ECDC and EFSA rapid outbreak assessment: multi-country Salmonella outbreak linked to chocolate products

The European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) have reported on a multi-country outbreak of monophasic Salmonella Typhimurium linked to chocolate products made at a factory in Arlon, Belgium, with most cases in children under ten years of age.

As of 8 April 2022, 150 cases, including 119 confirmed and 31 probable, have been reported in nine EU and EEA countries (Belgium, France, Germany, Ireland, Luxembourg, the Netherlands, Norway, Spain, and Sweden) and the UK. The first identified case was in the UK and had a sampling date of 21 December 2021. The ECDC and EFSA continue to monitor the situation and encourage member states to be alert for new cases, investigating human infections with strains that have multi-drug resistance profiles. Further sequencing of such isolates is recommended, and ECDC offers sequencing support for countries with limited or no genome-sequencing capacity.

In December 2021, Salmonella Typhimurium was detected in a buttermilk tank at the Belgian establishment during the manufacturer’s own checks. The company implemented some hygiene measures and increased sampling and testing of the products and the processing environment. After negative Salmonella testing, it then distributed the chocolate products across Europe and globally. At the end of March 2022, upon availability of sequencing data, scientists linked human cases to Belgium through advanced molecular typing techniques.

On 8 April 2022, the food safety authority in Belgium performed official controls at the factory and withdrew the company’s authorisation for production. In addition, the company recalled all batches of products produced at the Arlon factory, regardless of their lot number or expiration date. The recalls and withdrawals launched worldwide will reduce the risk of further infections. However, because molecular typing is not routinely performed in all countries, cases may go undetected.

Experts from ECDC and EFSA have concluded that further investigations are needed at the production site in Arlon, to identify the root cause, timing, and possible factors behind the contamination, including the evaluation of the possibility of the wider use of contaminated raw material in other processing plants.

Source: ECDC, 12 April 2022 and EFSA, 12 April 2022