Spring onions from Egypt had been seemingly within the attend of a deadly E. coli outbreak in Denmark in 2021, in step with researchers.
Between November and December 2021, the foremost recorded outbreak of enteroinvasive E. coli (EIEC) in Denmark befell. A total of 88 unwell folks, in conjunction with 58 women, with a median age of 52 and a fluctuate from 0 to 91 years inclined had been detected. Three sufferers died.
Simplest 34 sufferers had been confirmed by culture, serotyping, and complete genome sequencing. Isolates from cases had been grouped into two serotypes: 24 had been O136:H7 and 10 had been O96:H19. From 40 cases, the date of symptom onset ranged from mid-November to Dec. 24, 2021. The date of sampling used to be from Nov. 23 to early February 2022.
Ill folks lived in four Danish regions. Signs incorporated diarrhea and bloody diarrhea. Twenty-six folks had been hospitalized and three died internal 30 days of trying out certain for EIEC, in step with a glance published in Eurosurveillance.
Suspicion falls on imported spring onions
No linked cases had been reported from various European international locations. However, in 2021, the UK had an epidemic of Shigella sonnei where spring onions from the equivalent producer in Egypt had been the suspected offer.
Because it used to be the foremost EIEC outbreak in Denmark, there used to be no regular questionnaire accessible, so a trawling questionnaire on the complete inclined for Shiga toxin-producing E. coli (STEC) and Salmonella outbreaks had been employed. Culture-impartial diagnostic tests (CIDT) also made keeping apart outbreak and sporadic cases animated.
Interviews of 42 cases and traceback investigation pointed to ready-to-eat salads with fresh cabbage as the trigger. In total, 27 of 42 cases reported having salad with fresh cabbage and 20 of them inclined the equivalent grocery chain. While salads had various vegetables, imported spring onions had been the most classic regular ingredient. Environmental investigations did now not increase outbreak traces.
The Danish Veterinary and Meals Administration (Fødevarestyrelsen) chanced on that spring onions had been imported pre-processed from the Netherlands and incorporated by the Danish producer within the salads.
The company examined samples of spring onions and prepared-to-eat salads in December. Shigella and EIEC had been no longer detected. In November 2021, the Dutch supplier analyzed a batch of this product. The producer of ready-to-eat salads also examined samples of two batches of spring onions between tiring December and early January. No E. coli had been detected within the tests.
Spring onions originated from Egypt and had been delivered by a Dutch industrial that rinsed and root-lower the product. No explicit batches had been identified as being the provision of the outbreak.
Floods in Egypt
No recall befell since the imported spring onions had been allotment of ready-to-eat fresh salads, which had a snappy shelf life. The salad producer also changed the spring onion supplier.
The Worldwide Meals Security Authorities Network (INFOSAN) secretariat urged Fødevarestyrelsen in tiring January 2022 that it had contacted the INFOSAN Emergency Contact Point in Egypt touching on the outbreak. However, the secretariat did now not receive a response.
The Danish embassy in Egypt contacted Fødevarestyrelsen referring to the outbreak in February 2022, providing to attend. The embassy shared reports from 2021 indicating several cases of the Nile overflowing its banks. Flooding peaked with the onset of the rainy season in Would possibly per chance presumably well even simply 2021 and endured except December of that yr.
“The outbreak underlines that high hygiene requirements for imported fresh vegetables must peaceful be maintained when these are to be inclined in ready-to-eat products,” stated researchers.