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Salmonella Dublin Outbreak Linked to Consumption of Raw-Milk Morbier Cheese: Update as of February 7, 2020
Thirteen cases of Salmonella Dublin are currently under investigation: a link has been identified to the consumption of raw-milk Morbier cheese between November 2019 and January 2020.
Salmonellosis
thematic dossier
Non-typhoid salmonellosis refers to infectious diseases caused by Salmonella bacteria that infect the digestive tract. These diseases are generally characterized by gastrointestinal symptoms.
Background / Alert
Santé publique France is currently investigating 13 cases of salmonellosis caused by Salmonella enterica serotype Dublin (S. Dublin) reported by the National Reference Center (CNR) for Salmonella (Institut Pasteur) because the strains belong to the same genomic cluster. The strains were isolated between week 48 (late November 2019) and week 1 (early January 2020). The cases include 8 men and 5 women, with a median age of 72 years. The cases are spread across 7 regions.
Among these 13 cases, 3 patients have died, though it is not yet clear whether salmonellosis was the cause of death.
Investigations
Epidemiological investigations conducted by Santé publique France
The onset of symptoms, for the cases interviewed, ranges from week 48 to week 1, with the majority of cases concentrated over a 3-week period (W48 to W50). Nine cases were hospitalized. The majority of cases reported having consumed raw-milk Morbier cheese, purchased from different retailers, prior to the onset of their symptoms.
Microbiological investigations by the CNR
The CNR confirmed that the S. Dublin strains from the 13 cases belonged to the same cluster using two complementary methods following whole-genome sequencing.
Traceability investigations by the DGAL and its DDPPs
Analysis by the Directorate General for Food (DGAL) of cheese purchases based on the cases’ loyalty cards revealed that the Morbier cheeses purchased by the cases came from the same supplier. Investigations at this producer’s facility are currently underway by the DDPP in coordination with the DGAL to identify the causes of this contamination and take the necessary corrective measures.
Control Measures
Following the results of the investigations, SA PERRIN (FR 25-155-001 CE), in coordination with health authorities, is proceeding on February 7, 2020, with the withdrawal from sale and recall of the following raw milk Morbier cheeses:
Whole wheels from batches: No. 23240923 (Best Before 02/10), 23240924 (best before 02/01), 23271122, 23271123, 23271124, 23271125, 23271126, and 23271127 (best before 03/05 and 03/30)
Cutting lot: No. 13 (Best Before 02/12)
These products are sold in the traditional and self-service sections of supermarkets and hypermarkets (GMS) throughout France and can be identified by the approval number (FR 25-155-001 CE) printed on the cheese or packaging.
Health authorities recommend that anyone who still has the affected products should not consume them and should return them to the store where they were purchased.
Overview of the Disease
Non-typhoid salmonellosis is an infectious disease caused by Salmonella bacteria, which infect the digestive tract (enterobacteria). These bacteria of the genus Salmonella primarily cause digestive disorders. Salmonella is one of the leading causes of foodborne bacterial illness in developed countries.
Salmonellosis manifests as isolated cases, community outbreaks, or outbreaks of foodborne illness (the occurrence of at least two clustered cases with similar symptoms, generally digestive, whose cause can be traced to a single food source).
Salmonella is primarily transmitted to humans through food when contaminated animal-derived foods are consumed raw or undercooked (meats, including ground meats and certain deli meats, eggs and products made with raw eggs, raw milk cheeses, etc.). In rarer cases, contamination can occur through the consumption of fresh fruits or raw vegetables contaminated by animal feces. Outbreaks of salmonellosis among infants and young children associated with the consumption of contaminated powdered milk can also occur.
Symptoms of salmonellosis appear after an incubation period of 12 to 72 hours on average. Clinical signs include acute gastroenteritis with sudden onset of abdominal pain, diarrhea (which may be bloody, particularly in infants), nausea, vomiting, fever, and headaches. Diarrhea often persists for several days and can lead to severe dehydration, particularly in vulnerable individuals (infants, young children, pregnant women, the elderly, or immunocompromised individuals). Salmonella infection can lead to complications such as generalized infection (sepsis), meningitis, or abscesses.
While the mortality rate associated with salmonellosis is low in non-immunocompromised adults, the number of cases and the costs associated with salmonellosis are significant.
Prevention Measures
The risk of salmonellosis transmission can be reduced through good hygiene practices, whether in institutional food service settings, at home, or through contact with animals.
In the context of home cooking, following simple recommendations can reduce the risk of salmonellosis:
wash your hands before cooking;
keep raw and cooked foods separate;
vulnerable individuals (young children, pregnant women, the elderly) should not consume raw or undercooked eggs;
ground meat and poultry must be cooked thoroughly;
vulnerable individuals (young children, immunocompromised individuals, the elderly) should avoid consuming raw-milk cheeses.
See also
Previous national outbreak in South Dublin, 2015–2016
