Kinder chocolates are withdrawn from the French market because of salmonella present in the production plant located in Belgium. These bacteria can survive in dry products such as chocolate, cakes… Symptoms, effects on children, adults, treatments: everything you need to know about salmonella.
[Mis à jour le 15 avril 2022 à 17h38] Salmonella are bacteria responsible for salmonellosis. Salmonella infections are manifest as acute gastroenteritis. The evolution is generally favorable within a few days. In cases more serious, this infection may evolve into a septicemic or localized form, which may require a hospitalization. Since April 4 and the announcement of a salmonellosis epidemic in Europe (about 100 cases), several Kinder chocolates (Surprise, Choko-Bons, Mix…) are withdrawn from the market. France is concerned. In total, according to Santé Publique France, 21 cases of salmonellosis were reported after the consumption of the famous chocolates. Out of 15 cases interviewed, 8 children were hospitalized. At this stage, for the cases interviewed, no deaths or stays in intensive care units have been recorded. From Advent calendars marketed in December 2021 were added to the list on April 13. This outbreak strain has a multidrug resistance to several families of antibiotics. “Other cases could occur” warns the Health Branch. Also in any case of febrile diarrhea in a childconsult a physician. A coproculture can be performed to confirm the diagnosis.
Definition: what is salmonella and salmonellosis?
Salmonella is a bacterium that causes salmonellosis and typhoid and paratyphoid fever. Salmonella are bacteria that accumulate in the digestive system. They can lead to symptoms of gastroenteritis and sometimes evolve into a septicemic form or localized, which can requiring hospitalization. It is estimated that 15% of Salmonella are imported into Europe following travel in Africa or Asia. It should be noted that 90% of reptiles, birds and pets are carriers of Salmonella and can transmit it to their owners. As for Salmonella responsible for typhoid and paratyphoid fever, 17 million infections are recorded each year in the world, this time mainly in poor countries. The salmonellosis refers to all infectious diseases caused by a bacterium of the genus Salmonella. Most cases of salmonellosis are mild, but occasionally the disease involves the life-threatening. The severity of the condition depends on host factors and the Salmonella serotype.
What are the types of salmonella?
Salmonella is a genus of gram-negative bacilli belonging to the Enterobacteriaceae family. Bacteria of the Salmonella genus are divided into two major types, according to their characteristics (serotypes):
- Salmonella called “typhic”. (S.Typhi and S.Paratyphi), which are the cause of typhoid fevers in humans. Infection by these salmonellae is exceptional in developed countries.
- Other salmonella, called “non-typhoidal” salmonella (numerous serotypes, in particular S.Typhimurium), which under certain conditions cause salmonellosis, one of the main gastroenteric syndromes of bacterial origin in industrialized countries.
Salmonella Enteritidis and Salmonella Typhimurium predominate in food, but their relative importance varies over time and between countries.
The Salmonella Typhimurium is a type of salmonella rather found during food contaminations. It is part of the so-called “non-typic” salmonella. It is the salmonella that was found in Kinder chocolates, responsible for an epidemic of salmonellosis in Europe in April 2022.
Salmonella is found in most domestic and wild animals. They are present in food animals such as poultry, pigs and cattle, but also in pets, cats, dogs, birds and reptiles, such as turtles. Salmonella can move through the food chain from animal feed, through primary production, and up the food chain to households, food services and institutions. Humans typically contract salmonellosis by consuming contaminated food of animal origin (mainly eggs, meat, poultry and milk), but also raw vegetables or soiled vegetables (cucumbers, salads…) or untreated water. Cases also occur in humans through contact with infected animals, especially pets. These animals often show no signs of illness.
What is the incubation period for salmonellosis?
The incubation time is 6 to 72 hours (usually 12 to 36 hours) after ingestion of Salmonella, and theillness lasts 2 to 7 days.
What are the symptoms of salmonellosis?
Salmonellosis is usually characterized by:
- an abrupt onset of fever,
- of abdominal pain,
- of the diarrhea,
- of Nausea and sometimes vomiting.
Symptoms are usually relatively mild and, in the majority of cases, patients recover without special treatment. In some cases, however, especially in very young children and the elderly, the associated dehydration can become severe and life-threatening.
What foods are at risk of salmonellosis?
Salmonellosis is an infection always caused by ingestion of salmonella, especially consumption of contaminated food. The main categories of food identified are eggs and raw egg productsthe meats (bovine, porcine and poultry and the dairy products. From many other foods (plants (e.g. sprouted seeds), shellfishetc.) can be vehicles for Salmonella. It is capable of surviving for a long period (years) in a dry environment. It can be found in products with low water activity (Milk powders including infant formula, dried fruits, chocolate, cereals, spices…).
Who are the people most at risk?
Salmonellosis can affect anyone in the population. However, it can affect babies more severelyyoung children, pregnant women, the elderly, people with health problems or immunocompromised people.
