Cucumber from Spain is suspected source of Salmonella Agona outbreaks in Norway, Sweden
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In a follow-up of the Salmonella Agona outbreaks in Norway, Sweden and the Dutch, Norwegian health authorities report that the results of the outbreak investigation show that some batches of cucumber from a Spanish supplier stand out as a likely source of infection. These batches of cucumber are no longer on the market and we have therefore not been able to test the product for the outbreak bacteria, says senior advisor at the Norwegian Institute of Public Health (FHI) Heidi Lange.
It is likely that the outbreak is over, but we cannot rule out that more individual cases may appear. We are following the situation closely, she says.
A total of 72 people live across the country who have been diagnosed with the gastrointestinal bacterium Salmonella Agona. All contracted salmonellosis during a short period, from the end of October to the beginning of December, with a peak in weeks 45 and 46. Cases with the same outbreak strain have also been reported in Sweden and the Netherlands during the same period.
Suspicion has therefore been directed at an imported food item that is available throughout the country, has a relatively short shelf life and is common for many people to eat, says Heidi Lange.
The Public Health Institute has analyzed over 50 patient interviews and purchase information. The institute has also carried out a case-control study comparing what the infected have eaten with what a random selection of other people have eaten. Almost 90 percent of those infected state that they have eaten cucumber in the week before they got sick, but since cucumber is common in Norway, this product does not appear in the case-control study. However, this study helps refute other hypotheses as a source of infection in this outbreak.
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In addition, the Norwegian Food Safety Authority has carried out extensive tracing work where certain batches of cucumber from a Spanish supplier have been identified as the most likely source of infection.
The outbreak investigation has been carried out in collaboration with local municipal chief medical officers, the Food Safety Authority and the Veterinary Institute.
Those infected are aged 1–88 years, the median age is 36 years and 37 of those infected are women. 24 of the infected have been admitted to hospital.
Bacteria with the same genetic profile have been detected in 58 of 72 infected people. For the remaining 14 infected, the sequencing results (results from examinations in the laboratory) are not yet ready.
The people live in Viken (18), Vestland (15), Vestfold and Telemark (14), Oslo (8), Innlandet (5), Rogaland (3), Trøndelag (3), Troms and Finnmark (3), Møre and Romsdal (2) and Nordland (1). It is only Agder county that has no registered infected persons in the outbreak.
Salmonella Agona is a rare serovariant of salmonella, both in Norway and the rest of Europe.
Salmonella Agona has previously been detected in Norway, but then only as isolated cases and often related to infection abroad.