More than 150 people were affected by an outbreak of Salmonella from raw goats’ milk cheese in 2018, according to a recent report.

France recorded 147 cases, of which 133 were //confirm/i/ied, 13 were probable and one possible. Of 38 cases wher clinical history was known, 13 were hospitalized. One person died but salmonellosis was not the principal cause and food exposure information was not available.

Scottish authorities recorded six infections. Four cases reported consumption of the implicated cheese in Scotland wher it was sold by a single vendor, one consumed a variety of unspecified cheeses while travelling in Spain during their exposure period, and for the other information on exposure to the product was not known.

L’Earl Mounier recalled the product “Pélardons” in August 2018. The company, based in Quezac, a commune of the Lozère department in France, issued a recall following detection of Salmonella.  More than 23,000 potentially contaminated units were distributed in France and internationally.

Small producer but large outbreak
Salmonella Newport is an uncommon cause of sporadic salmonellosis and outbreaks in France. It accounts for 1 percent to 2 percent of human cases per year and since 2000 and has been responsible for four outbreaks linked to different raw goats’ milk cheeses. Raw milk is not pasteurized, which kills bacteria including Salmonella.

In the journal Epidemiology and Infection, researchers described the fifth Salmonella Newport outbreak linked to a raw goats’ milk cheese, which was detected separately by both of France’s surveillance systems. They said the outbreak highlights how even a relatively small scale producer can contribute to a large scale, international incident.

In early August 2018, five familial clusters of gastrointestinal illness, originating from the Bouches-du-Rhône area were reported to the regional health agency of Provence-Alpes-Côte d’Azur in the south of France as part of the foodborne outbreak surveillance system.

These clusters included 15 ill people with dates of symptom onset between July 28 and Aug. 8. Stool samples from nine of 10 tested cases were positive for Salmonella spp. and isolates were sent to the French national reference center for E. coli, Shigella and Salmonella (FNRC-ESS) for typing.

Investigation by the health agency found that the consumption of a raw goats’ milk cheese manufactured by L’Earl Mounier was common to all clusters. Samples of two batches of cheese from a vendor common to two of the clusters and of two further batches from the producer were positive for Salmonella spp. A product recall was issued concerning cheeses produced since July 10 and placed on the marked since July 21.

Confirmation that some cases had purchased the cheese before July 21, suggested that earlier batches were also contaminated. A second recall was issued which concerned batches produced since late June 2018.

A reminder of the risks
In the third week of August, a national increase in Salmonella Newport multilocus sequence type 118 cases was detected by the FNRC-ESS. It had found 36 isolates of Salmonella Newport ST118 with a sampling date between July 10 and Aug. 2 compared with eight isolates in July and August 2017.

From 142 infections in France, 52 percent were in males and the median age was 46 years with a range from 3 to 87 years old. The six cases in Scotland had symptom onset between July 20 and Aug. 15.

The implicated cheese was the only one of the producer who used milk from his own herd. Milk from one animal tested positive for Salmonella Newport.

The first recall stemming from the foodborne outbreak surveillance system occurred almost two weeks before it was detected through laboratory surveillance.

L’Earl Mounier halted production during the first alert pending investigation. The source animal was removed from the herd and the facility was cleaned. After resuming production, the producer was subject to enhanced microbiological monitoring. Environmental and product samples remained negative for Salmonella.

“Results are also a reminder of the risks associated with raw milk cheeses and that measures to prevent the entry of pathogens into the artisanal raw milk cheese production chain and the optimization of surveillance aimed at the prevention of foodborne outbreaks such as in France should be extended or strengthened in other regions of Europe with a tradition in the production of cheeses made from raw milk,” said researchers.