Large drop but France still records more than 1,000 outbreaks in 2020

Large drop but France still records more than 1,000 outbreaks in 2020

by Sue Jones
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The number of outbreaks fell by more than 40 percent in France in 2020, largely because of COVID-19 measures, according to new numbers from the French public health agency.

Overall, 1,010 outbreaks were declared in 2020 affecting 6,814 people. Of these, 396 went to hospitals and nine died. Officials are compiling outbreak numbers for 2021.

In 2020, outbreaks went down by 43 percent from 1,783 in 2019 when 15,641 people were sickened, according to Sante publique France.

The drop in outbreaks is greater for those linked to commercial and catering settings but can be seen, to a lesser extent, for domestic outbreaks. The decrease is more marked during times of lockdown because of the pandemic but can also be noted outside these periods when social distancing measures, working from home and closure of restaurants were in place.

Confirmed and suspected outbreaks
In 276 outbreaks in 2020, a pathogen could be confirmed microbiologically in food or in at least one sick person. The most frequently confirmed agent was Salmonella in 120 outbreaks that were responsible for 519 patients and 135 hospitalizations. While most of the time the type was not known, Salmonella Enteritidis was behind a third of these outbreaks.

Campylobacter was linked to 63 confirmed outbreaks, 37 were from Bacillus cereus, 17 because of Clostridium perfringens and 13 from Staphylococcus aureus.

Shiga toxin-producing E. coli (STEC), Yersinia enterocolitica, Clostridium botulinum, Shigella, Listeria monocytogenes, Trichinella pseudospiralis and Cryptosporidium caused a few outbreaks each.

A pathogen was suspected without microbiological confirmation for 555 outbreaks. The top supposed agents, based on epidemiological and clinical information, were the toxins Staphylococcus aureus, Clostridium perfringens and Bacillus cereus, making up almost three quarters of such outbreaks. For these three pathogens, 2,612 patients and 98 hospitalizations were recorded.

Other suspected incidents were caused by histamine, Ciguatera, Vibrio parahaemolyticus, Yersinia enterocolitica and Anisakis. For 179 outbreaks involving 1,304 patients and 48 hospitalizations no agent was confirmed or suspected.

Food sources
Nine outbreak related deaths were reported in 2020. One was from eating a type of poisonous plant. Three people died in two confirmed Salmonella Enteritidis outbreaks and two fatalities were linked to separate Bacillus cereus outbreaks. One person died in a suspected Bacillus cereus outbreak. There was also one death in suspected outbreaks of Staphylococcus aureus and norovirus.

Each year, there is a winter peak in outbreaks caused by enteric viruses, mainly norovirus. The main source of infection is usually consumption of shellfish, especially oysters. In 2019, 134 outbreaks reported in December were linked to eating oysters. Thirty outbreaks were linked to consuming oysters in January 2020. Norovirus was identified in stool samples from patients, in oyster samples and in harvesting areas.

For 43 percent of outbreaks for which a pathogen was confirmed or suspected, the implicated foods were multiple, made up of various ingredients or were ready-made foods such as salads. Consumption of eggs and egg products was suspected to be the cause of 11 percent of outbreaks, followed by poultry, meat, fish, shellfish and dairy products.

Non-conformities relating to products, materials, storage or preparation methods were identified for 362 outbreaks. Corrective measures included cleaning and disinfection of the establishment and staff training while a few commercial sites were ordered to close.

Other surveillance and control results
Meanwhile, the General Directorate for Food (DGAL) has published findings from 16 food chain surveillance plans in 2020 looking for chemical substances and residues as well as physical and biological contaminants.

The majority of the 58,000 samples related to primary production, and mainly the meat livestock sector, followed by the poultry sector and a few fisheries products.

Most samples were in line with the limits in European regulation but for animal primary production non-compliances were found for trace metals in game products. Issues in plant production involved exceeding authorized maximum levels or presence of unauthorized substances.

Finally, the General Directorate for Competition Policy, Consumer Affairs and Fraud Control (DGCCRF) has revealed results of checks on products consumed during the holiday season undertaken in 2019 and 2020.

In 2019, investigators found the origin of seafood was not always clear and festive sweets lacked correct allergen labeling and contained illegal dyes.

A withdrawal and destruction of products was ordered after finding use-by dates being exceeded. A butcher shop was closed and 240 kilograms of meat destroyed because of traceability concerns. Checks on charcuterie products also revealed items past their use-by date. A total of 266 kilograms of frozen fish and meat were seized that showed signs of thawing and refreezing.

Controls in 2020 for food products, that focused more on online, found similar problems as well as a shellfish farm being fined for a lack of traceability. Because of the frequency and nature of the breaches, the agency ran this control operation again in the final weeks of 2021.

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