Outbreak News reports that aIn a follow-up on the Salmonella Braenderup outbreak in Sweden, the Swedish Public Health Agency now reports a total of 36 confirmed outbreak cases reported from 13 different regions during the period 4 April to 15 May.
The cases of the disease are in the ages 0-95 years and 29 of the patients are women. The cases have been linked using whole genome sequencing (analysis of the bacterium’s genome).
The outbreak is international as several countries in Europe have identified cases of the same variant of salmonella. The source of infection is suspected to be a food that has been widely distributed both in Sweden and abroad.
The affected infection control units, municipalities, the National Food Administration and the Swedish Public Health Agency jointly investigate the outbreak at national level, while collaboration at international level is handled by the central authorities and coordinated by the European Anti-Infection Authority ECDC.
Outbreak News Today reports in a follow-up on the Yersinia enterocolitica outbreak in Sweden, The Swedish Public Health Agency says the outbreak of Yersinia enterocolitica is over.
During the period January and up to the beginning of February, twice as many people fell ill with Yersinia infection as during the same period in a normal year. Of a total of 53 cases of Yersinia enterocolitica, 33 were resident in the regions of Stockholm, Västra Götaland and Halland.
Isolates from 24 of these cases were typed by whole genome sequencing, and 16 outbreak cases with clustered isolates could be identified.
A contaminated batch of iceberg lettuce distributed to a restaurant chain is the suspected source of infection.
Outbreak News Today reports that since the last report on the Cryptosporidium outbreak in Sweden about two weeks ago, health officials say the number of reported cases has decreased in recent weeks.
While cases are declining, the number of cases reported per week remains slightly higher compared to the same period in previous years. To date, some 400 Cryptosporidium cases have been recorded.
Most cases have been reported from Stockholm, Östergötland, Västra Götaland, Halland, Jönköping and Uppsala.
The Public Health Authority analyzes samples from the cases to determine what type of cryptosporidium they have become ill from. Of the 202 samples analyzed so far, 93 have been shown to belong to subtype (A) and 58 belong to subtype B of Cryptosporidium parvum. In addition to this subtype, a number of different subtypes have been detected.
The fact that different subtypes are seen indicates that there are different sources of infection for the cases reported during the fall. From the survey studies it was shown that cases with subtype A have drunk to a greater extent pre-purchased freshly squeezed fruit and vegetable drinks that are no longer on the market when the shelf life is short. The majority (almost 80%) of cases with subtype A were reported to have fallen ill.
Outbreak News Today reports Swedish health authorities, or Folkhalsomyndigheten are reporting 17 additional Salmonella Typhimurium cases in the current outbreak, bringing the total outbreak cases to 71 since August.
The Swedish National Food Agency and the Public Health Agency continue to investigate the outbreak to identify the source of the infection. The investigation shows that small tomatoes are the likely source of the outbreak. The tomatoes are no longer left in grocery stores, the outbreak has subsided and the risk of being infected is very small.
SVT reports people have been sick with diarrhea between August 29 and September 14 with Salmonella Typhimurium. Anders Enocksson, infection prevention consultant at Region Halland.
In all, 11 counties are affected. Most cases are in Halland together with Dalarna, Jönköping and Västra Götaland, which P4 Halland was the first to tell . The infected are in all age groups, but just over half are 60 years or older. There are slightly more women than men.
The source of infection is not yet known, but there is suspicion of tomatoes, and cherry tomatoes. It is unclear where they come from. The investigation is allowed to show if it is correct, says Anders Enocksson.
To date, 36 cases from 10 counties have been linked with whole-genome sequencing. Most cases have been reported from Västra Götaland, Jönköping, Halland and Dalarna. Ill persons are found in all age groups, both among children and the elderly, and slightly more women (22) than men (14) have become sick.
The Swedish National Food Agency and the Public Health Authority together are investigating the outbreak to identify the source of the infection that is suspected to be a food that has been widely distributed in Sweden.
