Nontyphoidal salmonella outbreaks linked to chocolate products

Chocolate lovers may want to think twice before indulging in this confection as a recent study reports an association between nontyphoidal salmonellosis transmission and chocolate consumption.

A recent cross-border outbreak of nontyphoidal salmonellosis connected to the consumption of chocolate products led to the performance of this systematic review. Study authors conducted a comprehensive review of existing literature focusing on outbreaks of nontyphoidal salmonellosis associated with eating chocolates.

The systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in three databases, namely the US National Library of Medicine, Web of Science, and Excerpta Medica. Google Scholar and the bibliography of the identified reports were also sifted.

Studies were eligible if these were published after 1970 and described outbreaks of more than 10 patients with a nontyphoidal salmonellosis connected to chocolate consumption. As a result, 23 articles met the eligibility criteria. Twelve outbreaks involving a total of 3,266 patients were assessed.

All 12 outbreaks happened in high-income countries. Of these, one was limited to one city, six involved one county, and the rest involved two or more countries. Six outbreaks peaked during the winter season, three in autumn, two in spring, and one in summer. Notably, the outbreak affected mostly children. However, a predominant serotype was not identified.

“Our data documents that chocolate is an optimal medium for the transmission of nontyphoidal salmonellosis,” the authors said. “A connected worldwide reporting system including high-income, middle-income, and low-income countries is crucial to detect infectious diseases outbreaks in an early phase and avoid their spread.”