Abstract
In March 2010 the Rapid Alert System for Food and Feed (RASFF) was used to inform about Salmonella Montevideo in a herbal food supplement, formulated in capsules, distributed under a Dutch label in Germany. Simultaneous to the first RASFF notice, in the last two weeks of March 2010 an unusual number of 15 infections with S. Montevideo was notified within the electronic reporting system for infectious diseases at the Robert Koch Institute. Adult women (median age: 43, range: 1-90 years) were mainly affected. An outbreak was suspected and the food supplement hypothesised to be its vehicle. Cases were notified from six federal states throughout Germany, which required efficient coordination of information and activities. A case-control study (n=55) among adult women showed an association between consumption of the specific food supplement and the disease (odds ratio (OR): 27.5, 95% confidence interval (CI): 3.1-infinity, p-value=0.002). Restricting the case-control study to the period when the outbreak peaked (between 29 March and 11 April 2010) resulted in an OR of 43.5 (95% CI: 4.8-infinity, p-value=0.001). Trace-back of the supplement's main ingredient, hemp seed flour, and subsequent microbiological testing by pulsed-field gel electrophoresis supported its likely role in transmission. This outbreak investigation illustrates that information from RASFF may aid in hypothesis generation in outbreak investigations, though likely late in the outbreak.
Highlights
Launched in 1979, the Rapid Alert System for Food and Feed (RASFF) was put in place to provide food and feed control authorities within the European Union (EU) with an effective tool to exchange information about measures taken in response to serious risks detected in relation to food or feed [1]
Local health departments were asked to refer any remaining specific food supplement from company A, which was mentioned in the RASFF, from new caseshouseholds, to a food safety laboratory for microbiological testing
We report odds ratios (OR) and 95% confidence intervals (CI)
Summary
Launched in 1979, the Rapid Alert System for Food and Feed (RASFF) was put in place to provide food and feed control authorities within the European Union (EU) with an effective tool to exchange information about measures taken in response to serious risks detected in relation to food or feed [1]. Whenever the product is on sale to consumers, it is the responsibility of the Member Statesauthorities to take all necessary measures such as withdrawing or recalling food or feed products from the market in order to protect consumers’ health, as well as informing the public. The food supplement formulated in capsules, was produced by a German company but distributed under a Dutch label It had been marketed online and via teleshopping to menopausal and postmenopausal women. Montevideo in the withdrawn food supplement distributed under a Dutch label in Germany, followed by several additional notifications in RASFF throughout subsequent weeks with supplemental information on laboratory test results and trade routes of the product and its ingredients, as well as measures taken in the affected federal states in Germany
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