The number of people who became ill due to a salmonella outbreak linked to Kinder chocolate products has increased to 369 across Europe and North America, including 16 in Ireland.
One additional Irish case involving a second strain has been identified in addition to the initial 15, according to the European Centre for Disease Prevention and Control (ECDC). Five of the people affected required hospital treatment.
Across Europe and north America, 274 cases from first cluster or strain and 37 from a second have been confirmed in 16 countries, along with 58 suspected cases. Most cases involved children aged under 10.
The two strains are multi-drug resistant and some samples were also resistant to disinfection using ammonium or hydrogen peroxide. The outbreak has been linked to specific products made in Italian confectionery company Ferrero's factory in Belgium.
Two salmonella strains were identified in buttermilk used at the Belgian plant, which had come from Italy.
The risk of exposure has reduced since April, the ECDC said, when the Belgian plant was closed. However, eight cases - including one in Ireland - cannot be explained by consumption of chocolate products such as those manufactured in Belgium, suggesting there may be other sources of infection.
In the Irish case, a one-year-old child ate other Ferrero products before experiencing symptoms, according to the report.
Symptoms of salmonella infection in children include nausea and vomiting, abdominal cramps and diarrhoea, but are mild in the majority of cases.
Parents have been advised that if their children develop worrying symptoms such as severe or bloody diarrhoea, extensive vomiting, high temperature or severe headache, they should seek medical attention from a GP.