To make the diagnosis, the indication of a recent trip to tropical or North African countries may be suggestive. It is advisable to consult the attending physician, an emergency room or an infectious diseases department.
- A blood test with study of the markers of infection will almost always find an increase in C-reactive protein (CRP). A culture of the blood, or blood culture, is used to find the germ involved.
- Coproculture is the most effective method for diagnosing salmonellosis corresponding to the “gastroenteritis” type.
- Serology still performed on blood samples is also an argument, especially in the case of suspected salmonellosis corresponding to the typhoid or paratyphoid type.
The following serology results indicate recent or old infection:
- Type O antibodies: They appear around the 8th day of the disease and disappear in 2 to 3 months. If the titer is >100, they indicate a recent infection.
- H-type antibodies: They appear around day 10-12 and persist for several years. Their level is higher than that of type O antibodies at the state period.
The presence of O-type antibodies without H-type antibodies indicates recent infection. An elevated level of both O and H antibodies shows an ongoing infection. An isolated elevation of H-type antibodies indicates a very old salmonellosis.
“In all cases, salmonellosis requires medical advice. A fortiori, typhoid and paratyphoid fevers require prompt medical attention.” says Dr Claire Lewandowski, specialist in general medicine.
► One Routine antibiotic therapy is not recommended for mild to moderate forms in otherwise healthy individuals to avoid selecting resistant strains. Only infants, the elderly, pregnant women, and immunocompromised patients may require antibiotic therapy. We also administer antimicrobials if the infection spreads from the intestines to other parts of the body.
► In the most severe cases, a electrolyte supplementation (e.g. to replace sodium, potassium and chloride ions lost during vomiting and diarrhea) and a rehydration intravenous rehydration is prescribed during hospitalization.
► At the same time. patient must be isolated to avoid transmission and relatives should be screened and treated if necessary. Blood cultures should be checked at the end of treatment to ensure recovery. In addition, reporting of the disease to the Regional Health Agency is mandatory.
► Natural Remedies: a decoction of Guava Leaves can be used as a natural remedy in the treatment of gastrointestinal symptoms, to be used only after the approval of one’s physician. L
► La Consumption of vegetable activated charcoal, blond psylliumor probiotics can also be used in case of diarrhea, as can homeopathy: Arsenicum album 15 CH, Phosphorus 15 CH and Veratrum album 7 CH.
► For To help restore intestinal transit, it is advisable to avoid milk, green vegetables and fruits, but to prefer rice, ham, meat, fish, bananas, apples, quince, or blueberries and to drink water and rehydration solutions.
Do not wash eggs before storing them.
To avoid being contaminated with salmonella, untreated water and questionable foods should not be consumed, especially in areas at risk. In France, the Institut de Veille Sanitaire verifies the proper preparation and storage conditions of food. To avoid contamination, it is recommended to :
- Cook food thoroughly (70°C), especially pork and poultry, as well as minced meats.
- Avoid raw milk and raw milk products. Drink only pasteurized or boiled milk.
- Avoid ice cream unless it is nothas was prepared from water that is safe to drink.
- When the safety of drinking water is in doubt, it should be boiled or, if this is not possible, disinfected with a reliable slow-release disinfectant (usually available in pharmacies).
- Wash hands thoroughly and frequently with soap, especially after contact with livestock or pets or after using the toilet.
- Wash hands after handling raw eggs, raw meats, unwashed vegetables.
- Wash fruits and vegetables carefully, especially if they are to be eaten raw. Whenever possible, fruits and vegetables should be peeled.
- L’maintenance (scraping, washing with hot water and detergent) of work surfaces and utensils must be rigorous and carried out immediately after each use.
- Clean the refrigerator regularly.
- Contact between infants/young children and pets (cats, dogs, turtles, etc.) requires careful monitoring. In addition, a preventive vaccine exists that protects against some of these germs for three years. It is recommended for travel to certain areas of the world.
Eggs are particularly at risk for salmonellosis. The health authorities recommend :
- Keep eggs at the same temperature at all times to avoid condensation of water on their surface.
- Do not wash the eggs before storing them: washing allows the penetration of micro-organisms.
- Egg preparations without cooking (mayonnaise, creams, chocolate mousse, pastries, etc.) should be consumed immediately after preparation or kept refrigerated for consumption within 24 hours.
- It is recommended that the elderly, immunocompromised persons, the young children and pregnant women not to consume raw or undercooked eggs.
- It is also recommended that the elderly, immunocompromised persons, young children and pregnant womenavoid contact with pet reptiles.
Thanks to Dr. Claire Lewandowski for her medical validation.
Additional information related to the recall of Kinder brand products due to Salmonella Typhimurium contamination. Santé Publique France. 7 April 2022.
Multidrug-resistant salmonellosis outbreak. DGS Urgent, April 6, 2022.
Salmonella. Anses. June 2021.