EFSA and ECDC 2016 annual report on zoonotic diseases

Halt in decline of Salmonella cases is ‘reminder to stay vigilant’ - ECDC

By Joseph James Whitworth contact

- Last updated on GMT

Picture: iStock. Campylobacter, Listeria and STEC infections also increased
Picture: iStock. Campylobacter, Listeria and STEC infections also increased

Related tags: European union

Two EU agencies have warned against complacency when it comes to controlling Salmonella after figures show cases are no longer falling in Europe.

The decreasing trend for confirmed human salmonellosis cases since 2008 ended during 2012-16, and the proportion of Salmonella Enteritidis cases increased by 3% since 2014.

There were 94,530 cases of salmonellosis in the EU in 2016 with 128 deaths - 51 of which were reported by the UK.

The highest notification rates were by the Czech Republic and Slovakia with the lowest by Greece, Italy, Ireland and Portugal.

The increase (212.8%) in Estonia was mainly due to two outbreaks, one of which was not foodborne (person-to-person transmission), with a large number of illnesses; whereas in Poland the increased notification rate (18%) was accompanied by an increase in Salmonella outbreaks.

Better surveillance or decreasing focus?

“This could be partly attributable to more complete reporting and improvements in the surveillance of salmonellosis in few countries and could also partly reflect eventual decreasing focus on Salmonella control,”​ said the report.

Data comes from the 2016 annual report on zoonotic diseases​ by the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC).

Analysis shows Campylobacter is the most common foodborne pathogen, followed by Salmonella, Yersinia, Shiga toxin producing E. coli (STEC) and Listeria.

Mike Catchpole, ECDC’s chief scientist, said the increase shown by surveillance data is worrying and a reminder of the need for vigilance.

“Even in a state of high awareness and with national control programmes for S. Enteritidis in place, there is a need for continuing risk management actions at the Member State and EU level.”

S. Enteritidis focus

food safety egg_brookebecker
Picture: iStock

Denmark, Estonia, Finland, Germany, Italy, Malta and the Netherlands reported a decreasing trend of S. Enteritidis cases acquired within the EU in 2008-2016.

A significant increasing trend was seen in the Czech Republic, Greece, Ireland, Portugal, Slovakia, Spain, Sweden and the UK over the last five years (2012-16).

S. Enteritidis – the most widespread type, accounted for 59% of all salmonellosis cases in the EU and is mostly associated with consumption of eggs, egg products and poultry meat.

Two ‘new’ serovars (S. Bareilly and S. Weltevreden) entered the top 20 list in 2016 and replaced S. Oranienburg and S. Thompson.

The matrices with high frequencies of non-compliant samples were minced meat and meat preparations from poultry to be eaten cooked and meat products from poultry to be eaten cooked.

By contrast, the percentage of non-compliant samples among fresh poultry meat, for which food safety criterion considers exclusively S. Enteritidos and S. Typhimurium, was negligible.

Marta Hugas, EFSA’s chief scientist, said the decrease of Salmonella has been a success story in the EU food safety system in the last 10 years.

“Recent S. Enteritidis outbreaks contributed to a change in this trend in humans and poultry. Further investigations by competent authorities in the field of public health and food safety will be crucial to understand the reasons behind the increase.”

Campylobacter- most reported foodborne pathogen

For campylobacteriosis the increasing European Union (EU) trend for confirmed human cases since 2008 stabilised during 2012-16.

In food, Campylobacter occurrence was 36.7% and 11% in fresh meat from broilers and fresh meat from turkeys. For milk and milk products (including cheeses) occurrence was around 1%.

It was the most commonly reported zoonoses, as it had been since 2005, representing almost 70% of cases. Campylobacteriosis is followed by other bacterial diseases: salmonellosis, yersiniosis and STEC infections in being the most frequent.

Campylobacter was detected in 246,307 people, an increase of 6.1% compared with 2015. Despite a lot of cases fatalities were low (62).

Picture: iStock

The highest notification rates were in the Czech Republic, Slovakia, Sweden and the UK with the lowest in Bulgaria, Cyprus, Latvia, Poland, Portugal and Romania.

