National outbreaks of Salmonella infection in the UK, 2000-2011.

Over a 12-year period, the Health Protection Agency's (now Public Health England's) Department of Gastrointestinal and Emerging Infections (GEZI) investigated over 100 potential national outbreaks of Salmonella enterica. These ranged from a cluster of cases requiring data interrogation and monitoring of the situation, to full blown case-control studies involving hundreds of interviews, many staff, multi-agency collaboration and the media. Vehicles of infection ranged from the usual suspects of chicken and eggs, to the less frequently implicated snake feed and chocolate. This has forced us to alter our preconceptions of disease transmission. The way in which GEZI investigate outbreaks and conduct case-control studies is constantly evolving as we learn and adapt to the changing aetiology of S. enterica. We present the findings and lessons learned during the last 12 years of investigating S. enterica outbreaks in England and Wales.