Statistics show mixed results on progress against foodborne illness in EU

Salmonella and Campylobacter infections were at a stable level during the past five years, but Listeria cases continue to rise in Europe, according to an annual report on trends and sources of zoonoses.

The European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA) report is based on 2017 data from all 28 European Union member states and nine other European countries that reported on some zoonotic agents.

Listeriosis caused a reported 225 deaths, 156 fatalities were due to Salmonellosis, of which 57 came from the United Kingdom, 45 because of campylobacteriosis and 20 due to Shiga toxin-producing E. coli (STEC).

Halt in Salmonella decline
Salmonellosis cases in the EU fell slightly from 94,425 in 2016 to 91,662 in 2017, but the downward trend that began in 2008 has stalled in recent years.

The proportion of human Salmonella Enteritidis cases increased last year, mostly due to Poland starting to report serotype data. It was confirmed as the most common serovar responsible for human cases, particularly in those acquired in the EU.

“After years of significant progress in reducing the burden of foodborne illnesses in the EU, especially Salmonella, the situation has now stalled. Increased efforts are needed to push the figures further down,” said Marta Hugas, EFSA’s chief scientist.

The top five most common serovars in human cases acquired in the EU were Enteritidis, Typhimurium, monophasic Salmonella Typhimurium, Infantis and Newport. Three ‘new’ serovars (Brandenburg, Kottbus and Coeln), entered the top 20 list and replaced serovars Braenderup, Panama and Weltevreden.

Top notification rates were reported by the Czech Republic and Slovakia while the lowest came from Cyprus, Greece, Italy, Portugal and Romania.

The highest levels of Salmonella-positives occurred in foods of meat origin intended to be cooked before consumption such as minced meat and meat preparations from poultry and in minced meat and meat preparations from other species than poultry.

Campylobacter findings
Cases of campylobacteriosis decreased slightly from 246,158 in 2017 to 246,917 in 2016, but it remained the most commonly reported zoonotic disease in the EU as it has since 2005, representing almost 70 percent of all reported cases. The trend for confirmed human cases, which had been increasing since 2008, stabilized during 2013 to 2017.

Based on 2017 monitoring data, in fresh meat, its occurrence is still high ranging from 37.4 percent to 31.5 percent in broilers and turkeys, respectively. Campylobacter in milk and milk products including cheeses had an occurrence lower than 2 percent.

The highest country-specific notification rates were found in the Czech Republic Slovakia, Sweden and Luxembourg while the lowest were in Bulgaria, Cyprus, Latvia, Poland, Portugal and Romania.

Since January 2018, a new process hygiene criterion for Campylobacter is set in Regulation (EC) No. 2017/1495. The criterion is relevant for food businesses and the limit of less than 1,000 CFU/g applies to samples taken for officiall control to verify whether it has been met. Reporting of monitoring data collected by authorities and verifying compliance with the process hygiene criterion becomes mandatory from 2020.

Listeria data
Cases of listeriosis decreased slightly this past year as 2,480 infections were reported, against 2,509 in 2016, but the trend has been upward in the past five years. France had the highest number of fatal cases with 59 followed by Germany with 27.

The group most affected was the elderly, particularly those over 84. In this age group, the listeriosis fatality rate was 24 percent, while overall in the EU, the infection was fatal for one in every 10 patients. Based on severity data, listeriosis was the most severe zoonoses with the highest hospitalization and mortality rate.

Listeria monocytogenes occurrence was highest in fish and fishery products, RTE salads, RTE meat and meat products, soft and semi-soft cheeses, fruit and vegetables and hard cheeses.

The notification rate of human listeriosis increased, despite Listeria seldom exceeding the EU food safety limit in ready-to-eat food. Highest notification rates were observed for Finland, Denmark, Germany, Luxembourg, Sweden and Belgium while the lowest rates were by Bulgaria, Croatia, Cyprus, Malta and Romania.

Yersinia in third place
More than 6,800 confirmed and three fatal cases of yersiniosis were recorded in 2017 making it the third most reported zoonosis. The decreasing EU trend for confirmed cases since 2008 stabilized during 2013-2017.

Yersinia enterocolitica was the most common species from human cases. The top bioserotype was 4/O:3 followed by 2/O:9 and 2/O:5,27.

The highest country-specific notification rates were in Finland, Lithuania, Czech Republic, Slovakia and Denmark.

STEC is fourth most common
In 2017, 6,073 confirmed cases of Shiga toxin-producing E. coli (STEC) infections were reported in the EU – meaning it was the fourth most common zoonosis. A trend stable over the last five years.

The most common STEC serogroup in confirmed cases of human infections was O157. This serogroup was also the most frequently reported cause of hemolytic uremic syndrome (HUS) cases. The age group most affected were infants and children up to five years old, who made up two-thirds of HUS cases.

However, the proportion of O157 continued to decrease and non-O157 serogroups increased. Serogroup O157 was followed by O26, O103, O91, O145, O146 and O111. A new serogroup O76 was added and three (O5, O182 and O27) dropped out of the top 20 list in 2017.

Highest country notification rates were in Ireland, Sweden, Denmark, Austria and Germany while Bulgaria, Cyprus, Greece, Latvia, Lithuania, Poland, Portugal, Romania and Slovakia reported low rates.

Presence of STEC was reported in 1.8 percent of 21,574 food samples tested. The highest proportion of positives were from meat samples particularly small ruminants, followed by milk and dairy products.

The report also looks at trends and sources for bovine tuberculosis, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, Coxiella burnetii (Q fever), West Nile virus and tularaemia.

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