On 27 March 2022, WHO was informed by the IHR National Focal Point of the United Kingdom of a widely distributed cluster of Salmonella enterica serovar Typhimurium (S. Typhimurium) with an unidentified source. Molecular typing confirmed isolation of the bacteria S.
Typhimurium sequence typing (ST) 34 and epidemiological evidence has subsequently linked the outbreak to chocolate products from Belgium, which, as of 25 April 2022, have been found to be distributed to at least 113 countries and territories across all WHO Regions.
Monophasic S. Typhimurium matching the human outbreak cases were identified in buttermilk tanks at the Ferrero Corporate plant in Arlon, Belgium in December 2021 and January 2022. After implementing hygiene measures and negative Salmonella testing, the implicated products (all Kinder products manufactured at the implicated facility (Arlon) including Kinder Surprise, Kinder Mini Eggs, Kinder Surprise Maxi 100g and Kinder Schoko-Bons) were distributed across Europe and globally.
According to the analyses of the United Kingdom Health Security Agency (UKHSA), the outbreak strain is resistant to six types of antibiotics: penicillins, aminoglycosides (streptomycin, spectinomycin, kanamycin, and gentamycin), phenicols, sulfonamides, trimethoprim, tetracyclines.
As of 25 April 2022, a total of 151 genetically related cases of S. Typhimurium suspected to be linked to the consumption of the implicated chocolate products have been reported from 11 countries: Belgium (26 cases), France (25 cases), Germany (10 cases), Ireland (15 cases), Luxembourg (1 case), the Netherlands (2 cases), Norway (1 case), Spain (1 case), Sweden (4 cases), the United Kingdom (65 cases) and the United States of America (1 case).
Symptom onset dates of cases ranged from 21 December 2021 to 28 March 2022. Children under 10 years of age (n=134; 89%) were disproportionately affected and females represented 66% (n=99) of reported cases. Information on reported symptoms and severity were available for 21 cases, and of these, 12 (57%) reported bloody diarrhea and nine (43%) were hospitalized. As of 25 April 2022, no fatalities associated with the outbreak has been reported.
Salmonellosis is a disease caused by nontyphoidal Salmonella bacteria. While approximately 2,500 serotypes have been identified, the majority of human infections are caused by two serotypes of Salmonella: Typhimurium and Enteritidis.