Food poisoning in the EU Zoonoses, 2015 · In 2015, 20 MS reported 849 food -borne outbreaks caused...

Food poisoning in the EU Summary Report on Zoonoses, 2015

Valentina Rizzi

BIOCONTAM Unit, EFSA

TOBAFOOD conference, 9 November 2017 – Torino, Italy

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� Monitoring of zoonoses, FBO and AMR in the EU

� 2015 Monitoring results

� compliance with microbiological criteria

� food-borne outbreaks

� Discussion

OUTLINE

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� Monitoring of zoonoses, FBO and AMR in the EU

� 2015 Monitoring results

� compliance with microbiological criteria

� food-borne outbreaks

� Discussion

OUTLINE

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MONITORING OF ZOONOSES, FBO AND AMR IN THE EU

� Directive on the monitoring of zoonoses and zoonotic agents (2003/99/EC)

� Publication of the annual EU Summary Report

� MSs have an obligation to report each year

� Data collection mandatory for 8 zoonotic agents

Salmonella (+ antimicrobial resistance (AMR))Campylobacter (+ AMR)Listeria monocytogenesBrucellaTuberculosis due to Mycobacterium bovisVerotoxigenic Escherichia coli TrichinellaEchinococcus

� and also for food-borne outbreaks (FBOs)

� and susceptible animal populations

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DATA FLOW AND EFSA'S INTEGRATED APPROACH FOR THE PRODUCTION OF THE JOINT EFSA-ECDC EU SUMMARY REPORTS (EUSRS)

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MONITORING OF ZOONOSES, FBO AND AMR IN THE EU

In addition, Member States are requested to submit data on 3 microbiological contaminants for which microbiological criteria have been set up by EU Regulations1

� Histamine

� Cronobacter spp. (E. sakazakii)

� Staphylococcal enterotoxins

~ monitoring of compliance

1. Commission Regulation (EC) No 2073/2005 of 15 November 2005 on microbiological criteria for foodstuffs and following amendments

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APPROPRIATE USE OF ZOONOSES MONITORING DATA

The degree of harmonisation of the applied monitoring schemes and collected data limits the type of analysis that can be performed. Based on the obtained data, three main data categories can be distinguished:

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EUSR ZOONOSES-FBO 2015 ON WILEY PLATFORM

http://onlinelibrary.wiley.com/doi/10.2903/j.efsa.2016.4634/full

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HUMAN ZOONOSES CASES IN EU, 2015

Reported notification rates of zoonoses in confirmed human casesin EU, 2015

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� Monitoring of zoonoses, FBO and AMR in the EU

� 2015 Monitoring results

� compliance with microbiological criteria

� food-borne outbreaks

� Discussion

OUTLINE

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MONITORING OF COMPLIANCE WITH FSC

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MONITORING OF COMPLIANCE WITH PHC

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STAPHYLOCOCCAL ENTEROTOXINS IN FOOD, EU, 2015

In total, 12 MS and 1 non-MS reported data on the food categories mentioned in the Regulation on Microbiological Criteria: cheeses, milk powder and whey powdercheeses, milk powder and whey powder.

It total, 1,964 units were tested and 16 (0.8%) were positive.

� At retail

- Italy: positive samples in hard cheese made from sheep’s milk (1 out of 1 tested), cheeses made from unspecified milk (3 out of 365).

� At processing plant level

- mostly reported by Italy: positive reports from hard cheese made from sheep’s milk (5 out 5 tested), soft and semi-soft cheese from unspecified milk (2 out of 55), cheeses made from unspecified milk (4 out of 704),

- Portugal: one positive sample out of 50 samples of cheeses made from sheep’s milk.

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STAPHYLOCOCCAL ENTEROTOXINS IN FOOD, EU, 2015

Data on other foods other foods were reported by MS.

�� Positive samples Positive samples were in:

- Dairy products (excluding cheeses) at retail (BE: 1 out of 1 sample tested)

- Raw cow milk at retail (IT: 2 out of 31 samples)

- Other processed food products and prepared dishes, pastaat retail (BE: 1 out of 1 sample tested; IT: 1 out of 27 samples)

- All foodstuffs at retail (IT: 1 out of 33)

- Other processed food products and prepared dishes, unspecified at retail (IT: 1 out of 248; ES: 5 out of 92)

- Sauce and dressings at retail (IT: 1 out of 33)

- Meat preparation from poultry meat intended to be eaten cooked at retail (SK: 2 out of 5)

- Bakery products, desserts (ES: at processing 6 out of 12; at retail 3 out of 8)

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� Monitoring of zoonoses, FBO and AMR in the EU

� 2015 Monitoring results

� compliance with microbiological criteria

� food-borne outbreaks

� Discussion

OUTLINE

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FBO, OVERVIEW, EU, 2010-2015

Total n. FBOs: 4,362 (strong-evidence: 422; weak-evidence: 3,940)

In 2015, 20 MS reported 849 food849 food--borne outbreaks caused by borne outbreaks caused by bacterial toxinsbacterial toxins (19.5% of the total outbreaks), which caused 8,847 cases of illness, 497 hospitalisations and 3 deaths.

