The impact of the Coronavirus pandemic is still being felt in figures on foodborne infections as the majority of them decreased in Norway this past year.

In 2021, there was a decline for most infectious diseases that spread from food, water and animals and are subject to notification. This is probably due to less travel and infection control measures as a result of the COVID-19 pandemic, according to the Norwegian Institute of Public Health (FHI).

As in previous years, Campylobacter was behind the most reported cases, followed by E. coli and Salmonella. However, FHI said the pandemic made it difficult to interpret trends.

A previous report revealed 25 foodborne outbreaks in 2021 in Norway which is similar to the number in 2020 but down compared to 46 in 2019 and 52 in 2018.

Campylobacter and Salmonella figures
The most illnesses were caused by Campylobacter with 2,055 reported in 2021 versus 2,422 in 2020.

The proportion of cases infected abroad was only 11 percent in 2021 and 2020 compared with 2017 to 2019, before the pandemic, when it was about half of the cases.

Of the 1,196 domestic cases, 526 were hospitalized. Of 223 sickened abroad, they were mostly infected in Spain, including the Canary Islands and Mallorca, Turkey and Poland.

For salmonellosis, the 390 cases in 2021 and 440 in 2020 more than halved compared to before the pandemic. The decline is primarily due to fewer infections abroad, linked to less travel.

The top reported country of infection for those sick abroad was Spain, including the Canary Islands and Mallorca.

Almost half of the 390 cases were hospitalized. Salmonella Enteritidis caused the most illnesses, followed by Typhimurium, Newport and monophasic Salmonella Typhimurium. 

There was an increase in the proportion of hospitalized people for campylobacteriosis and salmonellosis. One possible explanation is that fewer people went to the doctor due to the pandemic, so only those with serious and long-lasting symptoms were diagnosed, said FHI.

E. coli rises but Listeria down
In 2021, 438 cases of E. coli infection were reported, an increase from 331 in 2020. The overall number is still lower than before the pandemic but it is steady for domestic infections. E. coli O103 was behind the most cases, followed by O157, O26 and O146.

Infection led to hospitalization for 145 patients and of three cases that developed hemolytic uremic syndrome (HUS), two were children. These involved E. coli O157, O26 and O113.

In 2021, 20 cases of listeriosis were reported with 14 infected in Norway. All were hospitalized.

There were more cases in the age groups 60-69 years old and 80-89. Seven patients were women and 13 were men. The number of reports dropped compared to 37 in 2020, and there were no outbreaks in 2021.

Reported cases of cryptosporidiosis decreased in 2021 to 355, which is the same level as the years before a peak in 2020 to 483 cases. More than 80 people were hospitalized this past year. In 2020 and 2021, however, the amount of domestic infections increased compared with previous years.

In 2021, 85 cases of yersiniosis were reported with all but two because of Yersinia enterocolitica. They were mainly in February, April and May and 36 were hospitalized. In 2020, 83 cases were recorded.

This past year, there were most cases in the age groups 20-29 years old, 30-39 and 0-9. Forty-five cases were women and 40 were men. In 2020 and 2021, there was a decrease in the number of people ill abroad, while domestic infections increased.

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A reduction in food business inspections and the delay in full import controls are two major issues identified by a recent report on food standards.

The Food Standards Agency (FSA) and Food Standards Scotland (FSS) report covers 2019 to 2021, a period when the United Kingdom was affected by leaving the European Union and the COVID-19 pandemic.

A fall in the number of inspections of businesses is due to resourcing pressures faced by local authorities. The delay in establishing full UK imports controls for high-risk food like meat, dairy and eggs from the EU has reduced the ability to prevent unsafe food entering the UK market. These checks should be in place by the end of 2023.

Findings come amid plans to cut the number of civil servants to 2016 levels in three years, a loss of full access to the EU’s Rapid Alert System for Food and Feed (RASFF) and losing a place in the Heads of Food Safety Agencies, a group of EU bodies that meet to share good practices. 

Positive findings but challenges remain
FSA chair, Susan Jebb, said the report provides reassurance that high food standards in the UK have been upheld during a tough period for the food system.

“We are under no illusions that there are major challenges ahead. Establishing full UK import controls on food from the EU by the end of next year is a priority. The longer the UK operates without assurance that products from the EU meet our high food and feed safety standards, the less confident we can be that we can effectively identify potential safety incidents,” she said. 

As the report also points out, local authority inspections declined during the reporting period. Even though there are signs of improvement, particularly on hygiene inspections, local authorities continue to face resourcing constraints which could affect progress.”

