Microbiological analysis of frozen profiteroles and mini chocolate eclairs implicated in a national salmonellosis outbreak

Rao, Mary; Tamber, Sandeep

doi:10.1016/j.fm.2021.103871

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…Twenty-three articles published between 1972 and 2022 were retained for the final analysis: 20 were written in English, 1 in Italian, 1 in Norwegian and 1 in Swedish. 6,11–32 The mentioned articles describe 12 outbreaks of nontyphoidal salmonellosis linked with chocolate consumption. The risk of bias assessment score could only be calculated for 7 studies (see Table, Supplemental Digital Content 2, http://links.lww.com/INF/F397) that were classified as case-control studies.…”

Section: Resultsmentioning

confidence: 99%

Nontyphoidal Salmonella Outbreaks Associated With Chocolate Consumption: A Systematic Review

Patà,

Faré,

Lava

et al. 2024

Pediatric Infectious Disease Journal

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Background: A large, cross-border outbreak of nontyphoidal salmonellosis connected to chocolate product consumption was recently reported. This occurrence motivated us to conduct a comprehensive review of existing literature concerning outbreaks of nontyphoidal salmonellosis associated with chocolate consumption. Methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42022369023) in 3 databases: U.S. National Library of Medicine, Web of Science and Excerpta Medica. Google Scholar and the bibliography of each identified report were also screened. Eligible were articles published after 1970, describing outbreaks of more than 10 patients with a nontyphoidal salmonellosis associated with chocolate consumption. Results: Twenty-three articles were included, which described 12 outbreaks involving a total of 3266 patients. All outbreaks occurred in high-income countries: 1 was limited to 1 city, 6 involved 1 country and the remaining 5 involved 2 or more countries. Six outbreaks peaked in winter, 3 in autumn, 2 in spring and 1 in summer. Children were mainly affected. No predominant serotype was identified. Conclusions: Our data documents that chocolate is an optimal medium for the transmission of nontyphoidal salmonellosis. A connected worldwide reporting system including high-income, middle-income and low-income countries is crucial to detect infectious diseases outbreaks in an early phase and avoid their spread.

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Section: Resultsmentioning

confidence: 99%

Nontyphoidal Salmonella Outbreaks Associated With Chocolate Consumption: A Systematic Review

Patà,

Faré,

Lava

et al. 2024

Pediatric Infectious Disease Journal

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“…Several outbreaks of salmonellosis have previously been associated with the consumption of chocolate [10][11][12]. Chocolate products can function as a particularly effective transmission vehicle.…”

Section: Discussionmentioning

confidence: 99%

Investigation of a monophasic Salmonella Typhimurium outbreak linked to chocolate products as part of wider international outbreak: A matched case–control study, Ireland, 2022

Nielsen,

Garvey,

Cormican

et al. 2023

Public Health Challenges

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BackgroundIn March 2022, an outbreak investigation was initiated in Ireland after identifying a cluster of monophasic Salmonella Typhimurium cases, affecting primarily small children. Microbiological investigations revealed that the cluster was part of a wider international outbreak.MethodsA total of 18 Irish outbreak cases were identified. We undertook a matched case–control study using the case–case method to determine if exposure to the implicated products was associated with illness.ResultsIn univariable analysis, the highest odds of disease due to monophasic S. Typhimurium versus other gastrointestinal disease were obtained for a chocolate Product A of Brand A [matched odds ratio (mOR) = 7.77, 95% confidence intervals (CI): 0.89–67.20]. When grouping the implicated products in a composite variable, the odds of disease due to monophasic S. Typhimurium versus other gastrointestinal disease were 10.5 times higher with a consumption of at least one of the implicated products [mOR = 10.50, 95% CI: 1.24–88.60, p = 0.031].ConclusionThis analytical study supported the internationally generated hypothesis which led to the implementation of control measures. Owing to the high levels of chocolate purchasing with Easter approaching, early outbreak identification and involvement in the internationally coordinated investigation was essential to an efficient response and to minimise the risk of further harm to a particularly vulnerable population group.

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“…Historically, chocolate-associated outbreaks have been protracted and usually of large scale, probably reflecting both the long shelf life of chocolate and the long survival of Salmonella in these products, as well as difficulties in detecting and resolving such outbreaks [ 7 - 9 ]. Previous investigations have resulted in recovery of only small amounts of Salmonella bacteria from sampling of chocolate products, suggesting that contamination in chocolate may be difficult to detect in product sampling, as well as difficult to mitigate through routine food hygiene procedures [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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

Larkin¹,

Gándara

Hoban³

et al. 2022

Eurosurveillance

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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.

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Microbiological analysis of frozen profiteroles and mini chocolate eclairs implicated in a national salmonellosis outbreak

Cited by 9 publications

References 18 publications

Nontyphoidal Salmonella Outbreaks Associated With Chocolate Consumption: A Systematic Review

Nontyphoidal Salmonella Outbreaks Associated With Chocolate Consumption: A Systematic Review

Investigation of a monophasic Salmonella Typhimurium outbreak linked to chocolate products as part of wider international outbreak: A matched case–control study, Ireland, 2022

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

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