paula Vasconcelos, Oluwakemi Olufon, Carmellie Inzoungou-Massanga, Amy Douglas, Jacquelyn MccormickLesley Larkin, Sooria Balasegaram

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

In September 2023, the UK Health Security Agency identified cases of Salmonella Saintpaul distributed across England, Scotland, and Wales, all with very low genetic diversity. Additional cases were identified in Portugal following an alert raised by the United Kingdom. Ninety-eight cases with a similar genetic sequence were identified, 93 in the United Kingdom and 5 in Portugal, of which 46% were aged under 10 years. Cases formed a phylogenetic cluster with a maximum distance of six single nucleotide polymorphisms (SNPs) and average of less than one SNP between isolates. An outbreak investigation was undertaken, including a case-control study. Among the 25 UK cases included in this study, 13 reported blood in stool and 5 were hospitalized. One hundred controls were recruited via a market research panel using frequency matching for age. Multivariable logistic regression analysis of food exposures in cases and controls identified a strong association with cantaloupe consumption (adjusted odds ratio: 14.22; 95% confidence interval: 2.83-71.43; p-value: 0.001). This outbreak, together with other recent national and international incidents, points to an increase in identifications of large outbreaks of Salmonella linked to melon consumption. We recommend detailed questioning and triangulation of information sources to delineate consumption of specific fruit varieties during Salmonella outbreaks.

Original languageEnglish
Article numbere78
JournalEpidemiology and Infection
Volume152
DOIs
Publication statusPublished - 6 May 2024

Bibliographical note

Publisher Copyright:
© 2024 Crown Copyright - UK Health Security Agency.

Keywords

  • Salmonella
  • Salmonella Saintpaul
  • cantaloupe
  • melon
  • outbreak

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