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. 2021 Apr;26(14):2000221.
doi: 10.2807/1560-7917.ES.2021.26.14.2000221.

Exotic dried fruits caused Salmonella Agbeni outbreak with severe clinical presentation, Norway, December 2018 to March 2019

Tone Bjordal Johansen  1   2 , Lin T Brandal  1 , Emily MacDonald  1 , Umaer Naseer  1 , Pawel Stefanoff  1 , Margrethe Hovda Røed  3 , Turid M Berglund  3 , Gro S Johannessen  4 , Bjarne Bergsjø  4 , Line Vold  1 , Heidi Lange  1
Affiliations

Exotic dried fruits caused Salmonella Agbeni outbreak with severe clinical presentation, Norway, December 2018 to March 2019

Tone Bjordal Johansen et al. Euro Surveill. 2021 Apr.

Abstract

We describe an outbreak of Salmonella Agbeni sequence type (ST)2009 infections in Norway. Between 31 December 2018 and 16 March 2019, 56 cases (33 female and 23 male; median age: 50 years, range: 2-91) were reported, of which 21 were hospitalised. Cases were defined as people living in Norway, with laboratory-confirmed infection with S. Agbeni ST2009 and cluster type (CT)2489, reported between 31 December 2018 and 30 March 2019. We conducted a case-control study, with three controls per case (matched by age, sex and municipality), using the Norwegian National Registry. Cases were more likely to have consumed a commercial mix of dried exotic fruits than controls (cases = 8, controls = 31; odds ratio: 50; 95% confidence interval: 3-2,437). The outbreak strain was confirmed by whole genome sequencing (WGS) and was isolated from the fruit mix consumed by cases, resulting in withdrawal from the market on 6 March 2019.The fruit mix consisted of fruits from different countries and continents. It was packed in Italy and distributed to several European countries, including Norway. However, no other countries reported cases. This outbreak highlights that dried fruits could represent a risk in terms of food-borne infections, which is of particular concern in ready-to-eat products.

Keywords: Salmonella Agbeni; dried mixed fruit; outbreak; ready-to-eat products; whole genome sequencing.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Age and sex of identified cases in the outbreak of Salmonella Agbeni associated with consumption of dried fruit mix, Norway, 2019 (n = 56)
Figure 2
Figure 2
Salmonella Agbeni outbreak cases by week of symptom onset or week of specimen, Norway, December 2018–March 2019 (n = 56)
Figure 3
Figure 3
Minimum spanning treea of Salmonella Agbeni outbreak strains based on core genome multilocus sequence typing analysis, Norway, December 2018–March 2019
See this image and copyright information in PMC

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