One sick in U.S. as part of 11-country Salmonella outbreak traced to Ferrero chocolate

The United States has joined at least 10 other countries in recording a patient in the Ferrero chocolate Salmonella outbreak.

The World Health Organization (WHO) revealed the U.S. was affected in the monophasic Salmonella Typhimurium outbreak. It has not been reported when the person fell sick or where they live.

A spokeswoman at the Centers for Disease Control and Prevention (CDC) said: “The CDC is aware of one single case identified in the U.S. related to a possible Salmonella outbreak linked to Ferrero chocolate. However, we do not have follow-up information on the patient to confirm the link to said product. No other cases have been identified (in the United States).”

Recalls were previously issued in many countries, including the U.S. and Canada but there are no related illnesses in the latter country.

Multi-country outbreak
It is possible that further cases could be reported from other countries given the broad distribution of the products during the Easter season, which may lead to increased consumption or transportation to additional locations as a result of holiday-related travel, according to the WHO.

WHO said 151 genetically related cases suspected to be linked to the implicated chocolate products have been reported from 11 countries.

However, earlier figures from the European Centre for Disease Prevention and Control (ECDC) show 210 confirmed and probable cases from 12 countries. Children younger than 10 years of age and females have been most affected.

This includes 80 from the United Kingdom, 42 from France, 34 in Belgium, 18 in Germany, 16 in Ireland, six in Austria, four in Sweden, three in the Netherlands and Spain, two in Luxembourg and one in Denmark and Norway.

Since the ECDC stats were published, Austria and Spain have recorded an additional patient, another 20 infections are under investigation in Belgium, several cases in Switzerland have been linked to the outbreak and there are unconfirmed reports of an illness in Italy.

ECDC and the European Food Safety Authority (EFSA) are working on an update to the outbreak assessment published in April, which is expected on May 18.

In a virtual media briefing this week, ECDC director Andrea Ammon told reporters the recall should reduce the number of people getting sick.

“We are monitoring now the developments but we are expecting that the cases will go down,” she said.

Distribution to more than 110 countries
A total of 49 of 116 cases were hospitalized and 88 of 101 interviewed sick people in 10 countries reported eating various Ferrero chocolate products.

The first patient was reported in the UK on Jan. 7, with a sampling date of Dec. 21, 2021. The UK issued a notice on a European platform on Feb. 17 and another alert on March 25. It notified the WHO about the cluster of monophasic Salmonella Typhimurium on March 27.

The outbreak strain is resistant to six types of antibiotics: penicillin, aminoglycosides, phenicols, sulfonamides, trimethoprim and tetracycline but is susceptible to fluoroquinolones, azithromycin and third-generation cephalosporins.

Chocolate produced in Belgium was distributed to at least 113 countries. A global alert was made by the International Food Safety Authorities Network (INFOSAN) on April 10. Brazilian officials have banned the sale and import of Kinder products manufactured by Ferrero in Belgium after distribution was confirmed in the country.

Risk of spread in the WHO European region and globally is assessed as “moderate” until information is available on the full recall of products, said WHO.

Monophasic Salmonella Typhimurium matching the outbreak cases was identified in buttermilk tanks at the Ferrero plant in Arlon, Belgium in December 2021 and January 2022. After implementing hygiene measures and negative Salmonella testing, the implicated Kinder products were distributed across Europe and worldwide.

Belgian authorities stopped production at the facility in April, and an investigation has been opened by the Luxembourg Public Prosecutor’s Office.

About Salmonella infections
Food contaminated with Salmonella bacteria does not usually look, smell, or taste spoiled. Anyone can become sick with a Salmonella infection. Infants, children, seniors, and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC.

Anyone who has eaten any Kinder chocolates and developed symptoms of Salmonella infection should seek medical attention. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis.

Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Otherwise, healthy adults are usually sick for four to seven days. In some cases, however, diarrhea may be so severe that patients require hospitalization.

Older adults, children, pregnant women, and people with weakened immune systems, such as cancer patients, are more likely to develop a severe illness and serious, sometimes life-threatening conditions.

Some people get infected without getting sick or showing any symptoms. However, they may still spread the infections to others.

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