Multi-country outbreak of Listeria monocytogenes sequence type 8 infections linked to consumption of salmon products
A multi-country outbreak of 12 listeriosis cases caused by Listeria monocytogenes sequence type (ST) 8 has been identified through whole genome sequencing (WGS) analysis in three EU/EEA countries: Denmark (6 cases), Germany (5) and France (1). Four of these cases have died due to or with the disease. It is likely that the extent of this outbreak has been underestimated since the outbreak was identified through sequencing and only a subset of the EU/EEA countries routinely use this advanced technique to characterise L. monocytogenes isolates. The first case was sampled in October 2015 in Denmark and the most recent case was reported in May 2018 in Germany. In August 2017, Denmark identified the first cluster of cases, which was investigated and linked to the consumption of ready-toeat cold-smoked salmon produced in Poland. Control measures were implemented and the Member States and competent authorities were informed. In October 2017, France reported the identification of a matching L. monocytogenes strain in food isolates from marinated salmon originating from the same Polish processing company as identified in the Danish outbreak investigation. This supports the hypothesis that contamination may have occurred at the processing company in Poland. However, due to the lack of WGS data on the isolates found in the environmental and food samples taken at the Polish processing plant, it is not possible at present to confirm the contamination with the L. monocytogenes ST8 outbreak strain at the suspected Polish plant. Moreover, until detailed information on the Norwegian primary producers of the salmon used in the contaminated batches is reported and assessed, possible contamination at primary production level cannot be excluded either. Although control measures were implemented following the Danish outbreak investigation in September 2017, the identification of the same strain in a salmon product in France and a new human case in Germany suggest that the source of contamination is still active and contaminated products have been distributed to other EU countries than Denmark. Until the source of infection has been eliminated, new invasive listeriosis cases may still occur. Pregnant women, the elderly and immunocompromised individuals are at increased risk of invasive listeriosis, which is associated with severe clinical course and potentially death.