More than 1,600 foodborne outbreaks were declared in France in 2018 affecting 14,700 people with two deaths, according to statistics published by the national public health agency.

A total of 1,630 illness outbreaks were reported involving 14,742 people, and 777 of them needed hospital treatment.

Santé Publique France said the number has gone up from 2017 when 1,310 outbreaks were recorded affecting 13,010 people.

The two people that died were more than 85 years old. The first death was because of microbiologically confirmed poisoning from Bacillus cereus. The second followed intoxication where Bacillus cereus and Clostridium perfringens were suspected.

Confirmed source
A pathogen could be confirmed microbiologically in the food source or in at least one sick person in 389 outbreaks. It was suspected without microbiological confirmation in 973 outbreaks and for 268 no agent was confirmed or suspected.

As in previous years, the most frequently confirmed pathogen was Salmonella in 35 percent of outbreaks for which an infectious agent was known. These outbreaks caused by Salmonella were responsible for 723 patients and 188 hospitalizations.

Salmonella Enteritidis was the main serotype, followed by Typhimurium and the monophasic variant of Typhimurium. For almost a third of outbreaks confirmed with Salmonella, the serotype was not known.

Other confirmed pathogens were Campylobacter in 49 outbreaks, norovirus in 45 and histamine in 11. Shiga toxin-producing E. coli (STEC) caused 10, Anisakis in three and Shigella for two. One each was caused by Yersinia enterocolitica, Ciguatera, Datura and Phytohemagglutinin.

Suspected link
The most common suspected pathogens, based on epidemiological and clinical information, but not confirmed microbiologically, were the toxins Staphylococcus aureus, Clostridium perfringens and Bacillus cereus, corresponding to 70 percent of the outbreaks for which an agent was suspected.

For these three pathogens, 4,380 patients and 219 hospitalizations or emergency visits were recorded. Staphylococcus aureus has been the most frequently suspected or confirmed pathogen since 2006.

Other suspected pathogens included diarrheic shellfish poisoning, Ciguatera, Vibrio parahaemolyticus, Datura, STEC, Shigella, Streptococcus and Anisakis.

No agent could be identified or was suspected on the basis of epidemiological and clinical information in 16 percent of the reported outbreaks.

Food source and outbreak setting
In almost a third of outbreaks where a pathogen was confirmed or suspected, the food source was multiple, made up of various ingredients or were ready-to-eat meals. Meat consumption was suspected to be the source of 10 percent of outbreaks, followed by shellfish, poultry, eggs and egg products, fish, dairy products, crustaceans and charcuterie items. No food was suspected in a quarter of outbreaks.

For a third of outbreaks the mandatory declaration took place the same day or the day after the appearance of clinical signs in the first patient. More than half were declared within three days of the onset of symptoms in the first patient, three quarters were reported within one week and 91 percent within two weeks.

Among the 1,630 outbreaks in 2018, 471 occurred as part of family meals, 638 in commercial catering and 504 in collective catering such as for a business, school canteen or care homes.

Non-conformities of products, equipment, storage or preparation practices were identified in 589 outbreaks. In the three eating places the most frequent non-conformities were related to defective or unsuitable equipment, followed by non-compliance with hygiene rules or improper handling of food by a family member or staff.

Contamination of raw materials, intermediates or finished products were identified in almost a third of the outbreaks where non-conformities were noted. Problems such as failure of the cold chain, preparation errors,  and too long of a delay between preparation and service, were found in 4 percent of outbreaks where non-conformities were observed.

Corrective measures were put in place for 504 outbreaks occurring in commercial or collective catering and for 84 domestic setting outbreaks. More than half of the actions in commercial restaurants were disinfection of the establishment. Other measures included staff training.

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