<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>13</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Laurence Delbrassinne</style></author></authors><secondary-authors><author><style face="normal" font="default" size="100%">Dieter Van Cauteren</style></author><author><style face="normal" font="default" size="100%">Bavo Verhaegen</style></author><author><style face="normal" font="default" size="100%">Valeska Laisnez</style></author><author><style face="normal" font="default" size="100%">Wesley Mattheus</style></author></secondary-authors><tertiary-authors><author><style face="normal" font="default" size="100%">Vera Cantaert</style></author><author><style face="normal" font="default" size="100%">Géraldine de Muylder</style></author><author><style face="normal" font="default" size="100%">Tiffany Dierinck</style></author><author><style face="normal" font="default" size="100%">Naïma Hammami</style></author><author><style face="normal" font="default" size="100%">Veronica Jaramillo</style></author><author><style face="normal" font="default" size="100%">Inne Nauwelaers</style></author><author><style face="normal" font="default" size="100%">Koenraad Van Hoorde</style></author></tertiary-authors></contributors><titles><title><style face="normal" font="default" size="100%">BSFM 2022 - International outbreak of Salmonella Typhimurium linked to a chocolate factory in 2022: Belgian findings</style></title><secondary-title><style face="normal" font="default" size="100%">BSFM</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">foodborne outbreak</style></keyword><keyword><style  face="normal" font="default" size="100%">foodborne outbreak investigation</style></keyword><keyword><style  face="normal" font="default" size="100%">Salmonella</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2022</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2022/10</style></date></pub-dates></dates><publisher><style face="normal" font="default" size="100%">Sciensano</style></publisher><pub-location><style face="normal" font="default" size="100%">Brussels, Belgium</style></pub-location><pages><style face="normal" font="default" size="100%">1</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;strong&gt;&lt;u&gt;Introduction&lt;/u&gt;&lt;/strong&gt;&lt;/p&gt;

&lt;p&gt;A multi-country outbreak caused by monophasic &lt;em&gt;Salmonella&lt;/em&gt; Typhimurium is presented. A link with chocolate products from a Belgian factory was established by epidemiological, microbiological and traceback investigations. Whole genome sequencing (WGS) analysis of human and food isolates revealed the presence of two clusters: &amp;nbsp;HC5_296366 (cluster 1) and HC5_298160 (cluster 2).&amp;nbsp; The investigation of the outbreak as well as&amp;nbsp; measures taken are presented.&lt;/p&gt;

&lt;p&gt;&lt;strong&gt;&lt;u&gt;Materials and Methods&lt;/u&gt;&lt;/strong&gt;&lt;/p&gt;

&lt;p&gt;Probable and confirmed cases were identified using ECDC case definitions. Raw materials and finished food products collected at the factory were analysed for &lt;em&gt;Salmonella&lt;/em&gt; spp. using ISO 6579-1:2017 and real-time PCR. WGS analysis of selected food and human isolates was performed.&lt;/p&gt;

&lt;p&gt;&lt;strong&gt;&lt;u&gt;Results &amp;amp; Discussion&lt;/u&gt;&lt;/strong&gt;&lt;/p&gt;

&lt;p&gt;In Belgium 64 confirmed and 2 probable cases were identified (89% children aged 1-9 years old, 43% hospitalizations), with illness onset from mid-January until April and a peak in cases mid-February 2022. WGS data revealed two distinct clusters at 62 allelic differences from each other. Seven of 229 food products tested positive for &lt;em&gt;Salmonella &lt;/em&gt;Typhimurium. WGS analysis of the food isolates indicated matches with both clusters. Moreover, in December 2021, &lt;em&gt;Salmonella&lt;/em&gt; isolates matching with the later identified clusters had also been found in samples during an own-check in the factory. Eleven types of products were recalled worldwide and food safety authorities shut down the factory 8 April 2022. A strong collaboration and information sharing between different stakeholders resulted in comprehensive measures to stop the spread of this international outbreak.&lt;/p&gt;

&lt;p&gt;&lt;strong&gt;&lt;u&gt;References&lt;/u&gt;&lt;/strong&gt;&lt;/p&gt;

&lt;p&gt;Joint ECDC-EFSA Rapid Outbreak Assessment &amp;nbsp;&lt;a href=&quot;https://www.ecdc.europa.eu/sites/default/files/documents/1st-update-ROA_monophasic-S-Typhimurium-ST34_2022-00014_UK-amended-8-June.pdf&quot;&gt;https://www.ecdc.europa.eu/sites/default/files/documents/1st-update-ROA_monophasic-S-Typhimurium-ST34_2022-00014_UK-amended-8-June.pdf&lt;/a&gt;&lt;/p&gt;

&lt;p&gt;RASFF 2022.1799 ; RASFF 2022.2201; RASFF 2022.2452&lt;/p&gt;
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