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In this issue, two reports on foodborne outbreaks caused by the same strain of Salmonella serotype Typhimurium DT104 illustrate the value of international collaboration in subtyping and surveillance [1, 2]. This collaboration led to the detection and linkage of two distinct outbreaks caused by the same organism traced to two types of raw beef from the same supplier. Each investigation proceeded independently and used different methods. The Danish investigation [2] relied mainly on the sampling of imported foods, and linkage of those strains with human clinical isolates via multiple laboratory methods, with the limited epidemiological information required to put them together. This worked because most cases were associated with carpaccio consumed at one restaurant, although it did not effectively address the other non-restaurant-associated cases. The Dutch investigation [1] of cases dispersed throughout the country was dependent on a substantial epidemiological effort, and is an excellent example of a multi-jurisdictional case-control study using a novel control selection strategy. In addition to these two recognized outbreaks, the same meats clearly went to other parts of Europe, where they may also have caused illness which was not identified.  These reports also point out some areas for further improvements in the recognition and investigation of multi-national foodborne outbreaks in Europe.

Investigation of multi-national foodborne outbreaks in Europe: some challenges remain