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Cryptosporidium parvum Caused a Large Outbreak Linked to Frisée Salad in Finland, 2012
Authors:R Åberg  M Sjöman  K Hemminki  A Pirnes  S Räsänen  A Kalanti  T Pohjanvirta  S M Caccio  A Pihlajasaari  S Toikkanen  S Huusko  R Rimhanen‐Finne
Affiliation:1. Food Safety Department, Environment Centre, Helsinki, Finland;2. Social and Health Services, Environmental Health, Espoo, Finland;3. Health Services, Tampere, Finland;4. Clinical Microbiology, Helsinki University Central Hospital, Hospital District of Helsinki and Uusimaa, Laboratory Services, HUSLAB, Helsinki, Finland;5. Veterinary Bacteriology Unit, Finnish Food Safety Authority Evira, Kuopio, Finland;6. European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy;7. Food Hygiene Unit, Finnish Food Safety Authority Evira, Helsinki, Finland;8. Department for Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
Abstract:Over 250 individuals fell ill in five outbreaks caused by Cryptosporidium parvum in Finland, October–November 2012. The cases were connected by lunch meals at restaurants in four different cities. In two outbreaks, the same C. parvumIIdA17G1 subtype was found in patients’ stool samples which supports a single source of infection. Frisée salad was the only common food item served at the restaurants, and consumption of lunch salad containing the frisée salad was associated with the illness. Lunch customers who responded that they had eaten lunch salad were three times more likely to have become ill than those who had not answered whether they had eaten the salad or not (RR 2.66; 95% Cl 1.02–6.9, P‐value <0.01). Cryptosporidiosis should be considered as a causal agent in long‐lasting watery diarrhoea combined with abdominal cramps, and clinical samples should be tested for Cryptosporidium at the same time bacteria and viruses are tested. Measures to prevent contamination of ‘ready‐to‐eat vegetables’ with Cryptosporidium oocysts and methods to test frozen food samples should be developed.
Keywords:Cryptosporidium  outbreak  lunch salad
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