LETTERS

Salmonella bongori Until now, the rare S. bongori XbaI showed a banding pattern simi- 48:z35:–, an apparent epidemiologic lar to that of all previously identifi ed 48:z35:– in Migratory peculiarity of Sicily, could not have S. bongori 48:z35:–. In particular, the , Italy been traced to a well-defi ned source. DNA restriction pattern proved to be Indeed, in past years, many infre- indistinguishable from patterns of To the Editor: Serovars of quently isolated and new serovars of the human isolates belonging to the , other than subspecies Salmonella have been identifi ed in Sic- epidemic clusters and of the pigeon enterica, are primarily associated ily from wild , but S. bongori isolates (3). with cold-blooded animals and in- 48:z35:– has never been isolated from Previous studies have document- frequently colonize the intestines of these animals (5). Moreover, whether ed that carriage of Salmonella spp. by warm-blooded animals. Strains of S. pigeons that live in urban areas have apparently healthy migrating birds is bongori, in particular, are rarely iso- epidemiologic importance as sources infrequent, although some isolates lated from human patients (1,2). How- of infection is questionable, because have been recovered (7,8). Prevalence ever, during 1984–2004, 27 strains of of the apparently exclusive infection has been shown to be higher during S. bongori with the antigenic formula of infants in the fi rst months of life. breeding season and during wintering 48:z :– were identifi ed from 2 epi- 35 The role of migratory birds has not in some urban-associated , demic clusters in Italy (Messina, Oc- previously been assessed. especially in those that feed on refuse, tober 1984–May 1985, and Palermo, To determine the prevalence of such as corvids and gulls (9). How- July–October 1998), and from sporad- birdborne in the migratory ever, to our knowledge, S. bongori ic cases of acute that occurred bird fauna of the Mediterranean ba- in migratory birds has not previously in several cities in Sicily. Almost all sin, we conducted a study in October been reported. cases involved children 1 month to 3 2006, during ringing (banding) activ- Our fi ndings suggest that passer- years of age (3). By 2006, 8 additional ity at the station of the University of ine migratory birds may play a role isolates of the same serovar had been Palermo on Ustica, a small island in in the introduction or persistence of collected in southern Italy from the the Tyrrhenian Sea (38°42′N, 13°11′E) S. bongori 48:z35 in southern Italy. following sources: 1) a healthy human near the northern coast of Sicily. Ap- The also have the potential carrier; 2) 3 warm-blooded animals (2 parently healthy birds trapped by mist for gaining access to the food chain, apparently healthy pigeons and a nets during active migration were as confi rmed by their presence in the with ); 3) 2 food products (soft sampled. Fresh fecal samples or cloa- shell of hen eggs. Moreover, a bird- cheese and the shell of a hen’s egg); cal swabs from 239 birds belonging to environment-food network could and 4) urban wastewater (3). the orders Passeriformes, Gruiformes, perpetuate a reservoir of S. bongori No cases of human infections and Caprimulgiformes were analyzed 48:z35:–. Most small passerine mi- caused by S. bongori 48:z :– have 35 to determine whether birds were colo- gratory birds, including blackcaps, do been reported in countries other than nized with Salmonella. Routine proce- not share a niche with humans and are Italy. Except for the original strain dures for isolation of Salmonella spp. most likely to be found in rural habi- isolated from a in Chad in 1966 were used. Colonies with morphologic tats (10). However, some species are (4), the only recorded isolates of this characteristics of Salmonella spp. were developing an increasing ability to live serovar are 4 isolates from foodstuffs fully identifi ed by standard biochemi- in urban and suburban environments, recovered in England in 1985 (M.Y. cal and serologic testing. especially where winter feeding by hu- Popoff, pers. comm.). Two isolates, from 2 blackcaps mans attracts birds, forcing changes in Pulsed-fi eld gel electrophoresis (Sylvia atricapilla), were identifi ed the species balance. Because of their (PFGE) analysis of XbaI-digested as Salmonella spp. Morphologic fea- ability to fl y through long distances DNA of the 35 isolates obtained from tures of the external fl ight apparatus during annual migrations, wild birds Sicily showed identical or similar pro- and weight clearly indicated that the 2 could also play a role in the epidemi- fi les that differed from each other by individuals belonged to the migratory ology of zoonoses. Thus, risk assess- 2–5 bands (>79% similarity), except subspecies of blackcap (6). ment of Salmonella carriage in wild for the profi le obtained from the soft The Salmonella isolates were birds warrants further investigation. cheese isolate (<40% similarity) (3). characterized by serotyping at the Thus, all but one of the isolates could Centre for Enteric Pathogens of South- Acknowledgments be considered closely or at least likely ern Italy, University of Palermo, as S. We are deeply indebted to Bruno related to the oldest profi le character- bongori 48:z35:–. Molecular typing Massa for providing additional data and izing the putative ancestor clone. by PFGE after digestion of DNA by valuable suggestions.

