Italy's Emilia-Romagna Region Bans Raw Tomatoes in Schools and Hospitals as Salmonella Outbreak Spreads Across Europe

Health authorities in Italy's Emilia-Romagna region have ordered all public and private foodservice providers at schools, hospitals, nursing homes and social care facilities to stop serving raw cherry tomatoes, regional officials said this week, as a multi-country Salmonella outbreak tied to Sicilian produce continues to grow across Europe. The order, which regional officials say will remain in force until further notice, makes Emilia-Romagna the second Italian region in less than a month to suspend raw tomato service in institutional kitchens, following a similar move in Puglia.

Officials said the measure was adopted under the precautionary principle while investigators work to pin down exactly how the bacteria are entering the supply chain. Anyone found violating the order could face prosecution, according to the regional notice, as reported by Food Safety News.

What investigators have found so far

The outbreak involves two closely related strains, monophasic Salmonella Typhimurium and Salmonella Strathcona, both of which have repeatedly been detected in raw cherry and datterini tomatoes grown in Sicily. According to the European Centre for Disease Prevention and Control, which has tracked the Strathcona strain since a first rapid outbreak assessment in November 2024 and an update a year later, the pattern is now considered a prolonged, recurring, multi-country event rather than an isolated incident.

In Emilia-Romagna alone, regional surveillance has logged 112 Strathcona infections and five monophasic Typhimurium cases since 2024. Austria's food safety agency, AGES, said in an Oct. 16 consumer warning that more than 160 confirmed infections have been reported across ten European countries since July alone, with roughly 100 additional suspected cases still awaiting laboratory confirmation. Looking back further, the agency counted more than 800 confirmed cases across 17 countries since 2023.

Genetic sequencing has repeatedly pointed back to the same source region. Investigators in Austria previously identified the outbreak strain in organic cherry tomatoes imported from Italy, and Italian authorities separately detected it in irrigation water drawn by a tomato grower in Sicily. A national Italian task force that met Sept. 30 concluded that recent clusters in Puglia, Lombardy, Lazio and Friuli-Venezia Giulia were all linked to fresh tomatoes, particularly raw cherry varieties, contaminated with either Typhimurium sequence type 34 or Strathcona sequence type 2559.

Who is affected

Austria has recorded 29 cases since late July — 21 confirmed and eight classified as probable — spread across seven of the country's nine federal states, with seven patients, or about a quarter of cases, hospitalized. Germany's Robert Koch Institute, in a bulletin published Sept. 24, described the 2025-2026 season as the country's largest Strathcona outbreak to date, with 116 cases, and said 39 additional patients have been linked to the outbreak since June of this year. Denmark, France, Ireland, Luxembourg, the Netherlands, Norway and Sweden have also reported illnesses this season, according to AGES.

The outbreak is not confined to Europe. Earlier phases of the same recurring strain have turned up in the United States and Canada as well, though in far smaller numbers than in Italy, Germany or Austria, Food Safety News has reported in prior coverage of the multi-year pattern. Most patients interviewed report no direct link to a single retailer or restaurant chain, which investigators say reflects how widely Sicilian tomatoes are distributed once they leave the farm.

Within Italy, the people most directly affected by Monday's order are children in school cafeterias, hospital patients, and residents of nursing homes and other care facilities — groups considered at higher risk of severe illness from Salmonella and whose meals are typically prepared in large institutional kitchens rather than purchased fresh at the point of service.

Why tracing the source has proven difficult

Regional officials in Emilia-Romagna said the complex traceability of fresh tomato supply chains has made it difficult to identify which specific operators and distribution points are implicated, even as the overall link to Sicilian-grown tomatoes strengthens. Cherry and datterini tomatoes typically pass through multiple packers, distributors and retailers before reaching institutional kitchens, and growers in the Ragusa and Caltanissetta provinces — the two Sicilian areas named in Austria's warning — supply markets well beyond Italy's borders.

The regional notice cited two formal outbreak assessments from the ECDC and the European Food Safety Authority, covering 2024 and 2025, along with multiple notifications filed through the European Union's Rapid Alert System for Food and Feed. Italy's health ministry has separately recalled at least one specific lot of cherry tomatoes produced in Gela, in Caltanissetta province, after contamination was confirmed.

Austria's warning advises that if cherry tomatoes from Ragusa or Caltanissetta must be used, they should be cooked thoroughly rather than eaten raw, noting that washing alone reduces but does not eliminate surface contamination. The ECDC has said it expects further infections are possible as long as contaminated product remains in circulation, though it continues to describe the precise link between Sicilian growing conditions and the recurring contamination as requiring further confirmation.

What happens next

Emilia-Romagna's suspension has no stated end date, with regional officials saying it will stay in effect until investigators are satisfied that the contamination risk has passed. Puglia's earlier, similar order — issued after the Sept. 30 national task force meeting — covers the same categories of institutional catering: nurseries, schools, hospitals, residential care homes and other social and health care facilities.

Public health officials in Austria and Germany say they expect the outbreak to recur in future growing seasons unless the contamination's root cause, whether in irrigation water, packing facilities or elsewhere in the supply chain, is identified and controlled. The ECDC and EFSA are continuing joint surveillance, and additional Italian regions could take similar precautionary steps if new clusters are confirmed in the coming weeks, according to earlier Food Safety News coverage of the pattern.