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.
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.
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.
More Related Videos
Related Concept Videos
Investigation of Disease Outbreaks
Reservoir of Infection
Fungal Phylum Microsporidia
Bacterial Gastroenteritis
Cholera
Diversity of Protists II