The FSA and FSS said that food safety standards have largely been maintained in the period. However, the pandemic disrupted regular inspections, sampling and audits, reducing the amount of data to assess business compliance against food law. It also changed patterns of consumer behavior.

About 40 million tons of food are imported from abroad each year. The EU remains the biggest supplier, accounting for over 90 percent of beef, dairy, eggs and pork products imported into the UK and nearly two-thirds of all food and feed not of animal origin. 

British Lion Eggs urged retailers and foodservice operators to use domestic eggs instead of importing them.

Andrew Joret, British Egg Industry Council chairman, said: “There have been ongoing food safety issues associated with non-UK eggs for many years and it is essential that effective food safety controls are in place for imports to ensure British consumer are protected from any potential risks, particularly vulnerable groups. This report confirms that the current controls on the import of eggs are not sufficient and until they are, any operator choosing to sell imported eggs is taking a gamble with the health of their customers.”

Picture of incident reporting
Analysis of compliance in import controls between 2020 and 2021 shows there has not been any meaningful change in the standard of imported goods due to the pandemic or Brexit.

There was a rise in reports of contamination by microorganisms from 360 in 2019 to 584 in 2021, as a result of more advanced surveillance such as Whole Genome Sequencing (WGS) to track the source of outbreaks and Salmonella in breaded chicken products. There was a nearly three-fold increase in poultry‑related incidents following a series of Salmonella outbreaks in breaded chicken from Poland in 2020 and 2021, which affected more than 1,000 people.

There was a fall in incidents related to food allergens from 355 in 2019 to 272 in 2021. Ethylene oxide in sesame seeds from India accounted for many reported cases of chemical contamination in 2020 and 2021.

There were 100 disruptions of criminal activity in the supply chain reported by the UK’s two food crime units in 2021. Five cases in Scotland have been referred to the Crown Office and Procurator Fiscal Service, with three being considered as serious offences. Last year also saw the first prosecution after an investigation by the National Food Crime Unit (NFCU), related to the sale of 2,4 dinitrophenol (DNP) and other offences linked to controlled drugs and prescription only medicines.

The growth in e-commerce is creating complexity by increasing the number of online businesses. Online marketplaces are not inherently risky, but they allow new businesses to pop up very quickly, with the associated risk that many may be unregistered and operating without adequate oversight or inspection.

FSS chair, Heather Kelman, said the report’s findings were encouraging but the effects of Brexit and the pandemic are still being felt, and will continue to impact food systems for years to come.

“This joint report comes at what we believe is a make or break juncture for food quality and safety, as we transition into a post-pandemic landscape and take on new responsibilities following our departure from the EU,” she said.

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By Kitt Tovar Jensen

 Not only did the novelty of the pandemic cause national concern, but so did shortages of food and other basic supplies. Although a multitude of brands and meat products flood stores, there are relatively few companies providing the products. In fact, 85 percent of U.S. cattle are slaughtered by just four companies. 

While the current large-scale meat processing system is both effective and efficient, any processing plant closure creates a ripple effect throughout the entire meat product supply. Due to the mechanics of a processing plant as well as consumer taste, livestock must be slaughtered by a certain weight or age. This leaves livestock producers with relatively few markets in which to sell their products. 

 As COVID-19 vaccines became available, the pandemic appeared to near its end. Residual supply chain issues, however, still plague product accessibility. Coupled with rising inflation rates and international disputes, many consumers have begun to turn towards smaller, local meat lockers. 

In response to the pandemic-caused disruptions, many states are working to address meat product supply chain issues. Iowa and South Dakota have enacted legislation to provide grants for small establishments processing locally raised livestock. The purpose of this funding is to relieve pressure on the meat supply chain by expanding meat locker space, assisting small meat locker owners with purchasing new equipment, and creating new curriculum to establish an artisanal butchery program. 

Other states, such as Oregon, are trying to address supply chain issues by applying for a State Meat Inspection Program with the USDA. Establishing a state inspection program would create more opportunities for livestock producers, as there are less than 15 federally inspected meat processing plants in the state.

At the same time, consumers are increasingly interested in learning how their food is grown and are seeking to buy local products. Due to several key federal laws, Americans are accustomed to relatively few foodborne illnesses and outbreak. Consumers should be able to confidently support small, artisanal butcheries without sacrificing food safety and quality.

