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Investigating the Meat Pathway as a Source of Human Nontyphoidal Salmonella Bloodstream Infections and Diarrhea in East Africa.

  • Crump, John A1, 2, 3
  • Thomas, Kate M1
  • Benschop, Jackie4
  • Knox, Matthew A4
  • Wilkinson, David A4
  • Midwinter, Anne C4
  • Munyua, Peninah5
  • Ochieng, John B6
  • Bigogo, Godfrey M6
  • Verani, Jennifer R5
  • Widdowson, Marc-Alain5, 7
  • Prinsen, Gerard8
  • Cleaveland, Sarah9
  • Karimuribo, Esron D10
  • Kazwala, Rudovick R10
  • Mmbaga, Blandina T2, 3
  • Swai, Emanuel S11
  • French, Nigel P4
  • Zadoks, Ruth N9, 12
  • 1 Centre for International Health, University of Otago, Dunedin, New Zealand. , (New Zealand)
  • 2 Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania. , (Tanzania)
  • 3 Kilimanjaro Christian Medical University College, Moshi, Tanzania. , (Tanzania)
  • 4 School of Veterinary Science, Massey University, Palmerston North, New Zealand. , (New Zealand)
  • 5 Division of Global Health Protection, US Centers for Disease Control and Prevention, Nairobi, Kenya. , (Kenya)
  • 6 Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya. , (Kenya)
  • 7 Institute of Tropical Medicine, Antwerp, Belgium. , (Belgium)
  • 8 School of People, Environment and Planning, Massey University, Palmerston North, New Zealand. , (New Zealand)
  • 9 Institute of Biodiversity, Animal Health, and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom. , (United Kingdom)
  • 10 College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania. , (Tanzania)
  • 11 Department of Veterinary Services, Ministry of Livestock and Fisheries, Dodoma, Tanzania. , (Tanzania)
  • 12 Sydney School of Veterinary Science, University of Sydney, Sydney, Australia. , (Australia)
Published Article
Clinical Infectious Diseases
Oxford University Press
Publication Date
Oct 05, 2021
DOI: 10.1093/cid/ciaa1153
PMID: 32777036


Salmonella Enteritidis and Salmonella Typhimurium are major causes of bloodstream infection and diarrheal disease in East Africa. Sources of human infection, including the role of the meat pathway, are poorly understood. We collected cattle, goat, and poultry meat pathway samples from December 2015 through August 2017 in Tanzania and isolated Salmonella using standard methods. Meat pathway isolates were compared with nontyphoidal serovars of Salmonella enterica (NTS) isolated from persons with bloodstream infections and diarrheal disease from 2007 through 2017 from Kenya by core genome multi-locus sequence typing (cgMLST). Isolates were characterized for antimicrobial resistance, virulence genes, and diversity. We isolated NTS from 164 meat pathway samples. Of 172 human NTS isolates, 90 (52.3%) from stool and 82 (47.7%) from blood, 53 (30.8%) were Salmonella Enteritidis sequence type (ST) 11 and 62 (36.0%) were Salmonella Typhimurium ST313. We identified cgMLST clusters within Salmonella Enteritidis ST11, Salmonella Heidelberg ST15, Salmonella Typhimurium ST19, and Salmonella II 42:r:- ST1208 that included both human and meat pathway isolates. Salmonella Typhimurium ST313 was isolated exclusively from human samples. Human and poultry isolates bore more antimicrobial resistance and virulence genes and were less diverse than isolates from other sources. Our findings suggest that the meat pathway may be an important source of human infection with some clades of Salmonella Enteritidis ST11 in East Africa, but not of human infection by Salmonella Typhimurium ST313. Research is needed to systematically examine the contributions of other types of meat, animal products, produce, water, and the environment to nontyphoidal Salmonella disease in East Africa. © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

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