A Salmonella outbreak in Denmark affecting 25 people has been traced to a brand of herbal supplement, according to food safety officials.

The majority fell sick in March and Orkla Care A/S, the seller of the implicated products, has issued a recall of several batches.

The Statens Serum Institut (SSI), Danish Medicines Agency, the Danish Veterinary and Food Administration (Fødevarestyrelsen) and DTU Food Institute investigated the outbreak.

Earlier this past week, SSI revealed that 23 people had been infected by the same type of Salmonella Typhimurium between mid-November and March. The update features two more patients bringing the total to 25. They are aged 2 to 92 years old and live across the country. In total, 13 are women and 12 are men. Fourteen people have needed hospital treatment.

Efforts to trace the source
Patient interviews showed most had eaten HUSK Psyllium husks in capsule form. A comparison with healthy controls who were asked about consumption of the same product showed that those sick had eaten the herbal medicine to a much greater extent than the control subjects.

HUSK Psyllium husks was approved as an herbal medicine for diarrhea, constipation, irritable bowel syndrome and elevated cholesterol by the Danish Health and Medicines Agency in 1996.

Luise Müller, an epidemiologist at SSI, said it was unfortunate that an herbal medicine intended to work against diarrhea and constipation is making people sick with Salmonella.

“It is very possible that people who already have stomach problems are more vulnerable to getting a serious Salmonella infection,” she said.

Testing by the Danish Veterinary and Food Administration has found Salmonella in the remaining product that two patients had at home.

Orkla Care said its own tests and quality controls have not shown a connection between the product and the outbreak but it was issuing a recall on the basis of the precautionary principle and in accordance with the Danish Medicines Agency’s recommendation.

Consumers who have purchased HUSK Psyllium seed husks, herbal capsules or the HUSK Psyllium Gut Balance Basic capsules from certain batches should discard them or take the products back to the store where they were purchased. The items were sold in specialty stores and pharmacies as well as online. Expiration dates range from May to October 2023.

About Salmonella infections
Food contaminated with Salmonella bacteria does not usually look, smell, or taste spoiled. Anyone can become sick with a Salmonella infection. Infants, children, seniors, and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC.

Anyone who has eaten any recalled products and developed symptoms of Salmonella infection should seek medical attention. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis.

Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Otherwise, healthy adults are usually sick for four to seven days. In some cases, however, diarrhea may be so severe that patients require hospitalization.

Older adults, children, pregnant women, and people with weakened immune systems, such as cancer patients, are more likely to develop a severe illness and serious, sometimes life-threatening conditions. Some people get infected without getting sick or showing any symptoms. However, they may still spread the infections to others.

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