One brand of dry exotic fruit mix has been found to be linked to a growing Salmonella Agbeni outbreak in Norway.

The Norwegian Institute of Public Health (Folkehelseinstituttet) reported there are 21 confirmed and nine possible cases in an updat from the 11 confirmed and 12 suspected infections this past week.

The agency is investigating with local authorities, the Veterinary Institute, and the Norwegian Food Safety Authority (Mattilsynet) to confirm the suspected link. The public health officials report it is too early to conclude the fruit mix is the source of infection.

However, several people who became ill reported eating the fruit mix. Product samples have been sent for analysis but results will not be available until next week.

Bama Gruppen AS, a distributor of fruit and vegetables in Norway, has recalled the implicated dried fruit mixture, which is packaged with the label “husk! eksotisk miks” according to the public health update.

The product has been on sale across the country since mid-November 2018 in NorgesGruppens chains such as Spar, Bunnpris, Jacobs, Joker, Kiwi, and Meny. A total of 3,250 bags have been sold. Bama is the importer into Norway. The dried fruit mix was produced by Eurocompany srl in Italy, a firm involved in the processing and marketing of dried fruit.

Suspected contamination is limited to lot number 8291 with a best-before date of June 30, 2019, but all lots have been withdrawn from the market. Consumers who have the product at home have been advised to throw it away or take it back to the store wher they bought it.

Most of the outbreak patients reported they ate mixtures of dried fruit, berries and nuts before becoming ill. The Norwegian Food Safety Authority is continuing investigations of such products. Interviews with patients and healthy controls are being done as part of a case-control study. Food samples have been taken to determine the source of infections.

People began reporting illnesses in January and February. Confirmed and possible cases include 12 men and 18 women aged from 2 to 91 years old. They live in Oslo, Akershus, Buskerud, Østfold, Vestfold, Vest-Agder, Rogaland, Møre og Romsdal, Trøndelag and Nordland.

Bacteria with a similar DNA profile has been detected in confirmed cases, which strongly suggests a common source of infection, most likely a food item, distributed throughout the country, according to the outbreak update.

Between 900 and 1,300 cases of salmonellosis are reported in Norway each year with the majority infected while traveling abroad. Salmonella Agbeni is one of the rarer serovars in Europe based on data from the European Food Safety Authority (EFSA).

People can experience symptoms of Salmonella infection between six and 72 hours after exposure and these usually last for three to seven days. They include fever, diarrhea, vomiting, headaches, stomach cramps and loss of appetite. More severe symptoms may occur in young children, older people, pregnant women and people who are immunocompromised.