New report shows Listeria up, other diseases down in Europe in 2019
Campylobacter, Salmonella and E. coli infections declined in Europe but Listeria monocytogenes infections went up in 2019, according to figures from the zoonoses report.
Campylobacteriosis was the top infection followed by Salmonellosis, Shiga toxin-producing E. coli (STEC), yersiniosis and listeriosis, according to the European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control (ECDC) annual report. For data on outbreaks in Europe in 2019 click here.
The EFSA and ECDC were told about the incompleteness of some data by a few member states because of the COVID-19 pandemic. This impacted on resources allocated to zoonoses and foodborne data collection leading to a delay in reports from regional to national levels.
In 2019, campylobacteriosis was the most commonly reported zoonosis, as it has been since 2005, representing 50 percent of all infections. The number of confirmed cases was 220,682, which is a decrease from 246,571 in 2018. Almost 20,500 people needed hospital treatment and 47 died in 2019.
The highest numbers of reports were in Czech Republic, Slovakia, Denmark and the United Kingdom. The lowest were in Bulgaria, Cyprus, Greece, Latvia, Poland, Portugal and Romania. Turkey, Thailand and Morocco were the main probable countries of infection outside the EU.
Seven member states reported results from official control samples collected as part of the Campylobacter regulatory limit for food businesses. Of the 3,346 neck skin samples from chilled broiler carcasses, 1,365 were positive and 506 exceeded 1,000 colony forming units per gram (CFU/g).
Seven countries reported such data based on sampling results from food companies. Of the 15,323 neck skin samples, 2,038 tested positive and 1,033 exceeded the limit of 1,000 CFU/g.
Salmonella Mikawasima rise
Salmonellosis was the second most common gastrointestinal infection with 87,923 confirmed patients reported, which was down from 91,858 in 2018. In total, 140 fatalities were noted, of which 46 were recorded by the UK.
The highest notification rates were reported by Czech Republic and Slovakia while the lowest came from Cyprus, Greece, Ireland, Italy, Portugal and Romania. Turkey, Egypt, Thailand and India were the places with the most travel-associated infections outside Europe. In the EU, Spain and Greece were the main destinations linked to sickness.
The top Salmonella serovars were Enteritidis, Typhimurium, monophasic Typhimurium (1,4,,12:i:-) and Infantis. Salmonella Mikawasima increased by 92.1 percent and 137.1 percent compared with 2018 and 2017, respectively, and entered the top 20 list in 2019, replacing Brandenburg.
Infant formula had 123 Salmonella positives for ready-to-eat (RTE) products and 562 for non-RTE products. These findings merit attention because this product is intended for young, susceptible children and past outbreaks have been recorded, according to the report.
Deadly Listeria and changing STEC trends
In 2019, 2,621 confirmed invasive cases of listeriosis were recorded compared to 2,545 in 2018. The EU case fatality was high and increased compared with 2018 and 2017.
The highest reporting rates were in Estonia, Sweden, Denmark and Malta while the lowest were in Bulgaria, Croatia, Cyprus and Romania.
Listeriosis had the highest proportion of hospitalized cases of all zoonoses under EU surveillance and 300 people died. France had the most fatal cases with 56 followed by 55 in Spain and 54 in Poland.
In 2019, 7,775 confirmed cases of Shiga toxin-producing E. coli (STEC) infections were reported, which is down from 8,161 in 2018.
The highest notification rates were in Ireland, Malta, Denmark and Sweden while Bulgaria, Cyprus, Greece, Lithuania, Poland, Portugal and Slovakia had low figures. Egypt was most frequently listed as the probable country of infection of travel-associated cases, followed by Turkey, Spain, Morocco, Italy and Thailand.
The 394 hemolytic uremic syndrome (HUS) cases was about the same level as 2018. Serogroup O26 was the most common among HUS cases instead of O157, as it has been since 2016.
In 2019, 10 deaths because of STEC infections were reported compared with 11 in 2018. Half the deaths were associated with HUS. The serogroups linked to fatalities were O157, O145 and O8.
The most common serogroup was O157 but its proportion has been decreasing since 2012. E. coli O26 was second followed by O146, O103, O91, O145 and O128. Three new serogroups — O27, O78 and O182 — were added to the Top 20 list in 2019 replacing O5, O55 and O174.
Those most affected by STEC were infants and children up to 4 years of age, who accounted for two-thirds of HUS cases. However, most deaths were in people older than 25.
Yersinia, Brucella and Trichinella
Yersiniosis was the fourth most common zoonosis with 6,961 confirmed patients in the EU. Almost 650 people needed hospital treatment and two died.
Germany had the most patients with France in second. Finland had the highest rate, followed by Lithuania and Czech Republic. Infants and children up to 4 years old accounted for almost one-quarter of all confirmed patients.
In 2019, 310 confirmed brucellosis cases were reported with 98 people needing hospital treatment and two deaths compared to 358 infections in 2018. The number of confirmed cases was at the lowest level since the beginning of EU-level surveillance in 2007.
The highest reporting rates were in Greece and Portugal. Among travel-associated cases most went to Iraq, Turkey, Bosnia and Herzegovina and Egypt. In the EU, three people reported travel to Spain and one person had been to Romania during the incubation period.
An outbreak of Brucella melitensis from home-made fresh goat cheese was reported in northern Portugal in 2018 to 2019. This outbreak adds to the concern of the illegal trade of raw milk cheese and challenging food safety standards in the EU, according to the report. Another outbreak was noted by Austria. It was linked to unpasteurized milk consumed in Turkey.
In 2019, 96 confirmed cases of trichinellosis were reported in the EU, up from 66 the year before. The increase was mainly because of a rise in Bulgaria, Italy and Spain. Six people were hospitalized and one died. The main reason for this rise was the higher consumption of homemade pork products during winter and the wild boar hunting season, according to the report.
(To sign up for a free subscription to Food Safety News, click here.)