Published Date: 2004-12-19 23:50:00
Subject: PRO/EDR> Salmonellosis, serotype Thompson, lettuce - Norway (02)
Archive Number: 20041219.3350
SALMONELLOSIS, SEROTYPE THOMPSON, LETTUCE � NORWAY (02)
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Date: Sat, 18 Dec 2004
From: ProMED-mail <promed@promedmail.org>
Source: Eurosurveillance Weekly 16 Dec 2004 Vol 8 Issue 51 [edited]
<http://www.eurosurveillance.org/ew/2004/041216.asp>
International outbreak of Salmonella Thompson caused by contaminated
ruccola salad � update
----------------------
We recently reported an outbreak of Salmonella Thompson associated with
ruccola salad* in Norway [1]. Almost all of patients interviewed mentioned
having eaten ruccola from a pre-prepared salad mix in pre-packed plastic
bags. So far, 20 laboratory confirmed cases linked to this outbreak have
been identified in Norway. No new cases have been reported in Dec 2004.
Based on evidence from our epidemiological investigation, the NorwegianFood
Safety Authority temporarily withdrew the incriminated product from the
market on 25 Nov 2004. The decision was also influenced by an alert of
_Salmonella enterica_ serotype Thompson isolated from ruccola salad sent by
the Swedish National Food Administration through the European Rapid Alert
System for Food and Feed
(RASFF, <http://europa.eu.int/comm/food/food/rapidalert/>). The ruccola in
both Norway and Sweden came from the same producer in Italy. After control
measures were implemented by the Norwegian Food Safety Authority and the
distributor of the incriminated salad, the ban was lifted on the 14 Dec 2004.
A request for information was sent via Enter-net (the international
surveillance network for human gastrointestinal infections,
<http://www.hpa.org.uk/hpa/inter/enter-net_menu.htm>) on 19 Nov 2004, to
ascertain whether any other country had noticed an increase in
notifications of Salmonella Thompson infections. Sweden and England and
Wales reported possible increases in cases of _S._ Thompson from Aug 2004,
while other countries had not experienced any increase in this serovar
recently [2,3].
_S_. Thompson is a rare serovar; data from the Enter-net salmonella
database show that in 2003, there were only 192 cases out of 73 894 (0.26
percent) reported in Europe, and in 2002 there were 153 out of 70 296
(0.22 percent). The emergence of this rare serotype in three countries at
the same time is a very unusual event. PFGE analyses to determine any
relationship between isolates from cases in England and Wales, Norway and
Sweden are being performed. Isolates from foods are also included in the
PFGE analysis.
Recently, salmonella in ruccola imported from Italy has been detected in
Denmark (type not specified) and in Slovenia (_Salmonella_ Napoli) [2], as
well as campylobacter in this ruccola in Sweden. In Norway, _Salmonella_
Braenderup has been isolated from a sample from a pre-packed bag with mixed
salad containing ruccola.
Although few countries have reported cases related to this outbreak, the
fact that different serovars have been detected in different countries may
indicate that the outbreak is not limited to _Salmonella_ Thompson cases.
This emphasises the need for good manufacturing practices for fruit and
vegetables that are to be consumed raw, and the potential for large
outbreaks related to fresh produce with wide distribution. Of great value
in this outbreak investigation was rapid communication of information
through international networks such as Enter-Net, the Early Warning and
Response System and RASFF.
*Eruca sativa, also known as rocket or arugula
1. Nygard K, Lassen J, Vold L, Aavitsland P. Outbreak of Salmonella
Thompson infections caused by contaminated ruccola (rocket) salad.
Eurosurveillance Weekly 2004; 8: 04/11/25
(<http://www.eurosurveillance.org/ew/2004/041125.asp#1>).
2. Andersson Y, Hjertqvist M, L�fdahl S. Mera Salmonella och
ruccolasallad. Epi-aktuellt 2004: 50
(<http://www.smittskyddsinstitutet.se/SMItemplates/BigArticle____4425.aspx
#Mera%20Salmonella%20och%20ruccolasallad>)
3. HPA. Salmonella serotypes recorded in the Health Portection Agency
Salmonella data set: July to September 2004. Commun Dis Rep CDR Wkly
2004:14(50):
enteric. (<http://www.hpa.org.uk/cdr/pages/enteric.htm#Gen_44_48>)
[Reported by: Karin Nyg�1 (kany@fhi.no), J�rgen Lassen1, Line Vold1,
Preben Aavitsland1 and Ian Fisher2
1 Norwegian Institute of Public Health, Oslo, Norway
2 Enter-Net project coordinator, Health Protection Agency Centre for
Infections, London, United Kingdom]
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ProMED-mail
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See Also
Salmonellosis, serotype Thompson, lettuce - Norway: alert 20041128.3178Salmonellosis, serotype Newport - UK (England)(03) 20041012.2786
Salmonellosis, serotype Newport - UK (England) 20040920.2604
2003
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E. coli O157, salad - USA (CA) (02) 20031010.2552
E. coli O157, salad - USA (CA) 20031009.2542
2002
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E. coli O157, lettuce: alert (03) 20020803.4934
2000
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Salmonella typhimurium DT204B - Europe 20001222.2253
....................mpp/ll/dk
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