A total of 35 confirmed Salmonella Agona infections among infants aged less than six months were found in different regions of France and for most, consumption of infant milk formula could be confirmed.

Sixteen cases were hospitalised and later discharged. The first was retrospectively identified in April 2017.

Discriminatory characteristic of outbreak strain

Institut Pasteur found the outbreak strain displays atypical biochemical characteristics and did not produce hydrogen sulphide and gas during 18 hours incubation on Kligler-Hajna media.

This characteristic appears discriminatory enough to identify probable outbreak cases, said the European Centre for Disease Prevention and Control (ECDC).

This trait was found in all cases in France and those from Spain and Greece.

Lactalis Nutrition Santé group recalled over 600 batches (more than 7,000 tonnes) of products manufactured at its site in Craon in France from mid-February last year.

The firm said two positive Salmonella tests, in August and November, were found in the environment and not in products.

Distribution was to 67 countries including 12 in the EU: Belgium, Bulgaria, Cyprus, Czech Republic, France, Greece, Ireland, Netherlands, Romania, Slovenia, Spain and the UK.

Biochemical tests and whole genome sequencing

Whole genome sequencing (WGS) analysis confirmed the Spanish case is associated with the outbreak in France and may provide further confirmation on the Greek case and possible infections from other countries.

ECDC is offering WGS services to countries which do not have the possibility to do timely analysis, with comparison of sequences by Institut Pasteur.

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