Cryptosporidium parvum Caused a Large Outbreak Linked to Frisée Salad in Finland, 2012

R Åberg1, M Sjöman1, K Hemminki2

  • 1Food Safety Department, Environment Centre, Helsinki, Finland.

Insights

Cryptosporidium parvum outbreaks in Finland were linked to frisée salad consumed at restaurants. This finding highlights the need for improved food safety measures for ready-to-eat vegetables to prevent future Cryptosporidium infections.

Area of Science:

  • Foodborne illness
  • Infectious disease epidemiology
  • Parasitology

Background:

  • Five Cryptosporidium parvum outbreaks occurred in Finland in late 2012, affecting over 250 individuals.
  • The outbreaks were traced to lunch meals consumed at restaurants across four cities.

Purpose of the Study:

  • To investigate the source and transmission routes of Cryptosporidium parvum outbreaks linked to restaurant meals.
  • To identify common food items associated with the illness and determine risk factors for infection.

Main Methods:

  • Epidemiological investigation of outbreak cases and controls.
  • Subtyping of Cryptosporidium parvum isolates from patient stool samples (C. parvumIIdA17G1 subtype identified).
  • Case-control study analyzing food consumption, specifically lunch salads containing frisée salad.

Main Results:

  • Frisée salad was identified as the sole common food item across the affected restaurants.
  • Consumption of lunch salad containing frisée salad was significantly associated with illness (RR 2.66, P < 0.01).
  • Identical C. parvum subtypes in two outbreaks suggest a single common source of infection.

Conclusions:

  • Cryptosporidiosis outbreaks can be linked to contaminated ready-to-eat vegetables like frisée salad.
  • Enhanced testing of clinical samples for Cryptosporidium and improved prevention of vegetable contamination are crucial.
  • Further development of methods for testing frozen food samples is recommended to prevent future outbreaks.

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