Investigation of an international outbreak of multidrug-resistant monophasic Salmonella Typhimurium associated with chocolate products, EU/EEA and United Kingdom, February to April 2022

Author:

Larkin Lesley1,Pardos de la Gandara Maria2,Hoban Ann1,Pulford Caisey1,Jourdan-Da Silva Nathalie3,de Valk Henriette3,Browning Lynda4,Falkenhorst Gerhard5,Simon Sandra6,Lachmann Raskit5,Dryselius Rikard7,Karamehmedovic Nadja8,Börjesson Stefan7,van Cauteren Dieter9,Laisnez Valeska109,Mattheus Wesley11,Pijnacker Roan12,van den Beld Maaike12,Mossong Joël13,Ragimbeau Catherine14,Vergison Anne13,Thorstensen Brandal Lin15,Lange Heidi15,Garvey Patricia16,Nielsen Charlotte Salgaard1016,Herrera León Silvia17,Varela Carmen18,Chattaway Marie19,Weill François-Xavier2,Brown Derek20,McKeown Paul16

Affiliation:

1. Gastrointestinal Infections and Food Safety (One Health Unit), UK Health Security Agency, London, United Kingdom

2. Institut Pasteur, Université Paris Cité, Centre National de Référence des E. coli, Shigella et Salmonella, Unité des Bactéries pathogènes entériques, Paris, France

3. Sante Publique France, Direction des Maladies Infectieuses Unité EAZ, Paris, France

4. Clinical and Protecting Health Directorate, Public Health Scotland, Glasgow, United Kingdom

5. Robert Koch Institute, Department of Infectious Disease Epidemiology FG 35 - Gastrointestinal Infections, Zoonoses and Tropical Infections, Berlin, Germany

6. Robert Koch Institute, Department of Infectious Diseases, Unit for Enteropathogenic Bacteria and Legionella / National Reference Centre for Salmonella and other Bacterial Enterics, Wernigerode, Germany

7. Public Health Agency of Sweden, Unit for Zoonoses and Antibiotic Resistance, Stockholm, Sweden

8. Public Health Agency of Sweden, Unit for laboratory surveillance of bacterial pathogens, Stockholm, Sweden

9. Epidemiology of infectious diseases, Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium

10. ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden

11. National Reference Centre for Salmonella and Shigella, Sciensano, Brussels, Belgium

12. National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, Netherlands

13. Health Inspection, Health Directorate, Luxembourg

14. Laboratoire National de Santé, Epidemiology and Microbial Genomics, Dudelange, Luxembourg

15. Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway

16. HSE -Health Protection Surveillance Centre, Dublin, Ireland

17. Instituto de Salud Carlos III. Centro Nacional de Microbiología, Madrid, Spain

18. Instituto de Salud Carlos III. CIBER epidemiología y salud pública. Madrid, Spain

19. Specialist Scientific Reference Service (Salmonella), Gastrointestinal Bacteria Reference Unit, UK Health Security Agency, London, United Kingdom

20. Scottish Microbiology Reference Laboratories, Glasgow, United Kingdom

Abstract

An extensive multi-country outbreak of multidrug-resistant monophasic Salmonella Typhimurium infection in 10 countries with 150 reported cases, predominantly affecting young children, has been linked to chocolate products produced by a large multinational company. Extensive withdrawals and recalls of multiple product lines have been undertaken. With Easter approaching, widespread product distribution and the vulnerability of the affected population, early and effective real-time sharing of microbiological and epidemiological information has been of critical importance in effectively managing this serious food-borne incident.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

Reference20 articles.

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4. GrapeTree: visualization of core genomic relationships among 100,000 bacterial pathogens.;Zhou;Genome Res,2018

5. European Committee on Antimicrobial Susceptibility Testing (EUCAST). EUCAST disk diffusion test methodology. Växjö, EUCAST; 2022. Available from: https://www.eucast.org/ast_of_bacteria/disk_diffusion_methodology

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