502 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 15, No. 3, March 2009 LETTERS

Maria Foti, Antonio Daidone, Address for correspondence: Caterina be useful for diagnosing this type of Aurora Aleo, Alessia Pizzimenti, Mammina, Centre for Enteric Pathogens dermatitis in outbreaks and sporadic Cristina Giacopello, of Southern Italy (CEPIM)], Department cases. and Caterina Mammina of Sciences for Health Promotion “G. Some years ago, we studied 3 out- Author affi liations: University of Messina, D’Alessandro,” University of Palermo, via breaks (with >100 cases) of dermati- Messina, Italy (M. Foti, A. Daidone, A. del Vespro 133 I-90127, Palermo, Italy; email tis caused by P. ventricosus parasitic Pizzimenti, C. Giacopello); and Univer- [email protected] in Castellón, Spain, produced by sity of Palermo, Palermo, Italy (A. Aleo, C. different infected materials (2). When Mammina) we published the results, we concen- trated on the epidemiologic character- DOI: 10.3201/eid1503.080039 istics and the discovery of the ; perhaps we paid too little attention to References the appearance of the lesions, of which 1. Aleksic S, Heinzerling F, Bockemuhl Comet Sign (and we did not provide images. Neverthe- J. Human infection caused by salmo- Other) in Pyemotes less, we also observed the descriptions nellae of subspecies II to VI in Ger- by Del Giudice et al., which we now many, 1977–1992. Zentralbl Bakteriol. Dermatitis 1996;283:391–8. show in the Figure. In 2 patients (Fig- 2. Woodward DL, Khakhria R, Johnson WM. To the Editor: Recently, Pascal ure, panels A and B), the comet sign Human associated with ex- Del Giudice et al. published an inter- can be clearly assessed; the patients otic . J Clin Microbiol. 1997;35:2786– esting article (1) about dermatitis in were 2 women who had had direct con- 90. 3. Giammanco GM, Pignato S, Mammina France caused by Pyemotes ventrico- tact with the infected material against C, Grimont F, Grimont PA, Nastasi A, et sus in which they highlight the pres- their legs. The other patient (Figure, al. Persistent endemicity of Salmonella ence of the comet sign in a number of panel C) displayed 56 macules with 1 bongori 48:z :– in Southern Italy: mo- 35 their patients. It is, they assert, a sign pruritic central vesicle. We did not ob- lecular characterization of human, animal, and environmental isolates. J Clin Mi- that because of its peculiarity could serve facial lesions on any of the case- crobiol. 2002;40:3502–5. DOI: 10.1128/ JCM.40.9.3502-3505.2002 4. Le Minor L, Chamoiseau G, Barbe E, Charie-Marsaines C, Egron L. Dix nou- veaux sérotypes isolés au Tchad. Ann Inst Pasteur (Paris). 1969;116:775–80. 5. Orlandella BM. Sulle nuove salmonelle isolate in Italia e considerazioni sull’in- fezione salmonellare. Igiene Moderna. 1997;107:283–93. 6. Lo Valvo F, Lo Verde G, Lo Valvo M. Re- lationship among wing length, wing shape and migration in Blackcap (Sylvia atrica- pilla) populations. Ringing & Migration. 1988;9:51–4. 7. Jourdain E, Gauthier-Clerc M, Bicout DJ, Sabatier P. Bird migration routes and risk for dispersion into western Med- iterranean wetlands. Emerg Infect Dis. 2007;13:365–72. 8. Hernandez J, Bonnedahl J, Waldenström J, Palmgren H, Olsen B. Salmonella in birds migrating through Sweden. Emerg Infect Dis. 2003;9:753–5. 9. Hubálek Z, Sixl W, Mikuláskova M, Sixl- Voigt B, Thiel W, Halouzka J, et al. Sal- monellae in gulls and other free-living birds in the Czech Republic. Cent Eur J Public Health. 1995;3:21–4. 10. Chamberlain DE, Cannon AR, Toms MP. Associations of garden birds with gra- dients in garden habitat and local habi- Figure. Photographs of 3 persons with skin lesions of Pyemotes dermatitis during the same tat. Ecography. 2004;27:589–600. DOI: 10.1111/j.0906-7590.2004.03984.x outbreak in Castellón, Spain, showing the comet sign in 2 affected women (panels A, B), and macular form of the lesions in 1 of the affected investigators (panel C).

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