There were an average of 100 food and waterborne outbreaks per week in Europe, according to the 2017 zoonoses report.

The European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) report also found the agent was unknown in 37.6 percent of all outbreaks.

A total of 5,079 foodborne and waterborne outbreaks were reported, 372 less than in 2016. These involved 43,400 involved cases (13,519 less than 2016), 4,541 hospitalizations (119 more) and 33 deaths (one more).

France notified the most outbreaks (1,378) and made up more than a quarter of all those reported in 2017 in the EU.

‘Household’ was the most frequent place of exposure of cases to contaminated foods and one in three outbreaks occurred in this setting.

Compared to 2016, a decrease (100 less outbreaks) was seen in incidents due to norovirus and Campylobacter (79 less outbreaks) while there was an increase for histamine (plus 22 outbreaks). Outbreaks of hepatitis E were noted by Germany for the first time since starting to report the data.

Analysis of 643 strong-evidence outbreaks (12.7 percent of the total) revealed that 60 percent were associated with food of animal origin; ‘Meat and meat products’ was the food group most frequent involved (121 outbreaks), followed by ‘Fish and fishery products’ (106 outbreaks), ‘Eggs and egg products’ (105 outbreaks) and ‘Milk and milk products’ (49 outbreaks).

Large (>100 cases) or very large (>200 cases) outbreaks occurred in Belgium, Estonia, France, Germany, Hungary, Italy, Netherlands, Poland, Romania, Spain, Sweden and the United Kingdom. Mostly caused by norovirus (10 outbreaks) followed by Salmonella (four), Clostridium perfringens (three), Bacillus cereus, Staphylococcus aureus toxins and Shigella flexneri (one each).

Mike Catchpole, ECDC’s chief scientist, said the slight decline was welcome but there were many challenges ahead.

“The fall in the number of outbreaks is to be welcomed, but we still saw an average of 100 food- and waterborne outbreaks per week in 2017, some of which affected several countries. The rising trend of listeriosis, which continues to cause deaths in vulnerable groups, needs to be reversed.”

Campylobacter outbreaks

Campylobacter was identified in 33 strong-evidence and 362 weak-evidence foodborne and waterborne outbreaks that affected 1,445 people with 207 hospitalized and one death.

The highest number of strong- or weak-evidence foodborne outbreaks was reported by Germany (147 outbreaks) with 552 cases followed by Slovakia (117 outbreaks) with 133 cases and one death after hospitalization and France (40 outbreaks) with 207 infections.

The most strong-evidence outbreaks caused by Campylobacter spp. originated from milk and broiler meat, with 18 and eight of 33 strong-evidence outbreaks, respectively.

In Sweden, an outbreak of Campylobacter from 2016 until mid-June 2017 resulted in almost double the number of domestic cases compared with previous years. It was linked to increase of the pathogen in a domestic broiler abattoir.

Salmonella top cause
Salmonella bacteria were the top cause of foodborne outbreaks with Salmonella Enteritidis causing one out of seven. Poland and Slovakia accounted for 63.3 percent of all outbreaks caused by this serovar. The 1,241 Salmonella outbreaks made up 24.4 percent of the total number.

Salmonellosis had the highest impact with 9,600 (22.1 percent) of all outbreak cases, 49 percent of hospitalizations and 33.3 percent of deaths. Salmonella in ‘Eggs and egg products’ caused the highest number of strong-evidence outbreaks (99 outbreaks). Salmonella in eggs and egg products and in meat and meat products were the highest risk agent/food pairs.

Listeria and STEC
Listeria monocytogenes was identified in 10 foodborne outbreaks affecting 39 people in six member states.

Four of the 10 outbreaks were reported as strong-evidence by Austria (two) and Denmark and Sweden (one each). Implicated foods were; ‘cheese’, ‘fish and fish products’, ‘meat and meat products’ and ‘vegetables and juices and other products thereof’. Denmark reported three weak-evidence outbreaks and Germany, Ireland and Italy had one each.

STEC was identified in 48 foodborne outbreaks affecting 206 people in 11 member states.

Nine outbreaks notified by seven member states were reported with strong-evidence on the incriminated food vehicle. Four from bovine meat and products and two from milk.

Brucella was identified in one outbreak in Germany. Shigella was reported by eight member states in 22 outbreaks, including S. flexneri (11 outbreaks) and S. sonnei (six). Nine outbreaks were associated with infection by pathogenic E. coli including enteroaggregative E. coli (EAEC), enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC), reported by five MS. Yersinia was identified in 12 outbreaks with 11 caused by Y. enterocolitica, including a large outbreak involving 80 patients in Denmark.

Outbreaks by bacterial toxins were reported by 20 member states and were associated with toxins by Clostridium perfringens, Staphylococcus and Bacillus cereus. Outbreaks by hepatitis A increased remarkably in 2017, from 17 in 2016 to 90 outbreaks. This was mainly due to reporting by Poland (99.4 percent increase, 64 more outbreaks compared to 2016).

Outbreaks by parasites were stable in 2017 compared with previous years. A large increase in trichinellosis cases was reported by Romania (111 cases in 2017 versus four in 2016) due to one outbreak involving 109 cases. Outbreaks by marine biotoxins including ciguatoxin also increased by 42 percent compared to 2016, mainly due to a higher reporting by France.

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