A Salmonella outbreak initially reported in France linked to a brand of raw milk cheese has affected at least one other country.

Thirteen people in France have been infected with the same strain of Salmonella Dublin from late November 2019 until early January this year. French authorities identified a link between eating raw milk Morbier cheese made by the company Jean Perrin and illness. SA Perrin withdrew from sale and recalled several lots and dates of Morbier cheese in early February.

An alert on the Rapid Alert System for Food and Feed (RASFF) portal showed distribution of the product included Spain, Sweden and the United Kingdom. It also shows the European Food Safety Authority (EFSA) is involved because the outbreak concerns other countries.

Rikard Dryselius, a microbiologist with the Public Health Agency of Sweden (Folkhälsomyndigheten), told Food Safety News that two people in the country had been sick.

“Sweden has two cases, both microbiologically confirmed using whole genome sequencing, that are connected to the outbreak. The cases became ill in late December and January and are now recovered. Interviews have not provided a connection to a specified product,” Dryselius said.

Multi-country dimension
A spokeswoman for EFSA said the agency is monitoring the event like it does for other outbreaks with a multi-country dimension but would not give further details. There have been no reports of illness in the U.K.

When there is a serious cross-border threat to health, in response to a request of DG Sante and/or the European Centre for Disease Prevention and Control (ECDC), EFSA provides scientific assistance to investigate multi-country foodborne outbreaks.

EFSA uses RASFF to contact authorities at member state level to collect more information on a foodborne outbreak investigation at country level to confirm if there is a multi-country level dimension and to assess robustness of the possible link to the suspected food source.

The International Food Safety Authorities Network (INFOSAN) is also involved as Japan is listed in the RASFF alert.

In France, eight men and five women with a median age of 72 fell ill. They live across seven regions of the country and nine needed hospital treatment. Most of them reported having eaten raw milk Morbier cheese bought in different stores before symptoms began.

Three people have died but it is not clear what role salmonellosis played in the deaths, according to Santé publique France.

Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Healthy adults are usually sick for four to seven days. Older adults, children, pregnant women, and people with weakened immune systems are more likely to develop a severe illness and sometimes life-threatening conditions.

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