Human Salmonella Typhi Murium Infection Due to Duck Eggs

Field: Medicine (Health Sciences)

In recent years increasing interest has been shown in the role of the duck in human Salm.typhi murium infections.That ducks may be symptomless faecal excreters of this organism and that their eggs, if ingested, may cause acute gastro-enteritis are wellrecognized and accepted facts.Although duck-egg infections have often been reported, the suspected eggs have less frequently been traced to the appropriate flocks of ducks and the necessary measures been taken to control or to eradicate the infection.The purpose of this paper is to describe two fatal and two severe cases of food-poisoning attributed to the eating of duck eggs, in three of which the incriminated eggs were traced to the appropriate flocks of ducks by means of bacteriophage typing of the strains of Salmonella typhi murium and by agglutination tests on ducks' sera.From the public health point of view this must be regarded as an important investigation.Case 1A fit and active man aged 58, who had had few illnesses in his lifetime, ate a raw duck egg on May 30, 1949, and within less than 24 hours developed severe abdominal pain and diarrhoea and, later, sickness and vomiting.During the next four days his symptoms became more severe.On June 3 he was acutely ill, with raised temperature, persistent and uncontrolled diarrhoea, and severe muscle cramps.He was profoundly shocked and dehydrated.His extremities were cold and blue.He was admitted to hospital on June 3 and died the following day.The cause,of death appeared to be acute septicaemia, probably due to salmonella infection.The necropsy examination, conducted less than 24 hours after death, revealed the signs of acute septicaemia: both lungs showed scanty subpleural petechial haemorrhages and their substance acute passive congestion.The heart showed clusters of petechial haemorrhages, mainly on the left auriculo-ventricular groove; the right side was dilated and engorged.The mucosa of the jejunum and ileum was in- tensely congested and Peyer's patches were enlarged and prominent.Both kidneys were small, with adherent capsules, and had the appearance of chronic nephritis.A postmortem specimen of blood contained 253 mg. of urea per 100 ml.The probable cause of death was acute septicaemia and uraemia.Cultures of post-mortem specimens of faeces, of stomach and small-bowel contents, and of urine gave heavy growths of Salm.typhi murium which belonged to Vi phage Type 2.Source of Infection.-Thepatient suspected the duck egg to have been the cause of his illness, although he thought it was perfectly fresh when he ate it.No portion of the suspected egg remained, and there were no more eggs in the house.As a result of inquiries it wa § learned that he had obtained half a dozen hen and duck eggs from a friend four days before his illness.The time of the laying of these eggs is unknown.The flock which had produced the in- criminated egg consisted of seven white Aylesbury ducks- six in lay and one not in lay-and one drake.They were all well-nourished healthy birds.There was no history of recent deaths or of illnesses among the ducks or among the hens.The duck eggs, after being cooked, had been eaten regularly by the family, which included children, without complaints or harmful results.