Salmonella in an egg, no surprise

EFSA and ECDC investigation

The EFSA and the ECDC (European Centre of Disease Prevention and Control) are looking into a multi-country Salmonella incident connected to chocolate goods (ECDC, 2022). However, foodborne incidents have been recorded ever since the 1970s due to consuming Salmonella-contaminated chocolate foods (D'Aoust, 1977; Werber et al., 2005). Processed foodstuffs such as peanut butter, baby formula chocolate, cereal products and dried milk are usually low-water-activity foods and do not promote the growth of pathogen bacteria such as Salmonella (Podolak et al., 2010). However, outbreaks of monophasic Salmonella are quickly spreading throughout seven EU/EEA nations, including the United Kingdom (UK). One hundred thirty-four instances have been documented as of 5 April 2022, predominantly among youngsters under ten. On 7 January 2022, the United Kingdom discovered the first case. Since 17 February 2022, instances have also been found in Europe (ECDC, 2022).

Salmonella contamination

Patient interviews and preliminary epidemiological investigations have led researchers to suspect certain chocolate goods as the probable source of illness (ECDC, 2022). In addition, salmonella contamination that happens after a lethal heat step might pose severe threats to the safety of the food products (Podolak et al., 2010). Salmonella cross-contamination in low-moisture foodstuffs has been linked to poor sanitation, inadequate equipment design, and ineffective ingredients management. Salmonella is widely known for its ability to thrive in low-moisture food items for extended periods (Podolak et al., 2010).

Symptoms

Salmonella infections commonly cause symptoms between 12 and 36 hours after infection. However, this might vary between 6 and 72 hours (FSAI, 2022). The most frequent symptom is diarrhoea, which may be bloody at times. Fever, headache, and stomach pains are possible additional symptoms. The illness lasts typically between 3 and 6 days (QAssurance, 2022). Diarrhoea may sometimes be severe enough to need hospitalization. The elderly, babies, and individuals with compromised immune systems are at a higher risk of developing serious illnesses. (QAssurance, 2022). The EFSA and ECDC have recorded multiple salmonella cases in the last month.

Table 1. The frequency of confirmed and probable cases* of monophasic S. Typhimurium infection by nation, EU/EEA, and the United Kingdom as of 5 April 2022 (ECDC, 2022).

Country	Confirmed cases	Probable cases	Total No of cases
Belgium	0	26	26
France	20	0	20
Germany	4	3	7
Ireland	10	0	10
Luxembourg	1	0	1
Netherlands	2	0	2
Norway	1	0	1
Sweden	4	0	4
Total EU/EEA	42	29	71
United Kingdom	63	0	63
Total	105	29	134

              Due to the immense possible salmonella cases in chocolate, the Irish food safety authority has announced an Extended Recall of chocolate Products of Kinder by Ferrero (FSAI, 2022).

iMIS records

              Nonetheless, chocolate contamination in chocolate has been happened before, according to the following Salmonella – Chocolate Hazard Cases records gathered by QAssurance;

Marshmallow easter eggs with chocolate casing infected with Salmonella?

• Hazard Salmonella
• Product Marshmallow easter eggs with chocolate casing
• Date 2 March 2013
• Location The United States

Case

The company Zachary recalled marshmallow chocolate pudding with chocolate casing because they were suspected of being contaminated with Salmonella. One laboratory believed to have found Salmonella, and the company decided to conduct a recall less than a month before Easter in consultation with the Food and Drug Administration (FDA). However, one day after the recall, the test proved a false positive result and nothing was going on.

Commentary

Laboratory mistakes can cause severe damage. Therefore, companies must carefully select their laboratories. Nevertheless, it is good to understand that Zachary has performed this recall because chocolate season items, such as Christmas wreaths, were involved in Salmonella food infections in the past.

Case Sources

• https://www.nbcnews.com/health/health-news/no-salmonella-candy-eggs-after-all-firm-says-flna1c8654123   

Mars recalls chocolate in Great Britain and Ireland

• Hazard Salmonella
• Product Chocolate
• Date June 2017
• Location Britain and Ireland

Case

In Great Britain and Ireland, a large recall occurred in various chocolate products from Mars because of salmonella contamination. Mars has not announced what type of Salmonella was present precisely. However, there are no indications that people have become ill.

Commentary

This recall concerns a wide range of popular Mars products. In the past, seasonal chocolate items, such as Christmas wreaths, have been the cause of Salmonella food infections. In addition, Cacoa can be infected with Salmonella. Salmonella can endlessly survive in high-fat foods and low water activity, such as peanut butter and chocolate. Salmonella can even survive at a temperature of 90 ° C for fifty minutes.