Federal Regulation and Inspection

Although rare, foodborne illnesses and outbreaks do occur and can cause a staggering amount of physical and financial damage in a relevantly short time. Because few Americans grow their own food, safety regulations necessarily focus on the commercial production and sale of meat and poultry products. In 1906, Congress enacted the Federal Meat Inspection Act (FMIA) to protect consumers from adulterated or misbranded meat products. The FMIA requires all meat products sold through interstate commerce to be processed in sanitary conditions and inspected. The Poultry Products Inspection Act sets similar national standards for poultry products.

The United States Department of Agriculture, through the Food Safety and Inspection Service (FSIS), manages the federal inspection of such meat and poultry processing establishments in order to ensure the health and safety of consumers. To achieve this goal, FSIS has established various regulations. For example, all applicable meat and poultry processing establishments must develop and establish written Sanitization Standard Operating Procedures (SSOP). SSOPs ensure that each meat and poultry processing establishment have sanitary conditions. FSIS also requires applicable establishments to develop a Hazard Analysis and Critical Control Point (HACCP) program. HACCP programs serve as a control system designed to prevent foodborne illnesses. 

If FSIS detects a violation, it may immediately remove the product in order to protect consumer health, stop production at the facility, or it may withhold inspection services. Without inspection services and approval, a meat or poultry processing plant cannot sell its products into interstate commerce.  In a severe situation, FSIS may refer the violation to the U.S. Attorney’s office for criminal prosecution. 

Consumers will be glad to know that these laws and regulations have relatively few violations. For the 2021 fiscal year, FSIS reported a 98.7 percent compliance rate. In 2021, FSIS investigated 11 outbreaks. The United States is able to provide a safe food system, because of regulations, investigations and recalls.

State Inspection

The FMIA allows individual states to enter into a cooperative agreement with FSIS and operate their own meat and poultry inspection (MPI) program. Any meat and poultry product from such a facility is limited to sales within the state. The State MPI program must establish enforcement requirements “at least equal to” the applicable federal regulations. Currently, 27 states have elected to do create MPI programs. 

 A State MPI offers protections similar to the federal programs as federal regulations set the baseline of safety and animal welfare. Additionally, FSIS requires each state with its own MPI program to conduct a yearly self-assessment demonstrating that its program is “at least equal to” federal inspection regulations. Under the assessment process, FSIS will evaluate each state’s statutory and regulatory authority, sampling procedures, and inspection coverage. In 2020, FSIS found that 26 of the self-assessments demonstrated that the State MPI programs have laws, regulations, and programs “at least equal to” the federal laws. One state received a provisional “at least equal to” status. In addition to the yearly self-assessment, each state’s MPI program is subject to a triennial on-site review. 

About 1,900 state inspected meat processing establishments exist throughout the country. Under USDA regulations, establishments with 10 to 499 employees are considered to be small and establishments with fewer than 10 employees are considered very small. In addition to meat inspection requirements, small-scale meat plants frequently need licensing for waste water disposal, business operation, and construction. Despite their size, small and very small meat processing plants offer additional options for livestock producers and consumers while simultaneously following food safety practices.

Inspection Exemptions

Because the prevention of large-scale foodborne illness outbreaks is a primary government objective, FSIS did establish several inspection exemptions for noncommercial meat processing establishments. First, FSIS allows a personal use exemption for anyone who slaughters her own livestock and will use the meat products only for herself, her family, or nonpaying guests. 

Second, any individual or establishment who slaughters and prepares livestock for the exclusive use of a livestock owner is able to receive the custom use exemption. Custom-exempt establishments do not require daily FSIS inspections. However, establishments in this category are still subject to adulteration and misbranding regulations and must maintain sanitary conditions.  

Conclusion

The impact of COVID-19 on the supply chain highlights the needs for a stable and consistent source of meat and poultry products. Such work is physically difficult and, unsurprisingly, the biggest issue many small-scale meat locker owners face is a lack of a trained worked force. However, by supporting small and medium size meat processing establishments, the pressure on the meat products backlog is able to be reduced.

In addition to supply chain issues, the consolidation of the meat processing industry has created further concerns about the industry’s vulnerability to cyber-attacks and allegations of antitrust law violations. There are over 6,200 federally regulated meat and poultry slaughter and processing establishments throughout the United States. Comparatively, state inspected meat processing facilities involve a minute number of establishments. However, these facilities, although small, receive the same level of food safety and quality oversight while simultaneously providing new job opportunities throughout many rural areas of the state. 

  1. See 21 U.S.C. § 601 et seq.
  2.  21 U.S.C. § 451 et seq.

https://www.fsis.usda.gov/sites/default/files/media_file/2021-11/qer-q4-fy2021-tables.pdf

 4. Methodology for Performing Scheduled and Targeted Reviews of State Meat and Poultry Inspection Programs – Revision 2, FSIS Directive 5720.3 (Nov 10, 2016). 

