A Hazard Does Not Always Equate to a Risk: Cronobacter is a rare opportunistic pathogen and the greatest risk is only for a small sub-population of infants and only associated with powdered infant formula or human breast milk
John Donaghy, M.H. Zwietering, Jeffrey M. Farber
Abstract
Cronobacter infections can result in a rare, but severe disease in infants and especially neonates. Powdered infant formula (PIF), formula for special medical purposes and human milk fortifiers are considered relevant for the exposure and risk of this organism. Recently, there have been a number of recalls due to the presence of Cronobacter spp. in infant cereals. These products are, however, generally not consumed by neonates or very young infants and there have been no reported Cronobacter infections in infants under the age of 12 months linked to the consumption of an infant cereal. Therefore, Cronobacter should not be considered a risk in these foods. The same reasoning can be followed for any other food product apart from PIF. The focus for Cronobacter control should be on PIF for infants less than 6 months of age, breast milk, and general hygiene in the environment and food preparation area for this age group, and even more so for newborns less than 2 months of age, premature infants and infants with weakened immune systems. • Cronobacter spp. can be isolated from many different environments and foods. • Control should focus on powdered infant formula and formula for special medical purposes. • Recalls of other food types results in unnecessary waste, costs and potential shortages without likely public health benefits.