“Half of the MS had statistically significant increasing trends also in the period 2012–2016 and majority of the countries had an increase in the number of confirmed cases in the last five years. The increase in reported cases in some of these countries may not only reflect changes in exposure, but also improvements in MS surveillance systems,” ​said the report.

In Belgium, more labs have begun to report campylobacteriosis since 2015 and the number of notified cases increased. In the Czech Republic, testing and diagnostics has improved since 2013.

In Spain, coverage of the surveillance system for campylobacteriosis has improved and the number of reported confirmed cases has almost doubled since 2012. In Sweden, an outbreak in 2016 resulted in almost double the domestic human cases compared to previous years.

Campylobacter has a characteristic seasonality with a sharp increase in summer and early autumn. A smaller but distinct winter peak has become apparent in the past few years, including 2016.

Worrying upward trend of Listeria

The number of human listeriosis confirmed cases further increased in 2016, despite Listeria seldom exceeding the EU food safety limit in ready-to-eat foods.

cheeses assortment
Picture: iStock

Listeria infections led to hospitalisation in 97% of reported cases. In 2016, listeriosis continued to rise, with 2,536 cases (a 9.3% increase) and 247 deaths reported.

Most deaths occur in people aged over 64 (fatality rate of 18.9%). France reported the highest number of fatal cases (53) followed by Germany (48).

L. monocytogenes was most frequently detected in ‘fishery products’ (5.6%), ‘fish’ (4.7%), ‘pork meat items other than fermented sausages’ (3.1%) and in ‘soft and semi-soft cheeses made from raw milk’ (2.5%).

Listeriosis is the only foodborne zoonosis which continues to show a significantly increasing trend in the EU/EEA in the last five years.

“Seven MS (Finland, France, Hungary, the Netherlands, Romania, Slovenia and Sweden) reported increasing trends over the last five years. This is partly attributable to more complete reporting and improvements in the surveillance of listeriosis in a few countries.”

The highest notification rates were for Finland, Belgium, Germany, Slovenia and Denmark.

Spain improved their surveillance system which resulted in an increase of reported confirmed cases by 75.7%. The lowest rates were by Bulgaria, Croatia, Cyprus and Romania.

A noticeable decrease in sample sizes tested and reported to EFSA for many RTE food categories led to the agencies saying: “MS should be prompted to increase sampling and testing efforts and abide by their regulatory obligations on the monitoring of L. monocytogenes in RTE foods.”

STEC O157 vs non-O157

The decreasing EU trend for confirmed yersiniosis cases since 2008 stabilised during 2012–2016 (6,861 cases and five deaths). 

However, it remains the third most commonly reported bacterial foodborne zoonosis in the EU.

The highest notification rates were in Finland and the Czech Republic.

lab meat
Picture: iStock

The number of confirmed Shiga toxin-producing E. coli (STEC) infections in humans (6,378 cases and 10 deaths) was stable. The EU notification rate was 1.82 cases per 100,000 population, which was an 8.3% increase compared with 2015.

The highest notification rates were in Ireland, Sweden, the Netherlands and Denmark and lowest in Bulgaria, Greece, Latvia, Poland, Portugal and Slovakia.

The most commonly reported STEC serogroup was O157 (38.6%) although its relative proportion compared with other non-O157 declined.

In 2016, serogroup O26 was the most frequently reported cause of haemolytic uraemic syndrome (HUS) instead of O157 for the first time.

The presence of STEC was reported in 2.5% of the 18,975 food samples tested. The highest proportion of positive food was from meat samples, particularly small ruminants (sheep and goat) followed by milk and dairy products.

“The major breakthrough during 2016 related to the proportion of food samples tested by the ISO TS 13136:2012 standard, the reference method for the detection of STEC in food, or by equivalent methods - methods detecting all STEC serogroups,” ​said the report.

“However, a major critical aspect is represented by the number of samples tested by the reporting countries for each food and animal category, which is highly variable; such an unequal distribution is likely to introduce selection bias in the estimates of STEC prevalence or STEC serogroup distribution, hindering spatial and temporal trend analyses.”

Related topics: Food Safety & Quality

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