Case Sources

• https://www.theguardian.com/business/2017/jun/09/mars-recalls-galaxy-teasers-minstrels-salmonella-fears-uk-chocolate#:~:text=Mars%20has%20recalled%20some%20Galaxy,the%20products%20might%20contain%20salmonella.&text=The%20recall%2C%20described%20as%20a,in%2055%20countries%20last%20year.
• https://www.fsai.ie/news_centre/food_alerts/mars_recall_salmonella.html
• https://www.bbc.com/news/business-40226415

Cross-contamination in the laboratory

• Hazard Salmonella Rissen
• Product Chocolate
• Date 10 September 2015
• Location Belgium

Case

The import of four containers of Belgian chocolate has been blocked in the United States because Salmonella Rissen was isolated from one of the chocolate bars. The discovery of Salmonella in the strips was unexpected because all of the ingredients had been examined during the production, and there was no Salmonella detected therein. Moreover, Salmonella Rissen is a type of Salmonella rarely isolated from food. Soon there was the idea that this might implicate cross-contamination in the laboratory because the same laboratory had already sent back seven weeks earlier a Salmonella Rissen isolated from a batch of fish flour. Both isolates were tested for their DNA profile to assess whether this idea was based on truth. To ensure that sufficient distinctiveness was in the DNA tests, the researchers took eleven other varieties of Salmonella Rissen along in their research, all from different sources. It turned out that the hypothesis that this was indeed cross-contamination was true. The researchers published the results in 2016 and warned of cross-contamination in the laboratory.

Commentary

This Belgian researcher published a significant risk that both government and businesses must deal with, namely false-positive or false-negative test results. In 2012, the discovery of E. coli O157: H7 in salad led to a massive recall in the US. A day later, the results of the laboratory proved false positive. The damage was already done. Laboratories must have watertight procedures, and principals must remain highly critical. Insurance for damage caused by incorrect laboratory results may be helpful.

Case Sources

• https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-016-1969-7

Chocolate waffles with Salmonella Enteritidis

• Hazard Salmonella Enteritidis
• Product Chocolate waffles
• Date 10 June 2021
• Location Sweden

Case

At least 32 people have become ill from eating chocolate wafers contaminated with Salmonella Enteritidis in Sweden. The outbreak started in late 2020, and people were still getting sick by mid- 2021. The waffles were produced in Poland and sold by the Swedish supermarket chain Axfood. The Swedish authorities isolated the S. Enteritidis from the chocolate wafers. However, the patients had the same DNA as the Salmonella found.

Commentary

Salmonella on chocolate is more common. Due to the fat in the chocolate, the Salmonella bacteria can survive for a long time but cannot grow on the chocolate. There is some evidence that chocolate protects bacteria from stomach acid. Most chocolate outbreaks don't make people sick. It turned out that the products had already been rejected but were sold again. This again shows that a good blocking form is significant.

Case Sources

• https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utbrott/utbrottsarkiv/salmonella-enteritidis-sverige-december-2020/#:~:text=I%20slutet%20av%20december%202020,%C3%A5r%20(n%3D4)
• https://www.axfood.se/nyhetsrum/pressmeddelanden/2021/04/axfood-aterkallar-eldorado-wafers-choklad-415g/
• Werber, D., Dreesman, J., Feil, F., Van Treeck, U., Fell, G., Ethelberg, S., … & Ammon, A. (2005). International outbreak of Salmonella Oranienburg due to German chocolate. BMC Infectious Diseases, 5(1), 1-10.
• Kapperud, G., Gustavsen, S., Hellesnes, I., Hansen, A. H., Lassen, J., Hirn, J., … & Helmuth, R. (1990). Outbreak of Salmonella typhimurium infection traced to contaminated chocolate and caused by a strain lacking the 60-megadalton virulence plasmid. Journal of Clinical Microbiology, 28(12), 2597-2601.

References

• D'Aoust, J. Y. (1977). Salmonella and the chocolate industry. A review. Journal of Food Protection, 40(10), 718-727.
• ECDC. (2022, 6 April). EFSA and ECDC investigate multi-country salmonella outbreak linked to chocolate products. European Centre for Disease Prevention and Control. Retrieved 8 April 2022, from https://www.ecdc.europa.eu/en/news-events/efsa-and-ecdc-investigate-multi-country-salmonella-outbreak-linked-chocolate-products
• FSAI. (2022, 5 April). Extended recall of additional kinder products due to the possible presence of Salmonella. Retrieved 8 April 2022, from https://www.fsai.ie/news_centre/food_alerts/extended_kinder_recall.html
• iMIS. (2022 8 April). Salmonella Endritis iMIS Knowledge Sheet https://www.qassurance.com/salmonelle-enteritidis-imis-knowledge-sheet/
• Podolak, R., Enache, E., Stone, W., Black, D. G., & Elliott, P. H. (2010). Sources and risk factors for contamination, survival, persistence, and heat resistance of Salmonella in low-moisture foods. Journal of food protection, 73(10), 1919-1936.
• Werber, D., Dreesman, J., Feil, F., Van Treeck, U., Fell, G., Ethelberg, S., … & Ammon, A. (2005). International outbreak of Salmonella Oranienburg due to German chocolate. BMC Infectious Diseases, 5(1), 1-10.