{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:44:36Z","timestamp":1790196276347,"version":"4.1.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"United States Centers for Disease Control and Prevention, Central Asia Field Epidemiology Training Program","award":["CDC Cooperative Agreement GH15-1619"],"award-info":[{"award-number":["CDC Cooperative Agreement GH15-1619"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>From June 13\u201316, 2022, a regional epidemiological department in Kazakhstan reported an increase in acute gastroenteritis cases among people who consumed food from a wedding at a restaurant. An investigation was initiated to determine factors associated with acute intestinal infection and prevent further illness.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The investigation team conducted a retrospective cohort study among people who consumed event food. Participants were classified as a case if they were acutely ill with diarrhea, vomiting, fever, vomiting, or weakness from June 13\u201318. We interviewed people to collect information on demographics, symptoms, and food exposures at the event. We calculated food-specific attack rates and estimated adjusted relative risks (aRR) using multivariable Poisson regression, which was adjusted for sex, age, and foods consumed. Patient stool and gastric lavage samples, leftover food, and restaurant environmental samples were collected for bacterial culture and chemical analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 138 participants, 66 became ill; the attack rate was 48%. The most reported symptoms were diarrhea (92%), abdominal pain (91%), and fever (89%). Symptom onset occurred between 6\u00a0h and 4 days after the event (median\u2009=\u20091\u00a0day). Overall, 50 (76%) cases were hospitalized; no deaths were reported. In bivariable analysis, a greater proportion of cases than non-cases ate honey cake (89% vs. 13%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and 45% of cases ate leftovers compared with 11% of non-cases (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). In multivariable analysis, honey cake was the only risk factor associated with illness (aRR\u2009=\u20097.8, 95% confidence interval\u2009=\u20093.5\u201320.1, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Honey cakes, which use raw eggs in cream layers, had been stored at room temperature for three days before the event. <jats:italic>Salmonella enterica<\/jats:italic> serovar Enteriditis (S. Enteritidis) was isolated from all patient stool samples (49\/49, 100%) and honey cake samples (2\/2, 100%). <jats:italic>Staphylococcus aureus<\/jats:italic> was detected in 92% (35\/38) of patient gastric lavage samples.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p><jats:italic>S. Enteritidis<\/jats:italic> was this outbreak\u2019s most probable etiological agent based on clinical manifestations and isolation from participant and honey cake samples. The improper storage of cakes containing raw eggs was a key contributing factor. Leftover event food was discarded, and the restaurant was closed for disinfection. Future outbreaks could be prevented by increased food safety awareness.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-024-10382-4","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T16:42:26Z","timestamp":1735144946000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Salmonellosis outbreak associated with the consumption of food at a wedding in an urban restaurant in Kazakhstan: a retrospective cohort study"],"prefix":"10.1186","volume":"24","author":[{"given":"Saya","family":"Gazezova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilyara","family":"Nabirova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Waltenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maral","family":"Rakhimzhanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manar","family":"Smagul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Kasabekova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Horth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,25]]},"reference":[{"key":"10382_CR1","unstructured":"Salmonellosis, Nontyphoidal | CDC Yellow Book. 2024. https:\/\/wwwnc.cdc.gov\/travel\/yellowbook\/2024\/infections-diseases\/salmonellosis-nontyphoidal [Accessed June 3, 2024]."},{"key":"10382_CR2","doi-asserted-by":"publisher","unstructured":"Hendriksen RS, Vieira AR, Karlsmose S, Lo Fo Wong DMA, Jensen AB, Wegener HC, Aarestrup FM. 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This activity was reviewed by the CDC Institutional Review Board, deemed not research, and was conducted consistent with applicable federal law and CDC policy (CGH-WIDB-7\/29\/22-96394).<sup>1<\/sup> All participants gave written informed consent. Parents or legal guardians gave consent to provide information about their children under the age of 18. Children under 18 years of age were not interviewed; instead, information about children was obtained from parents or legal guardians. Conducted under the principles of the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the U. S. Centers for Disease Control and Prevention.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}],"article-number":"1464"}}