5.  9 C.F.R. § 303.1(a).

About the author: Kitt Tovar Jensen is a Staff Attorney at Iowa State University’s Center for Agricultural Law and Taxation. She focuses on areas of agricultural law including farm succession planning, environmental and natural resource law, regulatory law, and farm policy.

Prior to joining CALT, Kitt worked as an undergraduate research assistant in the Animal Production department at the University of Lleida in Catalonia, Spain, and interned with the international trade department for the National Pork Producers Council in Washington, D.C. While in law school, Kitt served as the Associate Editor for the Drake Journal of Agricultural Law and clerked at the Iowa Farm Bureau Federation. 

Kitt earned her B.S. in Animal Science from Iowa State University and her J.D., with honors, from Drake University while completing certificates in Food and Agricultural Law and Legislative Practice. Kitt is an LL.M candidate at the University of Arkansas School of Law.

The number of Campylobacter infections were not impacted by public health measures taken due to the COVID-19 pandemic, according to French surveillance.

Data published by Santé publique France comes from the National Reference Center (CNR) for Campylobacter and Helicobacter as well as outbreak notifications.

A decrease in the number of strains compared to previous years was only seen in March and April 2020, in the first lockdown. The decline seems to reflect a lower use of healthcare during this period, but could also indicate a drop in incidence related to the restrictions. A peak was seen in summer 2020, as in previous years.

Other countries have reported that measures taken to control the pandemic had an impact on foodborne disease figures.

In 2020, the CNR reported 8,884 isolates of Campylobacter and related bacteria with 7,920 identified as Campylobacter. In 2019, 7,712 were identified as Campylobacter.

The majority of these were Campylobacter jejuni but 13 percent were Campylobacter coli.

Poultry link for most outbreaks
A higher number of cases were seen in children under the age of 10. Men were more affected than women, except in people aged 30 to 39. Age at infection varied between 0 and 108 years old, with an average age of 34.

Information on foreign travel in the 15 days before onset of the disease was specified for 50 percent of the patients and among these, 3 percent had a trip abroad

A total of 63 outbreaks due to Campylobacter were declared with 244 patients. The number of confirmed outbreaks and patients remained similar in 2019 and 2020.

Consumption of poultry was the incriminated or suspected source of contamination in 35 outbreaks.

There is a stable but high resistance to fluoroquinolones and tetracyclines used to treat infections. No notable increase was seen in the resistance rates of the six antibiotics tested routinely.

Campylobacter cases mostly appear to be isolated cases. The main risk factors for infection are handling of fresh poultry or beef, cross-contamination of food through contaminated surfaces in the kitchen, and eating undercooked poultry or beef, or to a lesser extent, pork.

Prevention is based on good hygiene practices in the kitchen such as handwashing, cleaning surfaces and kitchen utensils after handling poultry or raw meat and sufficient cooking of meat.

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The COVID-19 pandemic continued to affect reports of other diseases in 2021, according to the Public Health Agency of Sweden (Folkhälsomyndigheten).

A summary of the epidemiological annual report for 2021 shows that foodborne diseases, such as Campylobacter and Salmonella, increased slightly compared with 2020 but the number of cases was still down on levels before the pandemic in 2019.

Figures for several infectious diseases continued to be at low levels during 2021 but the role of Coronavirus measures were not as clear as in 2020.

In 2021, fewer cases of notifiable infectious diseases were reported than before the pandemic, but the difference was not as large as it was in 2020.

Impact on foodborne diseases
Yersinia, E. coli and Hepatitis A increased compared to 2020, while Shigella cases were unchanged.

The decrease was largely due to the continued low number of people infected abroad, according to the report. For Cryptosporidium, infections decreased for the second year in a row, while the situation was stable for Listeria.

Detailed annual reports on each disease will be published later this year.

There were more than 4,000 Campylobacter infections in 2021, compared to almost 3,500 in 2020 and 6,700 in 2019. Almost 950 Salmonella infections were reported in 2021 versus 826 in 2020 and nearly 2,000 in 2019.

The number of E. coli infections went up to 653 in 2021 from 491 in 2020 but decreased from 755 in 2019. A total of 313 Yersinia cases were recorded in 2021, 221 in 2020 and 393 in 2019. In 2021, 107 Listeria infections were noted compared to 88 in 2020 and 113 in 2019.

