Research – Avoiding a global chocolate disaster – how tracing and recalls avoided a worldwide Salmonella outbreak


Largest ever recall of chocolate products in global history, just before Easter 2022, prevented thousands of extra cases; a total of 455 cases of Salmonella Typhimurium found in 17 countries; UK had most cases with 128.

Like any other manufactured food product, chocolate can be contaminated if key ingredients or processes break down. In a presentation in a pre-ECCMID day for this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2023, Copenhagen, 15-19 April), Dr Johanna Takkinen, Principal Expert for Food- and Waterborne Diseases at the European Centres for Disease Control and Prevention (ECDC), Stockholm, Sweden, will discuss the drama as the story unfolded, and the lessons learned from an outbreak of Salmonella Typhimurium in Kinder Chocolate Eggs traced to a Belgian chocolate factory.

”If not for clear and co-ordinated action across Europe and beyond, there may have been many thousands more children falling ill, and potentially many deaths,” says Dr Takkinen.

Authorities in the UK (the UK Health Security Agency [UKHSA]) first raised the alarm in ECDC-hosted alert platform EpiPulse on 17 February 2022, reporting a cluster of 18 children reported ill with monophasic Salmonella Typhimurium infections since January 2022. Of these, seven were hospitalised and five of the seven had bloody diarrhoea, a serious symptom. “Preliminary interviews of first cases indicated Kinder chocolate products as a possible vehicle of infection. Several countries then began reporting an increasing number of infections with strains the same as the UK outbreak,” explains Dr Takkinen. By 18 February, France had reported its first 2 cases, and by 18 March 59 cases were reported in five countries.

Late in March 2022, ECDC coordinated a teleconference with affected countries when four non-human monophasic S. Typhimurium isolates, genetically close to the human isolates, were identified in a public database. Within a week, these isolates were confirmed originating from one particular Belgian chocolate factory. Prior to this, identifying which factory or factories were involved was difficult since there are four factories within the European Union that produce Kinder chocolate in large quantities. This new microbiological evidence allowed the various agencies to focus their investigations on one factory.

Meanwhile, the Food Standards Agency (FSA) in the UK* and the Food Safety Authority (FSA) in Ireland and the UK FSA decided to recall, on April 2**, certain Kinder Chocolate products (including Kinder Surprise Eggs).  On April 8 authorities, now confident the factory was identified, ordered that chocolate factory (Ferrero) closed, and two days later had issued a global recall of products from the factory. The alert reached 130 countries, and in addition to the 401 cases* identified in the EU and UK combined (the UK had the most cases, with 128), further cases were identified in Switzerland (49) and Canada (4) and the USA (1) – giving a global total of 455 cases in 17 countries.  The ECDC and EFSA also published Rapid Outbreak Assessments to keep the public updated.

For link to Dr Takkinen’s slides, click here

*For the ECDC update showing case numbers from different countries, click here

**For the Food Standards Agency (UK) notice on this, original published April 2, 2022, click here

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