An Outbreak of Shigella sonnei Infection Associated with Consumption of Iceberg Lettuce
1995

Outbreak of Shigella sonnei Infection Linked to Iceberg Lettuce

Sample size: 71 publication Evidence: high

Author Information

Author(s): J.A. Frost, M.B. McEvoy, C.A. Bentley, Y. Andersson, B. Rowe

Primary Institution: Central Public Health Laboratory, London, England

Hypothesis

Is iceberg lettuce associated with sporadic Shigella sonnei infection in adults?

Conclusion

The study found strong evidence that consumption of iceberg lettuce was linked to Shigella sonnei infections.

Supporting Evidence

  • Of 100 reported cases of Sh. sonnei infection in Sweden, 52 occurred in two outbreaks in mid-May.
  • 38 out of 40 case patients had eaten iceberg lettuce.
  • Illness was significantly associated with iceberg lettuce consumption (relative risk 3.68).
  • 27 cases and 44 controls were analyzed in the study.

Takeaway

Eating iceberg lettuce might make you sick with a type of bacteria called Shigella. This study looked at people who got sick and found a lot of them had eaten lettuce.

Methodology

A case-control study was conducted where cases were matched with controls based on age, sex, and area of residence.

Potential Biases

Potential bias from self-selection of case patients and reliance on recall for food consumption.

Limitations

The source of the iceberg lettuce could not be traced, and the study relied on self-reported food consumption.

Participant Demographics

Median age of case-patients was 47 years, with a range of 19 to 79 years; 19 were women and 8 were men.

Statistical Information

P-Value

0.0172

Confidence Interval

1.26 to 150.5

Statistical Significance

p = 0.0172

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