Emergence of Salmonella enteritidis phage type 4 in the Caribbean: Case-control study in Trinidad and Tobago, West Indies

A prospective case-control study involving 46 case patients and 92 age-and neighborhood-matched control subjects was conducted in Trinidad and Tobago (T&T) between March 1998 and May 1999 to determine the etiology, sources, a nd risk factors for Salmonella enteritidis (SE) infection. SE infection in T&T was found to be associated with the consumption of shell eggs, and in p articular raw or undercooked eggs. SE isolates from 30 (88%) of 34 patients and from 9 implicated egg or egg-containing food samples were phage type 4 . Homemade eggnog and ice cream, cake batter, and egg-containing beverages were the main raw egg-containing foods, reflecting the cultural practices o f the people of T&T. Public health education on the risks of eating raw or undercooked eggs, thorough cooking of all egg dishes, and refrigeration of shell eggs and egg dishes; studies tracing infected eggs to their sources; and testing of flocks of layer chickens for SE are needed to reduce the inc idence of this infection.