174 sickened in Sweden from Salmonella in spices

From 24 December to 24 July 2015, 174 cases were reported in a nationwide salmonellosis outbreak in Sweden: 108 cases were connected to a single restaurant. A spice mix, containing dried vegetables from the restaurant tested positive for the outbreak strain.

salm.spice.swedenAdditional spice mixes with similar content from different suppliers also tested positive. The outbreak investigation suggests there could be a risk of contaminated products being also on the market in other countries.

Outbreak of Salmonella Enteritidis phage type 13a infection in Sweden linked to imported dried-vegetable spice mixes, December 2014 to July 2015

Eurosurveillance, Volume 20, Issue 30, 30 July 2015

Jernberg C, Hjertqvist M, Sundborger C, Castro E, Löfdahl M, Pääjärvi A, Sundqvist L, Löf



Epidemiology counts: 143 sick with Salmonella in Sweden linked to spice mix

In the latest incident, at least 80 people picked up salmonella at a restaurant on the Swedish island of Öland last week, with Sweden’s Public Health Authority connecting the outbreak to the savoury spice mix, known as Allkrydda, which is sold in supermarkets across the nation.

Sevan AllkryddaIt said the mix was already suspected of making dozens of other people ill, with a total of 143 salmonella cases reported in 17 out of Sweden’s 21 regions since December 2014.

“This is one of the largest outbreaks in recent years,” Jonas Toljander, a spokesperson for Sweden’s Food Standards Agency (Livsmedelsverket) told the TT newswire on Tuesday.

He added that the spice mix, produced by food company Sevan, was thought to be behind the nationwide salmonella scare, although experts had yet to definitively prove a link.

“It is important to say that we do not yet know if our products are linked to this,” the business manager for Sevan, Julia Kronlund, explained to Swedish broadcaster SVT on Tuesday.

“What they [the victims] have in common is that they have consumed the seasoning mix,” she said, but added that other potential causes of the outbreak could not yet be excluded.

A spokesperson for Sweden’s Public Health Agency (Folkhälsomyndigheten) told TT that it was now carrying out tests on similar spices, while Sevan said that it had submitted more samples to be checked over by experts.

But Sevan said it was recalling all Allkrydda products sold since 2014, in order to avoid exposing customers to any unnecessary risks. It advised people who had the spice jars at home to return them to the stores where they bought them from, where they would be granted a refund, with Sevan footing the bill.

The recalled spice products are:

Sevan Allkrydda 900g (serial number 7221217881469)

Sevan Allkrydda 450g (serial number 7331217881452)

Sevan Allkrydda Hink 5kg (serial number 7331217010708)

40 sick in Sweden from Cryptosporidium at kosläpp (letting the cows out)

Apparently it’s a thing in Sweden to go and watch the cows being let out; so is Cryptosporidium.

kosläppSome 40 people have fallen ill after being infected by Cryptosporidium, reports Skovde News.

It is associated with kosläpp, a Hjo and one in Skövde, two outbreaks occurred in May.

Infectious disease doctors in the area now warning parents to let young children petting calves at kosläpp and immediately afterwards eat food or refreshments, writes Skovde News. Then they risk getting upset stomach with abdominal pain and diarrhea.

‘They should have been boiled’ 2 dead, 60 sick from Norovirus in frozen raspberries in Swedish retirement homes

I didn’t think about it much until a couple of years ago, but now I boil all frozen berries.

frozen_raspberries(1)(1)Apparently that’s a good idea.

But sad that consumers have to be the critical control point.

Two people have died of suspected food poisoning and another hospitalized. Some 60 people have suffered food poisoning on several retirement homes in Ljungby municipality. The cause is believed to be the raspberries in a dessert.

The raspberries served at several retirement homes in Ljungby municipality boiled never – contrary to the recommendations contained.

One should always boil the frozen foreign raspberries, says Elsie Castro, a molecular biologist at the National Public Health Agency.”

