Foodborne outbreaks and related deaths in Europe went up in 2022, according to EFSA and ECDC.

The 2022 One Health zoonoses report, published by the European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control (ECDC), revealed the number of foodborne outbreaks and cases, hospitalizations and deaths was higher than in 2021. Deaths from outbreaks was the most in the EU in the past 10 years, with 28 caused by Listeria monocytogenes.

In 2022, 27 European Union member states and Northern Ireland reported 5,763 outbreaks, 48,605 illnesses, 2,783 hospitalizations and 64 deaths. A total of 108 outbreaks, 2,166 cases, 186 hospitalizations and one death were recorded in Bosnia and Herzegovina, Iceland, Montenegro, Norway, North Macedonia, Serbia, and Switzerland.

EU outbreaks increased by 43.9 percent from 4,005 in 2021. Cases and hospitalizations also rose by 49.4 percent and 11.5 percent. Deaths jumped by 106.5 percent compared to 31 in 2021.

Belgium, France, the Netherlands and Spain accounted for three-quarters of the outbreaks. France had 1,861, followed by the Netherlands with 1,162, Belgium at 830 and Spain with 591.

In 2022, the highest number of outbreaks with unknown agents was reported to EFSA. Most of these were notified by Belgium and the Netherlands. Nine incidents had more than 100 cases.

Salmonella and Campylobacter

A causative agent was identified in 3,104 outbreaks. Salmonella remained the most frequent. Norovirus (and other calicivirus) was associated with the most cases at more than 7,300.

Salmonella was behind 1,014 outbreaks with 6,632 cases. Despite outbreaks jumping from 773 in 2021 the number of people sick in them declined from 6,755.

France, Spain, Poland, and Slovakia had the most while Bulgaria and Latvia didn’t report any. Belgium, France, Slovenia, and Sweden had large outbreaks with more than 100 cases. Salmonella Enteritidis was the main serovar reported, followed by Typhimurium and monophasic Salmonella Typhimurium.

In Spain, 34 Salmonella outbreaks were linked to egg products while it was 26 in Poland. One incident in Spain sickened 265 people.

Campylobacter caused 255 outbreaks and 1,097 cases – both up slightly from 2021. In Germany and Malta, it was the leading agent in outbreaks.

Listeria and E. coli

Listeria outbreaks rose from 23 to 35 and patients went up from 104 to 296. Italy had the two largest listeriosis outbreaks. The first involved 97 cases, all hospitalized, and five people died. The second had 43 hospitalized cases with one death. Implicated vehicles were broiler meat products and pig meat products, respectively. Finland reported two outbreaks in vegetables. The first involved eight cases with six hospitalizations and three deaths. The second continued from 2021 and was linked to pre-cut vegetables. In 2022, there were seven cases and two deaths.

STEC outbreaks jumped from 31 to 71 and cases numbers from 275 to 408. It was the most common causative agent in Ireland and Northern Ireland but France had 37 outbreaks.

E. coli O157 was associated with seven outbreaks, with others caused by O26, O104, O111, O113, O145, and O178. Poland reported a STEC O104 outbreak, involving 16 cases, five hospitalizations and one death. It is the first time this serogroup has been linked to an outbreak in Europe since 2011, when a large multi-country incident caused more than 3,000 cases, 50 deaths and 800 cases of hemolytic uremic syndrome. The outbreak occurred in a school or kindergarten but the implicated food was not identified.

Toxins, viruses and parasites

A Streptococcus equi subspecies zooepidemicus outbreak was reported to EFSA for the first time by Italy. It caused 37 cases with 23 hospitalizations and five deaths. A cheese made from unpasteurized milk was identified as the source.

A total of 27 Shigella and 14 Yersinia outbreaks were recorded. Other bacterial agents included Aeromonas caviae, Enterococcus spp., non-toxigenic Vibrio cholerae and Vibrio parahaemolyticus.

With 1,020, France contributed almost 90 percent of all outbreaks caused by bacterial toxins in the EU. Bacillus cereus toxins ranked first and was the causative agent in five outbreaks with more than 100 cases, reported by Spain and France. The largest had 383 sick people.

The largest outbreak caused by Clostridium perfringens had 950 cases and was in Portugal. It was linked to cooked RTE meat in temporary mass catering.

A dozen norovirus outbreaks in seven member states involved more than 100 patients each, totaling 1,606 cases. Three tick-borne encephalitis virus (TBE) outbreaks were reported by Slovakia from raw sheep’s milk and cheese made from sheep milk.

The two largest Cryptosporidium outbreaks occurred in Sweden and had 107 and 75 cases, linked to a RTE salad and buffet meals. Seven Trichinella outbreaks were reported by Croatia, France, Italy, Romania, and Spain with 68 sick.

France had 55 histamine and scombrotoxin outbreaks in 2022 while Spain had 19. Ciguatoxin was identified in 11 outbreaks and mushroom toxins in seven epidemics. Denmark reported two lectin outbreaks, involving 99 cases.

For the first time since collection of data began, the number of strong-evidence outbreaks in restaurants, pubs, street vendors, and takeaway exceeded those in a domestic setting.

In terms of contributing factors, an unprocessed contaminated ingredient was reported in 41 outbreaks. Other issues included inadequate chilling or heat treatment, time storage or temperature abuse, cross-contamination, and infected food handlers.

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