Campylobacter, Salmonella and norovirus cause most illnesses in France

Campylobacter, Salmonella and norovirus were responsible for more than 70% of foodborne illnesses in France during a five year period.

A study determined estimates for 2008-13 considering 15 foodborne pathogens (10 bacteria, three viruses and two parasites) and estimated that each year, the pathogens accounted for 1.28–2.23 million illnesses, 16,500-20,800 hospitalizations and 250 deaths.

Of the illnesses 880,500 (59%) were caused by bacteria; 579,500 by viruses and 45,000 by parasites.

Salmonella spp. and Listeria monocytogenes accounted for ≈50% of all foodborne illness–associated deaths.

Estimates of the annual numbers of foodborne illnesses and associated hospitalizations and deaths are needed to set priorities for surveillance, prevention and control strategies, said researchers.

Hepatitis E previously unrecognized

Campylobacter spp., non-typhoidal Salmonella spp. and norovirus accounted for 73% of all foodborne pathogen–associated illnesses and hospitalizations (76%).

Hepatitis E virus appeared to be a previously unrecognized foodborne pathogen causing ≈68,000 illnesses in the country every year.

“The substantial annual numbers of foodborne illnesses and associated hospitalizations and deaths in France highlight the need for food-safety policymakers to prioritize foodborne disease prevention and control strategies,” said researchers.

Foodborne pathogens

Bacteria: Bacillus cereus, Campylobacter spp., Clostridium botulinum, Clostridium perfringens, Shiga-toxin–producing E. coli [STEC], Listeria monocytogenes, Salmonella spp., Shigella spp., Staphylococcus aureus, Yersinia spp.; Viruses: hepatitis A, hepatitis E, norovirus); Parasites: Taenia saginata, Toxoplasma gondii.

Norovirus ranked first as the cause of foodborne illnesses (34%), third for foodborne illness–associated hospitalizations (20%) and seventh as a cause of foodborne illness–associated deaths (3%).

Salmonella spp. was third as the cause of foodborne illnesses (12%), second for hospitalization (24%) and first as a cause of death (27%).

L. monocytogenes ranked second (26%), before Campylobacter spp. (17%) as a cause of foodborne illness–associated deaths.

L. monocytogenes caused <0.1% of all foodborne illnesses but was just behind Salmonella spp in terms of deaths.

Estimates of the burden of foodborne illnesses in Europe also indicated the three most frequent causes were norovirus, Campylobacter spp. and Salmonella spp.

Data generation methods

Different approaches were used to generate estimates depending on the most suitable data available.

To estimate illnesses, researchers used surveillance data from the mandatory notification system, from the literature and from national reference laboratories and lab surveillance networks.

They also used seroprevalence data and health insurance reimbursement data for niclosamide (a drug used to treat tapeworm infestation).

The French Hospital Information System (FHIS) was the main data source for estimating the number of hospitalizations.

Researchers looked at death certificate data from the French national mortality database (Institut National de la Santé et de la Recherche Médicale, CépiDc [Epidemiology Center on Medical Causes of Death)] and data from FHIS to estimate foodborne illness–associated deaths.

Source: Emerg Infect Dis. 2017 Sep

Estimated annual numbers of foodborne pathogen-associated illnesses, hospitalizations, and deaths, France, 2008-2013

Authors: Van Cauteren D, Le Strat Y, Sommen C, Bruyand M, Tourdjman M, Jourdan-Da Silva N, et al.