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	va1-sg19016.securesites.net

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SHIGELLOSIS, BABY CORN - DENMARK, AUSTRALIA ex THAILAND

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The recently reported concurrent outbreaks of _Shigella sonnei_ 

infections in Denmark (1) and Australia (2) have been found to be 

linked to a common baby corn packing house in Thailand via trace-back 

of the distribution chain. Distribution records indicated that 3 

additional countries received affected product from the implicated 

Thai packing house during the period of potential contamination. 

These countries were notified through the World Health Organization's 

International Food Safety Authorities Network (INFOSAN). Associated 

cases of _S. sonnei_ have not been reported in these 3 countries.



Denmark

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In Denmark, 218 cases of laboratory-confirmed _S. sonnei_ infection 

were reported to the Statens Serum Institut, Copenhagen between 1 Aug 

and 30 Sep 2007. During investigations, 12 cases reported recent 

foreign travel, 2 had an alternative exposure and 3 were deemed to be 

secondary cases and were therefore excluded, leaving 201 primary 

domestic cases. Of the 201 primary cases, the median age was 38 years 

old (range 2-92 years), and 150 cases (75 percent) were female. 

available for 94 cases (Figure 1 [for figure, see original URL. - 

no more than 3 days after the recall of the implicated product on 17 Aug 2007.



Australia

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In Australia, a total of 12 laboratory-confirmed cases were reported, 

all of whom acquired their infection in the state of Queensland. This 

included 2 residents of the state of Victoria and one from New 

Zealand. The onset of illness among all cases was between 9 and 27 Aug 2007.



Food analysis

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Microbiological examination of the suspected batches of imported baby 

corn in Denmark detected various serotypes of _Salmonella enterica_ 

and high levels of _Escherichia coli_, indicating fecal 

contamination. _Shigella spp._ were not detected, suggesting that 

contamination levels were low. Australia was unable to test the 

implicated batch of corn, but did detect greater than 100 

colony-forming units of _E. coli_ per gram in 25 gram samples from 

other batches from the same importer.



Conclusion

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Baby corn was implicated in the Danish outbreak following case 

reports of baby corn consumption and baby corn being found to be 

significantly associated with illness in a cohort study (1). The 

possibility that the outbreaks might be linked was raised by the 

Australian public health authorities following the publication of the 

Danish outbreak strain's antibiotic resistance pattern (1). This was 

further reinforced when isolates from Denmark and Australia were 

found to display indistinguishable PFGE patterns. As well as the 

report in Eurosurveillance, international awareness of the outbreak 

and the outbreak strain was raised via numerous international 

networks, such as the Early Warning Response System (EWRS) and Rapid 

Alert System for Food and Feed (RASSF) of the European Union, 

Enternet, Pulsenet Europe, Pulsenet US, Pulsenet Asia, and INFOSAN. 

This outbreak highlights the importance of timely international 

communications in helping to identify when a contaminated food enters 

international trade and results in human illness.





outbreak of shigellosis in Denmark associated with imported baby corn 



/1,4, R Stafford /5, KEP Olsen /4, EM Nielsen /4, M Lisby /6, SB 

Madsen6 and K Molbak1 1. Department of Epidemiology, Statens Serum 

Institut, Copenhagen, Denmark 2. European Programme for Intervention 

Epidemiology Training (EPIET) 3. OzFoodNet, Commonwealth Department 

of Health and Ageing, Canberra, Australia 4. Department of 

Bacteriology, Mycology and Parasitology, Statens Serum Institut, 

Copenhagen, Denmark 5. OzFoodNet, Communicable Diseases Branch, 

Queensland Health, Brisbane, Australia 6. Fodevareregion Ost 

(Regional Veterinary and Food Control Authority East), Copenhagen, Denmark]



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used to produce baby corn. Seed companies offer special types of seed 

to grow baby corn, but all of these grow plants and corn ears that 

are just as big as the usual corn. The secret is in the harvesting. 

Baby corn ears are picked by hand immediately when the silks emerge 

from the ear tips or a few days after. Corn matures quickly, so the 

harvest must be timed carefully to avoid ending up with normal corn 

ears. Baby corn ears are generally 4.5 cm to 10 cm (approx. 2-4 in) 

in length and 7 mm to 17 mm (0.3-0.7 in) in diameter.



Most baby corn commercially available is grown and processed in Asia, 

particularly in Thailand. Because baby corn must be picked by hand, 

it is too labor-intensive for most western farms. It has been an 

extremely important crop in Thailand since 1976, and other Asian 

nations have also begun producing and exporting it. Perhaps this is 

why baby corn is so often found in Asian recipes. - Mod.LL]



Shigellosis, Thai baby corn - Australia (QLD, VIC) 20070913.3035

Shigellosis, Thai baby corn - Denmark 20070904.2913

2005

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Shigellosis, unpasteurized milk curds, 2004 - Lithuania (Vilnius) 20051203.3494

1999

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Shigellosis - Australia (South Australia) 19990101.0004

1998

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Shigellosis, imported food - Denmark 19980813.1604]

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