{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T14:13:24Z","timestamp":1791641604165,"version":"4.3.4"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T00:00:00Z","timestamp":1716163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p><jats:italic>Salmonella<\/jats:italic> infections are significant causes of foodborne outbreaks in the European Union. This study investigates a sudden increase in gastroenteritis patients in the hospital district of Central Finland in June 2021. The primary aim was to study the outbreak's magnitude and source of the outbreak.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Epidemiological, microbiological, environmental and traceback investigations were conducted. Over 700 persons fell ill during the outbreak caused by <jats:italic>Salmonella Typhimurium<\/jats:italic> associated with a daycare lunch. Similar <jats:italic>S. Typhimurium<\/jats:italic> was found in the patients and a vegetable mix containing iceberg lettuce, cucumber and peas served during lunch. The traceback investigation revealed that the batch information of vegetables from the wholesaler was not complete. The wholesaler had received quality complaints about the iceberg lettuce from the central kitchen. The manufacturer did not test the suspected batch for <jats:italic>Salmonella<\/jats:italic> since the production plant had given a certificate declaring it <jats:italic>Salmonella<\/jats:italic> negative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The most suspect ingredient was one batch of iceberg lettuce due to quality complaints. The lettuce had not been served in two daycare centres without cases. We recommend that in order to enable thorough microbiological investigation, institutional kitchens store the food samples separately as part of the internal quality control and that food items should always be tested when <jats:italic>Salmonella<\/jats:italic> contamination in an outbreak is suspected.<\/jats:p><\/jats:sec>","DOI":"10.1111\/zph.13157","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T04:37:56Z","timestamp":1716266276000},"page":"560-567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["<i>Salmonella Typhimurium<\/i> caused an unprecedentedly large foodborne outbreak in Finland in 2021"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4779-5501","authenticated-orcid":false,"given":"Satu\u2010Mari","family":"Lehti","sequence":"first","affiliation":[{"name":"Infectious Disease Control and Vaccinations Unit, Department of Health Security Finnish Institute for Health and Welfare  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole","family":"Andersen","sequence":"additional","affiliation":[{"name":"Pediatrics, Hospital Nova of Central Finland Wellbeing Services County of Central Finland  Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaana","family":"Lepp\u00e4aho\u2010Lakka","sequence":"additional","affiliation":[{"name":"Hospital Hygiene and Infectious Diseases Department, Hospital Nova of Central Finland Wellbeing Services County of Central Finland  Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eija","family":"Suominen","sequence":"additional","affiliation":[{"name":"Environmental Health Office  Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3276-9192","authenticated-orcid":false,"given":"Anni","family":"Vainio","sequence":"additional","affiliation":[{"name":"Infectious Disease Control and Vaccinations Unit, Department of Health Security Finnish Institute for Health and Welfare  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maire","family":"Matsinen","sequence":"additional","affiliation":[{"name":"Hospital Hygiene and Infectious Diseases Department, Hospital Nova of Central Finland Wellbeing Services County of Central Finland  Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3926-9762","authenticated-orcid":false,"given":"Henry","family":"Kuronen","sequence":"additional","affiliation":[{"name":"Animal Health Diagnostic Unit, Laboratory and Research Division Finnish Food Authority  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2867-7921","authenticated-orcid":false,"given":"Ruska","family":"Rimhanen\u2010Finne","sequence":"additional","affiliation":[{"name":"Infectious Disease Control and Vaccinations Unit, Department of Health Security Finnish Institute for Health and Welfare  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,20]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"CLSI. (2018).Performance standards for antimicrobial disk and dilution susceptibility tests for bacteria isolated from animals. CLSI Standard VET01. Clinical and Laboratory Standards Institute.https:\/\/clsi.org\/media\/2325\/vet01ed5_sample.pdf"},{"key":"e_1_2_12_3_1","unstructured":"CLSI. (2020).Performance standards for antimicrobial disk and dilution susceptibility tests for bacteria isolated from animals. CLSI supplement VET01S. Clinical and Laboratory Standards Institute.https:\/\/clsi.org\/media\/m1gppkx2\/vet01sed5_sample.pdf"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.2903\/j.efsa.2022.7666"},{"key":"e_1_2_12_5_1","unstructured":"Goverment Decree. (2011).Valtioneuvoston asetus elintarvikkeiden ja veden v\u00e4lityksell\u00e4 levi\u00e4vien epidemioiden selvitt\u00e4misest\u00e4. [Government Decree concerning the follow\u2010up and reporting of food\u2010 and waterborne outbreaks]. Pub. L. 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