Outbreaks down but illnesses up for Europe in 2023

There was a decrease in foodborne outbreaks in 2023 in Europe but the number of people sick and hospitalized increased.

Overall, 27 European Union member states and Northern Ireland reported 5,691 outbreaks, 52,127 cases, 2,894 hospitalizations and 65 deaths. There was one more death than in 2022, making it the highest total reported in the past 10 years. In 2022, there were 5,763 outbreaks, 48,605 cases and 2,783 hospitalizations.

Data from the One Health Zoonoses report published by the European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control (ECDC) shows 100 outbreaks, 1,158 illnesses, 125 hospitalizations, and eight deaths were reported by seven non-member states.

France recorded more than 2,000 outbreaks, while the Netherlands had 911, Belgium had 722, Spain had 614, and Poland recorded more than 400.

A total of 51 very large outbreaks had more than 100 cases each. In the largest incident, 740 people fell ill in France, milk products were suspected but the agent was not identified. A quark dessert with mixed berries contaminated with norovirus in Germany involved 538 cases and was linked to a canteen or workplace catering as the place of exposure.

Major Salmonella burden

Salmonella was identified in more than 1,100 outbreaks and was associated with the highest number of cases, hospitalizations, and 16 deaths. Salmonella Enteritidis was the most frequently reported serovar, followed by Salmonella Typhimurium and monophasic Salmonella Typhimurium. Salmonella was also behind the most multi-country outbreaks in the EU in 2023.

Poland had 269 Salmonella outbreaks, Spain had 252, France had 143, and Slovakia 120. Salmonella was the leading cause of outbreaks in 14 member states and three non-EU member states. Salmonella and egg products caused 83 outbreaks, with 44 in Spain, and more than 1,100 patients.

Campylobacter caused 229 outbreaks and was the top agent in Malta. Nineteen outbreaks were due to Listeria monocytogenes with 11 deaths. One outbreak was reported by Italy with 38 sick. All cases were hospitalized and two died. The implicated food was table olives.

Shiga toxin-producing E. coli (STEC) was responsible for 66 outbreaks. It ranked first in Ireland and Northern Ireland. E. coli other than STEC was reported in 20 outbreaks.

Viruses, parasites and unknown causes

Seventeen outbreaks were caused by Yersinia and seven by Vibrio parahaemolyticus. Eleven were due to Hepatitis A and three to Hepatitis E. Cryptosporidium, norovirus, Anisakis, Trichinella, histamine, mushrooms, and marine biotoxins such as Ciguatera also caused epidemics. One each was due to atropine in Portugal and lectins in Denmark.

One histamine outbreak involved 154 cases in Spain. It was linked to a canteen or workplace catering setting and to fish and fish products. Three outbreaks caused by tick-borne encephalitis virus (TBE) were reported by Slovakia. They were associated with consumption of fresh cheeses made from sheep’s milk.

Outbreaks caused by bacterial toxins were reported by 19 countries but France had the most with 769. Bacillus cereus toxins were the top agents in this group with 474 outbreaks, followed by Staphylococcus aureus with 207 and Clostridium perfringens toxins with 140. Clostridium botulinum toxins were responsible for five outbreaks reported by Bulgaria, Italy, Romania, and Spain.

The proportion of outbreaks caused by unknown agents was at its highest level since 2014. The Netherlands (880), France (759), and Belgium (661) contributed most to this reporting. The largest was reported by France in a canteen or workplace catering setting, which involved 740 cases. Consumption of milk or milk products was the suspected implicated food vehicle.

There were 20 outbreaks involving travel-associated cases, which is the highest ever reported to EFSA. They involved 96 cases, 19 hospitalizations but no deaths. Salmonella was the main causative agent with 11 outbreaks, followed by Campylobacter with seven, and hepatitis A virus and toxigenic Vibrio cholera, with one each.

Inadequate heat treatment or inadequate chilling were the main contributing factors to outbreaks. Other issued listed were unprocessed contaminated ingredient, cross contamination, time storage/temperature abuse and an infected food handler.

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Source: https://www.foodsafetynews.com/2024/12/outbreaks-down-but-illnesses-up-for-europe-in-2023/