Multi-country outbreak of monophasic Salmonella Typhimurium sequence type (ST) 34 linked to chocolate products

Risk assessment

On 17 February 2022, the United Kingdom (UK) reported a cluster of cases with monophasic Salmonella Typhimurium sequence type 34 infection. By 8 April 2022, 150 cases had been reported in nine EU/EEA countries and the UK. Most cases are below 10 years of age and many children have been hospitalised. The strain exhibits resistance to seven antimicrobial classes but remains susceptible to azithromycin, ciprofloxacin, meropenem, and cephalosporins. Case interviews and epidemiological investigations suggest specific chocolate products of Brand A, produced by Company A from Processing Plant B in Belgium as likely vehicles of infection.

Executive Summary

Monophasic Salmonella Typhimurium matching the human outbreak strain had been identified at Plant B in December 2021 in own-check samples. The processing step involving buttermilk was identified as the possible contamination point, and hygiene measures were implemented. Plant B distributed the implicated chocolate products across Europe and globally after negative Salmonella testing. Public warnings have been issued by the competent national authorities in different countries. On 8 April 2022, based on the official controls, the food safety authority in Belgium assessed that Plant B was not able to guarantee the safety of its products. As a result, the authorisation for production was withdrawn. Simultaneously, Company A decided to extend the recall to all batches of all products of Brand A produced at Plant B regardless of lot number or expiration date.

This outbreak is rapidly evolving, and children have so far been most at risk for severe infection among reported cases. The recalls and withdrawals launched worldwide will reduce the risk of further infections. However, further investigations are needed at the production site to identify the root cause, timing, and possible factors behind the contamination, including the evaluation of the possibility of the wider use of contaminated raw material in other processing plants.