“There is probably an effect of infection control measures against COVID-19 and changed behaviors, but the connections are complex. We will see an increase in infectious diseases when people meet more and more people travel abroad,” said state epidemiologist Anders Lindblom.

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Gastrointestinal infection outbreaks halved during the first six months of the COVID-19 pandemic in England but bacterial pathogens declined the least, according to a study.

Compared with the 5-year average from 2015 to 2019, there was a 52 percent decrease in such outbreaks in the first half of 2020 from 3,208 to 1,544.

There was also a 34 percent decline in laboratory confirmed cases from 42,495 to 27,859.

Changes may reflect a real reduction or be because of altered healthcare provision, health-seeking behavior or laboratory testing practices, found the study published in the journal BMJ Open.

Maintain momentum
Public health actions to slow the spread of COVID-19, such as improved hand hygiene, had a key role but several other factors also impacted the figures, said researchers. Control measures included better hand hygiene, reduced social contact, social distancing, increased environmental cleaning, and closure of premises.

They added if this level of hygiene was maintained once the pandemic is over, there could be a permanent reduction of gastrointestinal infections. Evidence suggests bacterial pathogens, which are more commonly foodborne and less influenced by hygiene and social distancing, were less impacted.

Researchers used data from seven English surveillance systems coordinated by the UK Health Security Agency (UKHSA), previously Public Health England, and Google Trend data, from January to August 2020.

Norovirus reports fell the most while Salmonella and Cryptosporidium also declined. The proportion of lab-confirmed patients with Giardia, Shiga toxin-producing E. coli (STEC) and Listeria during the COVID outbreak period remained comparable, while Campylobacter reports increased.

Salmonella was likely reduced by government guidance on non-essential foreign travel. Campylobacter was less impacted than other pathogens, although possible explanations for initial reductions include food business closures and improved hygiene limiting the risk of cross-contamination, according to the researchers.

Reports of outbreaks in food outlets also reduced prior to lockdown and remained low until pubs and restaurants reopened for dine-in customers.

Many factors behind shifting figures
During the COVID pre-outbreak phase, from weeks 1 to 4, reported gastrointestinal outbreaks were comparable to historic figures. Beginning with week 7, called the early outbreak phase, there was a 22 percent decrease in outbreaks from the 5-year average of 651 to 510. This trend continued to an 87 percent reduction in gastrointestinal outbreaks during the late lockdown phase of weeks 19 to 22; from a 5-year average of 350 to 46 outbreaks.

During the COVID-19 response period, there was a significant reduction in parasitic outbreaks from 32 to two and bacterial outbreaks from 97 to 51.

In terms of patients, decreased reports were apparent from week 10, the pre-lockdown phase with a low of 2,859 cases between weeks 13 and 18 in the early lockdown phase representing a 66 percent decrease on the 5-year average of 8,345.

Lab-confirmed cases began to rise from week 16 onward, mirroring the historic seasonal trend for gastrointestinal pathogen activity, despite numbers remaining significantly lower than average.

Google Trends data showed searches for key phrases, such as “food poisoning” “gastroenteritis” and “sickness bug” all dropped between weeks 11 and 13, while trends for “handwashing” and “disinfection” rose substantially between weeks 8 and 14.

Researchers said there had been a shift in trends of infections during the COVID-19 pandemic.

“The drivers of this change are likely to be multifactorial; while changes in health seeking behavior, pressure on diagnostic services and surveillance system ascertainment have undoubtedly played a role, there has likely been a true decrease in the incidence for some pathogens resulting from the control measures and restrictions implemented,” according to the research report.

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Researchers have looked at food safety actions in kitchens and the impact of the COVID-19 pandemic.

Kitchen Life 2 is a social research project commissioned by the Food Standards Agency (FSA) on behaviors in kitchens. The pilot study was completed in July 2021 with 22 households and 14 food businesses being filmed and analyzed. Further work is scheduled to take place in summer and potentially autumn this year.

The aim is to identify key behaviors relating to food safety in domestic and business kitchens, as well as the factors that may reduce the likelihood to follow recommended food safety and hygiene advice.

A literature review of materials from 2013 to 2021 was done to help develop behavioral interventions or risk assessment models. Seven expert interviews were also conducted to understand the impact of COVID-19 on food hygiene behaviors.

The review covers risk perception, trust in institutions and the supply chain and kitchen behaviors at households and businesses. This includes cross-contamination; cleaning, cooking, chilling and defrosting behaviors, and adherence to use-by dates.

