There was a big fall in the number of Shiga toxin-producing E. coli (STEC) infections in Europe in 2020, according to recently published data.

In 2020, 4,824 confirmed STEC infections were reported. This is down from 8,339 in 2019. STEC infection is mainly acquired through consumption of contaminated food or water and contact with animals or their feces.

Data on STEC infections were reported by 29 countries. Notification is voluntary in Belgium, France, Luxembourg, and Spain or based on another type of system in Italy.

Germany with 1,409 and Ireland with 734 had the most infections, accounting for 44 percent of all cases. The highest country-specific notification rates were in Ireland, Malta, Denmark, and Norway.

Data on HUS cases and type of E. coli
The age group 0 to 4 years old accounted for 1,326 of the 4,819 patients where age information was available.

A total of 39 percent of 1,957 STEC patients with information were hospitalized and 14 people died. Most deaths were in people above the age of 65 with a third of them having hemolytic-uremic syndrome (HUS), which is a type of kidney failure.

Of 324 HUS cases, the majority were in the 0 to 4 or 5 to 14 year old age group, with a case fatality rate of 2 percent.

Most HUS cases caused by O26 were reported by France, Italy, and Ireland, the first two base their surveillance of STEC infections on detection of HUS cases.

The five most common serogroups were O26, O157, O103, O145, and O146. There has been an increasing trend in STEC O26 in the past five years, while STEC O157 infections decreased during the same period, said the European Centre for Disease Prevention and Control (ECDC).

There were 34 outbreaks involving 208 people in nine countries. Two outbreaks were caused by tap or well water and one each by meat products, dairy products other than cheese and cheese made from cows’ milk. STEC O157 was behind three outbreaks, two were linked to STEC O145, and STEC O26 caused one.

In the five-year period from 2015 to 2019, there was an increase in the overall trend of reported STEC cases. However, in 2020, infections decreased notably because of the COVID-19 pandemic and figures from the United Kingdom no longer being included.

Brucella infections hit record low
Brucella infections also declined from 314 in 2019 to 134 in 2020.

Brucellosis occurs when people are in contact with infected animals or consume contaminated animal products like unpasteurized milk and dairy products or undercooked meat.

Brucellosis data were reported by 28 countries. In Denmark, it is not reportable or under surveillance. Reporting is mandatory in other EU nations but in Belgium it is based on another type of system.

Greece, France, Germany and Italy had the most confirmed cases. Greece had the highest rate, followed by Portugal and Sweden. In Sweden, all cases with information were travel related.

Almost two-thirds of 129 brucellosis cases with reported information were hospitalized and two were fatal.

The COVID-19 pandemic significantly impacted the number of infections reported in 2020 with cases decreasing to their lowest level since the beginning of EU-level surveillance in 2007, said ECDC.

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