Mariana Axelsson, nutrition manager in Ljungby municipality, admits that the infected raspberries that caused an outbreak of Norwalk virus should have been cooked. The procedures have failed and will now be reviewed.

Hallonparfaiten served on several retirement homes in Ljungby and caused 60 people fell ill with Norwalk virus. Two elderly also have died , probably as a result of the disease.

Sweden screens for STECs in kids

Background: Shiga toxin (Stx)-producing Escherichia coli (STECs) are the most common cause of acute renal failure in children. The present study evaluated a 10-year STEC polymerase chain reaction screening regimen in children.

dirty.jobs.daycare.e.coliMethods: All routine stool culture specimens from patients below 10 years of age (n = 10 342) from May 2003 through April 2013 in the County of Jönköping, Sweden, were included. Patients were divided in 1 group where analyses of STEC were requested by the clinician (n = 2366) and 1 screening group (n = 7976). Patients who were positive for STEC were tested weekly until they were negative. Clinical data were collected through a questionnaire and by reviewing medical records.

Results: In specimens from 191 patients, stx was found (162 index cases). The prevalence was 1.8% in the requested group and 1.5% in the screening group (P = .5). Diarrhea was the most frequent symptom reported in 156 cases and of these 29 (19%) had hemorrhagic colitis (HC) and 7 children developed hemolytic uremic syndrome (HUS). No difference regarding severity of symptoms between the groups was found. Stx2 predominated in cases with HC (P < .0001) and HUS (P = .04). Median stx shedding duration was 20 days (1–256 days), and no difference in duration was seen between stx types (P = .106–1.00) and presence of eaeA (P = .72).

Conclusions: Most STEC cases were found in the screening group with comparable prevalence and disease severity as in patients where analysis was requested. Furthermore, non-O157 serotypes caused severe disease when carrying stx2, and prolonged shedding of STEC may be a risk for transmission.

 Shiga toxin-producing Escherichia coli in diarrheal stool of Swedish children: Evaluation of polymerase chain reaction screening and duration of shiga toxin shedding

Journal of the Pediatric Infectious Diseases Society

Andreas Matussek, Ing-Marie Einemo, Anna Jogenfors, Sven Löfdahl3 and Sture Löfgren


STECs in Sweden on beef and leafy vegetables

This study investigated the occurrence of Shiga toxin-producing E. coli (STEC) in beef and leafy greens available on the Swedish market. New data are required for assessing the public health risk of STEC in food, which could be used for developing risk management strategies.

beef.stecFood samples were collected at retail stores, importers, outlets and the markets. Samples of minced or whole meat from cattle collected were fresh or frozen from 2010 to 2011. The beef sample collection included products from the most common countries or regions exporting beef to Sweden. The collection of leafy greens consisted of domestic and imported products that were available on the Swedish market from 2012 to 2013.

Detection of virulence genes (stx 1, stx 2, eae) and genes specific for different serogroups (O26, O103, O111, O145 and O157) was performed by real-time PCR followed by isolation of bacteria from the stx -positive enriched samples by use of immunomagnetic separation. STEC bacteria were overpriced isolated by an immunoblot thing method. All STEC isolated from the food samples were serotyped.

STEC was isolated from 23 (13 percent) of the 177 imported beef samples tested. Approximately 3 percent of the beef samples contained STEC on positive stx 2 and eae, both of which are important markers for the probability of the bacteria to  cause severe disease. In total, 27 STEC were isolated, belonging to 14 different serogroups. STEC O26 was most common (approximately 2 percent of the beef samples), whereas STEC O157, frequently implicated in STEC-related foodborne outbreaks in Sweden, was found in two (one percent) of the beef samples.

swedish-chefThe enrichment broth of 11 (approximately 2 percent) of the 630 samples from leafy greens were tested positive for stx 1 and / or stx 2 by PCR analysis; however, no bacteria were isolated. Presumptive STEC was detected in co-enriched samples from bothering domestic and imported products. E. coli was found in 68 (39 percent) out of 174 and 14 (30 percent) out of 46 samples of imported and English leafy greens, respectively, indicating that the proportion of stx -positive E. coli into the samples was low.

