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Salmonella Q&A: Israel’s massive bacteria-induced chocolate recall explained

Chocolates and snacks have been removed from shelves across country. Will every contaminated chocolate make you sick? And how does contamination come about?

Nathan Jeffay

Nathan Jeffay is The Times of Israel's health and science correspondent

Illustrative: A woman suffering from a stomach ailment. (iStock via Getty Images)
Illustrative: A woman suffering from a stomach ailment. (iStock via Getty Images)

Israel is in the midst of the biggest product recall in the country’s history, as numerous lines made by its biggest confectionary producer, Elite, are suspected of containing salmonella.

At least two children and one adult have sought out medical attention with suspected cases of salmonella poisoning since the Strauss Group, the parent company of Elite, announced the recall on Sunday. There are no reported cases among the elderly, who are more likely than others to experience serious consequences from salmonella, and sometimes even fatalities.

Health Minister Nitzan Horowitz said Tuesday that the incident will be fully investigated and the factory will not be allowed to resume operation before it is fully cleared. “The chocolate factory of Elite-Strauss will not return to production until we can reach an unequivocal conclusion that it can produce products that are healthy, clean, and pose no threat to the public,” Horowitz said.

Items suspected of contamination include chocolate, ice cream, pudding, and cookies. How could such contamination come about? Is it certain that eating infected chocolate will make one sick? And what can be the effects of salmonella? The Times of Israel spoke to Prof. Daniel Cohen from Tel Aviv University’s School of Public Health, an expert in epidemiology and preventative medicine.

What will be the impact on people if they do contract salmonella from eating these items?

Most people who become sick do so after an incubation period that is between 12 hours and two days, and will notice diarrhea, stomach pain, fever, and vomiting. Among those who are normally healthy, it tends to pass in a few days, but among older people or for those with weaker immune systems, it can be more serious and potentially fatal, which is one of the reasons for the concern.

Elite products being removed from shelves following the discovery of salmonella on the production line at a factory in the Galilee on April 25, 2022. (Avshalom Sassoni/Flash90)

Does every person who eats a contaminated item get sick?

No. It depends on a range of factors, including a person’s immune system, which can mean that people eat contaminated items and don’t get sick. I can’t say what percentage of people eat such items and do or don’t get sick, but it’s not certain that everyone contracts salmonella.

Does the amount of bacteria consumed make a difference?

Yes. There are pathogens that can affect people with a very tiny amount, for example, rotavirus, and others that need relatively more. Cholera is an example of a bacteria that harms people only when they take in a relatively large amount. Salmonella needs a relatively large amount, but not as much as cholera. In practical terms, this means that the extent to which a product is contaminated and how much of the product you eat impact your chances of getting sick.

Prof. Daniel Cohen of Tel Aviv University (courtesy of Tel Aviv University)

If there was salmonella at the production plant, would that mean a standard level of contamination among all products produced there?

No. It’s entirely possible that the level of contamination would have been different at different times, meaning that even if some chocolates and snacks had a high level of contamination, it wouldn’t be all.

What can cause contamination in food production?

It could arise from ingredients brought to a factory that were contaminated, for example, imported cocoa, if it was contaminated by a worker who had salmonella before import. It’s an ingredient that can be contaminated at source. It’s possible that this continuation could survive in to the final product, or that it’s killed in processing, but then restored due to cross contamination between the raw ingredient and the finished product. A third possibility is staff in Israel could have been carriers of salmonella and passed fecal matter, perhaps on hands, into the products.

If the final products left the factory in Israel contaminated, would the bacteria count continue to grow during all the time it sat on shelves in stores and on shelves at hone until it was eaten?

Not much, as items like solid chocolate, with a high sugar content and of a dry nature, aren’t conducive to the growth of bacteria.

If people have had salmonella before, does it give them any immunity?

It’s unlikely.

If people realize they have consumed contaminated items is there anything they can do to reduce their chances of getting sick, such as consuming probiotics?

No.

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