An outbreak of salmonella in chocolate candies detected in 10 European countries and in the United States

The World Health Organization reported this Wednesday of the appearance of an outbreak of salmonella that would have its origin in chocolate products of the brand Kindergarten produced in Belgium. The sweets would have been distributed in at least 113 countries and territories of all the regions of the health agency.

Although as of April 25, 2022, there are no known fatalities associated with the outbreak, more information is still needed to more accurately assess the severity associated with this episode, including data on symptoms.

Since the identification of existing cases was carried out using state-of-the-art molecular techniques, which are not routinely used in all countries, It points to the possibility that a part of the cases remain undetected.

Most of the cases happened in Europe

Until last Monday, practically all the cases were reported in ten European nations (150 of the 151), although an episode was also detected in the United States of America.

Similarly, it is indicated that, given the wide distribution of the products during the Easter holidays, it is likely that additional cases will be reported in other countries.

The first symptoms were detected between December 21, 2021 and March 28, 2022. The main affected by the outbreak were children under 10 years of age and women. Among the 21 severe cases reported, 12 had bloody diarrhea and nine were hospitalized.

Although salmonella infections are usually mild and do not require treatment, children and the elderly are at higher risk of serious complications from dehydration.

health response

The risk of spread of the outbreak within the European Region of the World Health Organization, as well as globally, rated as moderate until information is available on the full recall of the products involved.

Although the countries that reported the cases have good management capacity, it is also explained that the information on the severity of the disease associated with this event is still limited.

The countries that identified the cases of salmonella in chocolate investigated the food chain and took the corresponding risk management measures, such as the recall of all product lines manufactured in the facility involved in the outbreak.

The World Health Organization and the International Network of Food Safety Authorities issued a global alert on April 10 where they notified the member states of the outbreak and shared information on the products involved in the outbreak to initiate their withdrawal to world level.

Follow up and tips

The WHO Member States where the products affected by the outbreak were distributed must investigate and notify the health agency of salmonella cases and reinforce public health surveillance measures.

The prevention of salmonella requires control measures at all stages of the food chain, from agricultural production to processing, manufacturing and food preparation, both in commercial establishments and in the home.

Ordinary antibiotic treatment is not recommended for mild or moderate cases in healthy individuals.

The symptoms of salmonellosis are characterized by the appearance of high fever, abdominal pain, nausea, vomiting and bloody diarrhoea, as has been reported in most cases of the current outbreak.

The first symptoms usually occur between 6 and 72 hours after ingestion of food or water contaminated with Salmonella, and the illness lasts between two and seven days.

The symptoms of salmonellosis are relatively mild and patients recover without specific treatment in most cases. However, in some cases, the dehydration linked to the disease can be serious and life-threatening, especially in children and the elderly.

Salmonellosis prevention measures for the public are:

  • Wash your hands with soap and water, especially after coming into contact with pets or farm animals, or after going to the bathroom
  • Making sure food is well cooked
  • Drink only pasteurized or boiled milk
  • Do not drink ice unless it is made with drinking water
  • Thoroughly wash fruits and vegetables