Number of food-

borne and

waterborne

outbreaks reported

by causative agent

in the EU MS from

2010 to 2015.

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FBO, OVERVIEW, EU, 2015

� Top-5 combinations of causative agents and food vehicles associated with the highest health burden in strong-evidence food-borne outbreaks (including water-borne outbreaks)

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FBO, OVERVIEW, EU, 2015

� Top-5 combinations of causative agents and food vehicles associated with the highest health burden in strong-evidence food-borne outbreaks (including water-borne outbreaks)

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FBO, OVERVIEW, EU, 2015

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FBO DUE TO STAPHYLOCOCCAL TOXINS, EU, 2015

Total n. FBOs: 4,362 (strong-evidence: 422; weak-evidence: 3,940)

Outbreaks due to staphylococcal toxins in 2015

� Total: 434 (9.9% of total outbreaks)� Strong-evidence outbreaks: 39� Weak-evidence outbreaks: 395

Country Number of

s-e outbreaks

Cases

(s-e outbreaks)

Hospitalized

(s-e outbreaks)

Deaths

(s-e outbreaks)

Total outbreaks Reporting rate per

100,000

Austria 1 5 2 0 1 0.01

Belgium 4 112 1 0 4 0.04

Bulgaria 0 0 0 0 2 0.03

Croatia 1 45 9 0 1 0.02

Cyprus 2 15 0 0 2 0.24

Czech Republic 0 0 0 0 3 0.03

Finland 0 0 0 0 1 0.02

France 17 247 17 0 398 0.60

Germany 1 25 0 0 1 <0.01

Hungary 1 8 2 0 2 0.02

Netherlands 1 15 0 0 1 0.01

Poland 2 59 0 0 4 0.01

Portugal 1 67 54 0 1 0.01

Romania 7 67 28 0 9 0.05

Slovakia 1 93 0 0 3 0.06

Slovenia 0 0 0 0 1 0.05

Norway 0 0 0 0 3 0.06

Total (MSs) 39 758 113 0 434 0.15

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FBO DUE TO STAPHYLOCOCCAL TOXINS, EU, 2015

Outbreaks due to staphylococcal toxins in 2015

�Strong-evidence outbreaks: 39

‘cheesecheese’ was the most commonly implicated food vehicle (13 outbreaks), followed by ‘mixed food’ (6 outbreaks). No specific food category (reported as ‘other food’) was provided for five outbreaks

The most frequently reported place of exposure in the 39 strong-evidence outbreaks was ‘householdhousehold’ (14 outbreaks), followed by ‘restaurant, cafe, pub, bar, hotel, catering service’ (9 outbreaks).

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FBO DUE TO STAPHYLOCOCCAL TOXINS, EU, 2015

Distribution of food vehicles in strong-evidence outbreaks caused by staphylococcal toxins in the EU (excluding water-borne outbreaks) in the EU, 2015

PLACE OF EXPOSURE:

- ‘Household’ (14 outbreaks),

- ‘Restaurant, café, pub, bar, hotel’ (9 outbreaks)

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FBO DUE TO BACILLUS TOXINS, EU, 2015

Total n. FBOs: 4,362 (strong-evidence: 422; weak-evidence: 3,940)

Outbreaks due to Bacillus cereus toxins in 2015

� Total: 291 (6.7% of total outbreaks)� Strong-evidence outbreaks: 24� Weak-evidence outbreaks: 267

Country Number of

s-e outbreaks

Cases

(s-e outbreaks)

Hospitalized

(s-e outbreaks)

Deaths

(s-e outbreaks)

Total outbreaks Reporting rate per

100,000

Belgium 4 12 0 0 5 0.04

Czech Republic 0 0 0 0 1 0.01

Denmark 0 0 0 0 1 0.02

Finland 1 5 0 0 1 0.02

France 15 374 4 0 277 0.42

Germany 2 94 0 0 3 <0.01

Poland 1 10 0 0 1 <0.01

Romania 1 23 21 0 1 0.01

Slovenia 0 0 0 0 1 0.05

Norway 0 0 0 0 4 0.08

Total (MSs) 24 518 25 0 291 0.12

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FBO DUE TO BACILLUS TOXINS, EU, 2015

Outbreaks due to Bacillus cereus toxins in 2015

�Strong-evidence outbreaks: 24

�‘Mixed foodMixed food’ was the most commonly implicated food vehicle (8 outbreaks), followed by ‘cereal products including rice and seeds/ pulses (nuts, almonds)’ (2 outbreaks).