COVID impact
Findings suggest there was an increase in handwashing in domestic and business kitchens, cleaning frequency of business kitchens, and washing of fruits and vegetables in domestic kitchens because of the pandemic. However, researchers warned that observational studies were needed to see whether reported behavior actually translates in real life.

Cooking more from scratch in domestic kitchens and storing more food as frozen in business kitchens may have food safety implications such as defrosting methods, cross-contamination and cooking food at the right temperature and for long enough.

Previous studies found people often eat food past its use-by date. In particular, they reported having out of date cheese, bagged salad, cooked meat, milk and smoked fish. Those having cut or skipped meals for financial reasons were also more likely to eat food past its use-by date. This rise in eating food past its use-by date is concerning and needs to be studied further, said researchers.

One person interviewed said good practice in hospitality industry kitchens started because of the pandemic has continued, and handwashing and kitchen hygiene practices have improved, including an increased frequency of cleaning. One change was asking employees not to use gloves and to enhance handwashing practices to prevent cross-contamination.

Another person said changing consumer behavior in the kitchen is challenging because food safety is not a primary concern for people who believe their actions do not cause ill health.

Tracking trends during the pandemic
The amount of people eating certain foods past the use-by date significantly increased during the pandemic, according to other research in England, Wales and Northern Ireland.

The COVID-19 consumer tracker, commissioned by the FSA, ran from April 2020 to October 2021 and has since been replaced by a consumer insights tracker. It looked at food insecurity, food safety behavior and food concerns.

From July 2020 to October 2021, the proportion of people who ate foods past the use-by date went up for cheese from 40 to 50 percent, bagged salads from 37 to 47 percent, milk from 27 to 43 percent, cooked meat from 29 to 42 percent and smoked fish from 16 to 24 percent.

Overall, one in two respondents who cook reported using different chopping boards for different foods “always” or “most of the time.” On average, three in 10 who cook washed raw chicken “always” or “most of the time” across the tracker. Food safety experts say washing poultry is not a good practice because it easily spreads pathogens around the kitchen. Seven in 10 respondents reported following storage instructions on packaging once food is opened “always” or “most of the time.”

Concerns about the impact of COVID-19 on the food supply chain were highest in January 2021, but dropped to 36 percent in October 2021. The impact of Brexit on food imports and exports declined from January to October 2021.

Concerns around food hygiene when eating out or buying takeaways increased from 38 percent in January 2021 to 46 percent in October 2021.

In December 2020, 26 percent of respondents reported being highly or somewhat concerned about the quality of food produced in the United Kingdom, this rose to 34 percent at the end of the tracker in October 2021. More than half of those surveyed said they were highly or somewhat concerned about the quality of imported food in October 2021.

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A decline in Salmonella across Australia in 2020 has been linked to actions to tackle COVID-19, according to a study.

Researchers compared Salmonella rates in 2020 to past years and looked at the impact of COVID-19 measures. Findings were published in the Communicable Diseases Intelligence journal.

To control coronavirus, Australian public health measures included border closures, physical distancing and hygiene advice.

The annual salmonellosis notification rate was 27 percent lower in 2020 than the previous 5-year median. The decline varied throughout Australia. States and territories with more stringent and frequent or longer COVID-19 measures had generally greater reductions. However, Tasmania had a 50 percent bigger reduction than the Northern Territory, despite similar restrictions.

Annual median rates in the Northern Territory are three times that of national data. The persistence of high rates in this state could indicate the importance of demographic and environmental factors, said, researchers.

A peak in notifications in February 2020 was due to a large outbreak across several states. This caused the highest monthly rate since 1991. The outbreak of Salmonella Typhimurium was investigated between January and May.

State differences
Monthly and annual salmonellosis notifications per 100,000 population, for the eight states and territories for 2015 to 2020, were taken from the National Notifiable Diseases Surveillance System.

The five-year median of annual salmonellosis notifications for 2015 to 2019 in Australia was 16,375 while in 2020 there were 12,033 cases.

The lowest monthly rate for 2015 to 2020 was in the Australian Capital Territory in July and October 2020.

From March to December 2020, the monthly rates for all jurisdictions were below the five-year median except in June and September for Western Australia and December for Tasmania.

The rates in South Australia, Victoria, and New South Wales in 2020 showed prolonged low levels. Victoria had the greatest drop and longest plateau coinciding with two COVID-19 lockdowns. A reduced number of restaurant meals and social gatherings where food was produced for many people likely contributed to a reduction in salmonellosis risk, said, researchers.

