Rapid outbreak assessment: Multi-country outbreak of Salmonella Typhimurium and S. Anatum infections linked to Brazil nuts

As of 20 October 2020, 123 cases of S. Typhimurium ST19 and one case of S. Anatum have been reported, of which 105 were in the UK (including the S. Anatum case), 14 in France, three in Luxembourg, one each in the Netherlands and Canada. A case-control study in the UK and patient interviews in the UK, France and Luxembourg indicated Brazil nuts and nut bars as likely vehicles of infections.

Two batches of Brazil nuts from Bolivia, sampled at the British Processing Company B, tested positive for S. Typhimurium ST19 (Batch A) and S. Anatum ST64 (Batch B) matching the outbreak strains. These Brazil nuts were used for the production of certain batches of Nut Products A and Nut Product L. Brazil nuts, Nut Products A, and Nut Product L were identified as risk factors for illness in patients with S. Typhimurium ST19 infection in the UK. Brazil nuts were also used in other nut products manufactured by different companies in the UK and one in Austria. It is likely that the origin of infections is contaminated Brazil nuts, but with the available data the exact point of contamination cannot be established. Extensive recalls and withdrawals of nut products have been implemented since August 2020.

In conclusion, the outbreak appears to be controlled and the likelihood of the occurrence of new cases that are linked to this event is low but possible, as nut products have a long shelf-life and people may have bought the products before control measures were implemented.

ECDC and EFSA monitor the public health impact and the success of control measures with EU/EEA countries and the UK.