Abstract

Raw milk cheeses are commonly consumed in France and are also a common source of foodborne outbreaks (FBOs). Both an FBO surveillance system and a laboratory-based surveillance system aim to detect Salmonella outbreaks. In early August 2018, five familial FBOs due to Salmonella spp. were reported to a regional health authority. Investigation identified common exposure to a raw goats' milk cheese, from which Salmonella spp. were also isolated, leading to an international product recall. Three weeks later, on 22 August, a national increase in Salmonella Newport ST118 was detected through laboratory surveillance. Concomitantly isolates from the earlier familial clusters were confirmed as S. Newport ST118. Interviews with a selection of the laboratory-identified cases revealed exposure to the same cheese, including exposure to batches not included in the previous recall, leading to an expansion of the recall. The outbreak affected 153 cases, including six cases in Scotland. S. Newport was detected in the cheese and in the milk of one of the producer's goats. The difference in the two alerts generated by this outbreak highlight the timeliness of the FBO system and the precision of the laboratory-based surveillance system. It is also a reminder of the risks associated with raw milk cheeses.

Highlights

  • Raw milk cheeses are popular in France accounting for 15% of all mature French cheeses, 75% of protected designation of origin (PDO) and protected geographical indication (PGI) cheeses, and the majority of other artisanal cheeses [1]

  • The syndromic foodborne outbreaks (FBOs) surveillance system is based on mandatory notification to regional health agencies of clusters of gastrointestinal illness involving at least two cases having shared a common meal, and whose cause is suspected to be foodborne

  • We describe a fifth outbreak of S

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Summary

Introduction

Raw milk cheeses are popular in France accounting for 15% of all mature French cheeses, 75% of protected designation of origin (PDO) and protected geographical indication (PGI) cheeses, and the majority of other artisanal cheeses [1]. Raw milk cheeses have been the vehicle of 16 major Salmonella foodborne outbreaks (FBO) in France between 2008 and 2018, representing a third of Salmonella outbreaks with an identified source [3,4,5,6,7]. There are two French surveillance systems with the objective of detecting Salmonella FBOs. The syndromic FBO surveillance system is based on mandatory notification to regional health agencies of clusters of gastrointestinal illness involving at least two cases having shared a common meal, and whose cause is suspected to be foodborne. Once validated as true clusters of illness, they are notified to the national public health agency, Santé publique France (SpF). In around half of salmonellosis clusters, the serotype is not confirmed

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