Smaller decreases for Western Australia, Queensland, and the Northern Territory reflected milder public health steps. It could also suggest the role of a non-foodborne origin of Salmonella with social distancing changes having less of an impact, according to the research.

When such measures eased in June, notification rates did not go down as steeply as the seasonal five-year decrease.

Other factors
Not all people with infection seek medical treatment or get tested but another survey from January to June 2020 by the Australian Bureau of Statistics found no significant decrease in general practitioner service usage.

Changes in laboratory testing priorities likely contributed to the decline in notified salmonellosis cases but are unlikely to have fully accounted for the decrease, said researchers.

Scientists said reduced reports of Salmonella support the importance of behavioral factors in preventing infection.

“Wide-scale application of significant public health measures during COVID-19 appears to have had an impact in reducing infectious diseases including salmonellosis. It is recommended that public health advice continues to promote hand hygiene as this simple intervention has demonstrated to reduce Salmonella transmission,” they said.

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The number of foodborne infections in the Netherlands in 2020 fell sharply compared with previous years likely because of measures taken against coronavirus, researchers say.

Closures of cafes and restaurants, the decrease in social events including catering, travel restrictions, social distancing and increased attention to hygiene such as washing hands, reduced the contact between people and pathogens. Another reason for the decline in numbers is that people with gastrointestinal infections were probably less likely to seek medical help, according to a report published by the National Institute for Public Health and the Environment (RIVM).

Reports of norovirus and rotavirus decreased in 2020, with 56 percent and 68 percent fewer infections, respectively, than in 2019. These viruses are spread mainly through human-to-human transmission but are also spread through contaminated food and food surfaces and utensils.

Campylobacter and Salmonella findings
Food-related infections such as salmonellosis and campylobacteriosis also declined significantly but the number of people who became ill with listeriosis was unchanged.

It is estimated the number of campylobacteriosis cases was 3,942 based on 2,549 reports in a system that has a national coverage rate of 65 percent. These are the lowest numbers in a decade. The amount of people sick in 2019 was more than 6,000.

The percentage of highly contaminated poultry flocks at slaughter fell to 34 percent in 2020 after several years of going up. Highly contaminated means more than 10,000 colony forming units per gram. The percentage of contaminated fresh chicken meat increased to 40 percent of 232 samples.

There were 888 estimated salmonellosis cases, which is based on 568 lab-confirmed cases with 64 percent national coverage. This is the lowest since surveillance began in the 1990s. The number of lab-confirmed patients in 2019 was more than 1,000.

As in previous years, Salmonella Enteritidis, Typhimurium and monophasic Typhimurium were the main causes of salmonellosis. The relative share of Salmonella Enteritidis decreased sharply, probably because of a decline in travel-related salmonellosis and the closure of catering operations. Pork and egg products remained the main source of Salmonella infections.

A rise in Salmonella Virchow cases was investigated. Since October 2019, 15 people are part of the same whole genome sequencing cluster. Patient samples matched six food isolates from chicken meat in 2018 and 2019, which came from different goods with no relationship between the companies involved.

More Salmonella Manhattan cases were also seen, with nine people belonging to the same WGS cluster in September and October 2020, compared to an average of two per year from 2016 to 2019. However, no outbreak investigation was started because officials said the chance of finding a common food source with this number of patients was limited. In 2021, WGS was started for all Salmonella serotypes. This led to more clusters being found and more outbreak investigations opened.

Researchers find E. coli O104 isolate was linked to 2011 outbreak
In 2020, 323 people with a Shiga toxin-producing E. coli (STEC) infection were reported. This is the lowest since 2011 and below the 460 infections in 2019.

Eight patients developed hemolytic uremic syndrome (HUS) and two men died directly or indirectly as a result of STEC infection.

Out of 250 people who contracted infection in the Netherlands, almost all of them ate meat and nearly half had eaten raw or undercooked meat. Ten percent of 222 sick people had consumed raw milk.

From submitted patient isolates, STEC O157 was most commonly detected, followed by STEC O26, STEC O103 and STEC O145. In total, 23 different O-groups were found. The most notable finding, researchers said, was a STEC O104 isolate linked to the 2011 E. coli O104 outbreak in Germany.

Listeria infections and brucellosis
In 2020, 95 individuals were reported with listeriosis. At least 92 were hospitalized and 19 people aged 38 to 98 died. The median age of all patients was 75 years old with a range of 29 to 98 and 62 percent were male. In 2019, 117 cases were recorded.

The fact that, compared to other foodborne infections, there was no decrease in listeriosis can be explained by the fact that surveillance is mainly focused on very serious cases and infection is also mainly contracted at home through contaminated food products, said experts.