173 sick: Swedish school suffers vomiting bug outbreak

As the annual winter vomiting bug season starts to kick in it’s the Tofta high school in the south which is bearing the brunt of it so far. 

vomit.2In total 173 people who attend or work at the school have been affected by the bug. Even the headmaster hasn’t been spared.

“It struck last Friday but now I’m back at work,” headmaster Tobias Fahlén told the Expressen newspaper.

Parents reported that the bug began to take hold on Friday, with many stating that their children began vomiting uncontrollably. Several have asked the school to investigate the outbreak which has led to deserted classrooms.

As a result the school has now got in contact with the disease control centre in nearby Malmö. The centre advised the school to do some extra cleaning in the toilets and school kitchen to help combat the vomiting bug.

An epidemiologist with the disease control centre who is working with the school said it was most likely a vomiting bug that was ravaging the school, and not food poisioning as some parents had suspected.

Listeria fears prompt meat recall in Sweden

Tulip Food Company, which sells its meat products in both Denmark and Sweden, announced a recall of its Danish deli meat products on Friday after finding traces of listeria in portions of meat sold in Sweden.

2eb1ea2e55248a2b0bd20c0697e907e16ac21e40bbd998668014044d2c666427The company specified that the discovered amounts were miniscule, but that it was exercising caution.

“Listeria can grow in a product and even a very small amount can turn into a risky amount before the meat expires,” Michael Larsen, quality manager at Tulip Food Company, said in a statement.

The recalled products are Shächter Luftikus, Shächter Bauernskinka, Tulip Kokt Skinka, and Tulip Rökt Skinka, all in 500 gramme packages produced between August 7th and August 20th.

Contaminated meat has killed 13 people and caused at least 24 infections in Denmark, The Local Denmark reported. 

Salmonella prompts hamburger recall in Sweden

Swedish supermarket chain Coop has recalled its in-store brand of fresh hamburger meat after a routine check revealed traces of salmonella in the meat.

salm.coop.swedenCoop halted sales of its hamburger meat on Wednesday evening. The recall applies to Coop Hamburger 10×113 grammes, 4×113 grammes and 2×113 grammes, Coop Miniburger 8×56,5 grammes and Coop Megaburger 2×170 grammes.

The affected meat has been sold throughout Sweden and has a best-before date of August 5th, 2014. 

Barriers to trace-back in a salad-associated EHEC outbreak, Sweden, June 2013

In June-July 2013, six counties notified the Swedish Institute for Communicable Disease Control of enterohaemorrhagic E.coli (EHEC) infections among attendees at a hotel in Dalarna, Sweden. An outbreak control team investigated to identify the source and implement control measures.

lettuce.skull.e.coli.O145We included individuals who attended the hotel between June 19th-25th in a cohort. We asked them about animal contact, swimming, and consumption of food items during this time using a questionnaire. A confirmed case was an EHEC O157:H7 outbreak strain positive individual who developed abdominal pain or diarrhoea between June 20th-July 2nd. We described the outbreak in time, place and person, calculated risk ratios (RR) and 95% confidence intervals (CI). We investigated the kitchen, tested and traced back implicated food items.

172 individuals responded. We identified 19 confirmed cases (Median age: 17 years, 64% female) with symptom onset between June 22nd-27th. Eating green salad on June 20th was associated with illness (RR:3.7;CI:1.3–11). The kitchen mixed green salads without records and destroyed leftovers immediately. Hence we could not conduct trace-back or obtain microbiological confirmation.

Green salad contaminated before entering the kitchen was the likely outbreak source. We recommended early collaboration with food agencies and better restaurant records to facilitate future investigations.

PLOS Currents Outbreaks

Michael Edelstein, Camilla Sundborger, Maria-Pia Hergens, Sofie Ivarsson, Rikard Dryselius, Mona Insulander, Cecilia Jernberg, Yvan Hutin, Anders Wallensten