One morning when today’s school lunch was to be cooked at the Torskolan in Torsås, the staff discovered that the falu sausage that would have been cooked was covered with musbajs.
The school called me and told me that something similar to rodent spilling was found on the fallow basket. We then contacted the company from which we buy the sausage, which immediately withdrew it, says Gustaf Nilsson, environmental inspector at Torsås Municipality.
The planned sausage lunch was quickly replaced with soup and a detective work has been underway to find out where the mice have come in.
“I don’t know where they managed to get in, but before it came to school, the sausage was both at a factory and at a transhipment center. However, it is unlikely that it happened at school. The staff has detailed their routines there.
Gustaf Nilsson says he has not been to anything like it before.
“After all, the routines have failed and it is very unfortunate that this has happened. However, the staff at Torskolan did everything right to discover the pellet before starting to cook.”
Samples taken on the sausage show high levels of E. coli, ie some form of stool. The suspicion is that it comes from forest mice.
As of Monday, about 560 human cases have been reported, much more this time of year than usual and even more than 2015 when 859 people across the country suffered from the illness.
Most cases of illness are reported from central Sweden (the Dalarna region, Gävleborg and Örebro), but an increasing number of reports are also starting to come in from other regions, especially in northern Sweden.
Since the number of illness cases is usually highest in September in Sweden, the outbreak is expected to grow further in the coming weeks.
Infections in Sweden are mainly seen in forest and field hares and rodents, but the disease has been reported in several other species, including other mammals, birds, amphibians, insects, ticks and unicellular animals.
Tularemia, or harpest as it’s known as in Sweden, is one of the most common native zoonoses in people in Sweden. People are infected mainly through mosquitoes, but also through direct contact with sick or dead animals and by inhalation of, for example, infectious dust.
Outbreak News Today reports the Sweden Public Health Authority, or Folkhälsomyndigheten are reporting an outbreak of hepatitis A where the suspected source of infection is fresh dates from Iran.
Of the nine cases reported since late February, eight of the cases are confirmed and have the same type of hepatitis A virus (genotype IIIA) and one case is suspected.
The cases are between the ages of 28 and 73, five are men and four are women. The cases are from seven different counties (Örebro, Stockholm, Uppsala, Skåne, Södermanland, Kalmar and Halland). The latest case fell on April 16. Common to the cases is that they regularly eat fresh dates.
In the eight confirmed cases, four different strains with genotype IIIA have been detected. Two of these are similar to the tribes that caused an outbreak in Denmark in 2018 linked to dates from Iran. In that outbreak, several variants of genotype IIIA strains could be detected in the cases. One of these outbreak strains could also be detected in dates.
Health officials continue the investigation to identify the source of the outbreak.
Hepatitis A virus is an important cause of food-borne diseases and has been associated with several European outbreaks linked to berries [1–4]. Here, we describe an ongoing outbreak of hepatitis A virus (HAV) in Sweden and Austria and the confirmation of frozen strawberries imported from Poland as the source of infection. The aims are to highlight the importance of sequencing in outbreak investigations and, due to the long shelf-life of the food vehicle, to increase awareness and warnings towards HAV infections related to frozen strawberries in Europe.
According to a report by the scientific journal Eurosurveillance, 20 cases of hepatitis A were reported in six districts of Sweden between June and September 2018, of which 17 were confirmed and three were likely. “In combined epidemiological and microbiological studies, imported frozen strawberries produced in Poland were identified as the source of the outbreak,” the journal said. Also in Austria hepatitis A diseases have been associated with strawberries from the same manufacturer. Swedish and Austrian researchers have identified strawberries as a source of infection for many hepatitis A diseases in their countries. “Examinations and interviews with kitchen staff showed that the strawberries had never been sufficiently heated before serving. Strawberries were the only food that was common to all cases, “says the Swedish experts.
The best protection against hepatitis A is vaccination, which is available for children 12 months and older.
Hepatitis A outbreak linked to imported frozen strawberries by sequencing, Sweden and Austria, June to September 2018