Three patients with brucellosis were reported, of which two infections were contracted in Turkey and one in the Netherlands. Two people were hospitalized. Consumption of raw milk cheese was the most likely source for the Dutch case and one Turkish case.

A previous report revealed there were 559 outbreaks in 2020 with 1,907 patients.

A Salmonella Enteritidis outbreak with 56 patients in August 2020 was linked to Turkish pizza from one catering business. The incident initially affected an institution for the mentally and physically disabled but more cases were then identified in the general population. There was a major outbreak of norovirus with 63 sick related to a buffet on a boat and three smaller outbreaks of listeriosis linked to trout fillets, eel and soft cheese.

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As the United States enters its third pandemic year, the influences of the virus on the food industry will continue, even as supply chain partners embrace new trends and discard old ones this year not just to survive, but thrive.

John Rowley, vice president of NSF International’s Global Food Division, recently discussed his views on 2022 trends in the food industry, with a focus on food safety issues. NSF specializes in food safety training, testing, consulting and other services.

Rowley said all segments of the supply chain, from producers through retailers and restaurants, continue to shift to meet challenges, even as the pandemic has led to staffing woes and exacerbated supply chain gridlock.

The major trends anticipated for the industry, according to Rowley, include:

  • Rising demand for home delivery;
  • Staffing crisis;
  • Opportunities to cut food waste; and
  • Sustainability.

Knock Knock. Who’s there? Dinner
As coronavirus variants continue to curb dining at restaurants and elevate uncertainty in the sector, home meal delivery will remain popular in 2022, Rowley said. That includes traditional restaurants, pop-ups and ghost kitchens. An NSF survey released this month highlights pandemic concerns among quick service restaurant employees and decision makers across the globe.

According to the survey of almost 700 people, 38 percent of poll respondents said they feel added pressure to prepare food faster. NSF reported 22 percent said home delivery has increased food risks.

Rowley said foodservice establishments, regardless of their business models, have an obligation to serve quality, safe food. That includes preparation and how food is treated during transportation to the consumer, or the “post-order supply chain,” as Rowley calls it.

“As an industry, we need to help these companies be successful, help them have a opportunity to be successful so the consumer can get a satisfactory product,” Rowley said.

Now Hiring
A staffing crisis in the foodservice and other industries threatens recruitment and retention, he said. 

“The staffing shortages are a fundamental issue, but what are the unintended consequences?” Rowley said, pointing out that retail and foodservice outlets are under pressure to perform with pre-pandemic hours of operation, staffing and services.

“Does that put food safety to the fore?” he said.

The issue won’t disappear once the pandemic is over — however that’s decreed — and Rowley said efforts need to focus on a campaign to promote food safety careers at the college level.

“I think as an industry we have to make sure this (food safety) is seen as an interesting job and a critical role for the industry,” he said. “We need to do a better job marketing that, working together to make it a satisfactory and enjoyable career for those who do it.”

Rowley said long-time food safety professionals are choosing to retire from the industry as the pandemic continues. Their collective institutional knowledge is critical to retain, he said.

Waste Not … Waste Not
The food industry has taken great strides in recent years to curb food waste, from “upcycling” expired but edible food to selling “ugly” produce that doesn’t fit industry standards. This year’s food waste issue will be ensuring the failing supply chain doesn’t escalate a food safety concern to food wastage, Rowley said.

“When food gets delayed in transportation, it puts pressure on the storage and distribution quality controls,” he said. “ … If the food safety standards are good, it’s not really a food safety issue. It becomes more of a food wastage issue.”

In the early days of the pandemic, some retailers and foodservice operators began sourcing from closer suppliers. One example are the Eastern U.S. retailers that bought leafy greens from nearby small hydroponic indoor farms. Switching to local growers is trend that continues, he said.

Sustainability, as a Trend, Sustains
As more corporations chart their sustainability programs and release annual reports showcasing those steps, sustainability programs are gaining steam in every food sector. Rowley said sustainability is a huge metric to measure the performance of a company, along with food safety and finances.

“As we go forward, companies need to be measured on not just traditional financial metrics, which tend to be the core measurement of a company’s performance. I think we should elevate the importance of sustainability,” he said.

Post-Pandemic View
Rowley cautions companies against reverting to pre-pandemic trends once life returns to “more normal,” without assessing the business climate first.

“I think when the crisis is over, it doesn’t mean these trends will — or should — stop. Never waste a good crisis, if there is good that can come out of it.”

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