�The most frequently reported place of exposure was ‘restaurant, cafe, pub, bar, hotelrestaurant, cafe, pub, bar, hotel’ (7 outbreaks), followed by ‘household’ (5 outbreaks), ‘school and kindergarten’(4 outbreaks) and ‘residential institution (nursing home or prison or boarding school)’ (3 outbreaks), ‘canteen or workplace catering’ (2 outbreaks), ‘catering on aircraft or ship or train’ (2 outbreaks) and ‘hospital or medical care facility’ (1 outbreak).

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FBO DUE TO BACILLUS TOXINS, EU, 2015

Distribution of food vehicles in strong-evidence outbreaks caused by Bacillus cereus toxins in the EU (excluding water-borne outbreaks) in the EU, 2015

PLACE OF EXPOSURE:

- ‘Restaurant, café, pub, bar, hotel’ (7 outbreaks)

- ‘Household’ (5 outbreaks)

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FBO DUE TO CLOSTRIDIUM TOXINS, EU, 2015

Total n. FBOs: 4,362 (strong-evidence: 422; weak-evidence: 3,940)

Outbreaks due to Clostridium toxins in 2015

� Total: 124 (2.8% of total outbreaks)� Strong-evidence outbreaks: 39� Weak-evidence outbreaks: 85

Country Number of

s-e outbreaks

Cases

(s-e outbreaks)

Hospitalized

(s-e outbreaks)

Deaths

(s-e outbreaks)

Total outbreaks Reporting rate

per 100,000

Austria 1 2 2 0 2 0.02

Belgium 1 2 2 0 1 0.01

Croatia 2 5 1 0 2 0.05

Denmark 0 0 0 0 11 0.19

Finland 1 10 0 0 2 0.04

France 19 584 18 2 76 0.11

Germany 1 3 0 0 2 <0.01

Hungary 2 70 1 0 2 0.02

Italy 1 2 2 0 1 <0.01

Lithuania 1 2 2 0 1 0.03

Poland 0 0 0 0 2 0.01

Portugal 4 13 8 0 5 0.05

Romania 1 2 2 0 1 0.01

Slovakia 1 0 1 0 4 0.07

United Kingdom 4 57 0 0 12 0.02

Norway 1 18 0 0 1 0.02

Total (MSs) 39 752 39 2 124 0.03

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FBO DUE TO CLOSTRIDIUM BOTULINUM TOXINS EU, 2015

Outbreaks due to Clostridium botulinum toxins in 2015

� Total: 24 (9.9% of total outbreaks)� Strong-evidence outbreaks: 15� Weak-evidence outbreaks: 9

� The number of outbreaks in 2015 increased compared with 2014 (9 outbreaks).�The 24 outbreaks by C. botulinum toxins caused 60 cases, of which 43 hospitalised (hospitalisation rate of 71.7%).

�‘Pig meat and product thereofPig meat and product thereof’ (4 outbreaks, 2 of which associated with smoked ham), unspecified ‘meat and meat products’ (3 outbreaks, including smoked meat) and ‘canned food products’ (3 outbreaks including mushrooms in oil). Other food vehicles (including ‘mixed food’, ‘cereal products including rice and seeds/pulses’ and ‘other or mixed red meat and products thereof’) were associated with one outbreak each.

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FBO DUE TO CLOSTRIDIUM BOTULINUM TOXINS, EU, 2015

Distribution of food vehicles in strong-evidence outbreaks caused by Clostridium botulinum toxins in the EU (excluding water-borne outbreaks) in the EU, 2015

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FBO DUE TO CLOSTRIDIUM PERFRINGENS TOXINS, EU, 2015

Outbreaks due to Clostridium perfringens toxins in 2015

� Total: 96 (2.2% of total outbreaks)� Strong-evidence outbreaks: 24� Weak-evidence outbreaks: 72

�The C. perfringens outbreaks involved 2,014 cases, of which 25 were hospitalised and 3 died. �This was a decrease of 22% compared to 2014 (124 outbreaks).

�‘Bovine meat and products thereofBovine meat and products thereof’ (5 outbreaks), followed by ‘pig meat and product thereof’ (3 outbreaks), ‘broiler meat and products thereof’ (2 outbreaks), ‘other, mixed or unspecified poultry meat and products thereof’ and ‘sheep meat and products thereof’ (one outbreak each). Two outbreaks were associated with ‘mixed food’, one with ‘vegetables and juices and other products thereof’. � Place of exposure in strong-evidence outbreaks was ‘residential residential institutioninstitution’ (5 outbreaks) followed by ‘restaurant or cafe or pub or bar or hotel’, ‘catering on aircraft or ship or train’ and ‘canteen or workplace catering’ (4 outbreaks each).

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FBO DUE TO CLOSTRIDIUM PERFRINGENS TOXINS, EU, 2015

Distribution of food vehicles in strong-evidence outbreaks caused by Clostridium perfringens toxins in the EU (excluding water-borne outbreaks) in the EU, 2015

PLACE OF EXPOSURE:

- ‘Residential institutions’ (5 outbreaks)

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AcknowledgementsAcknowledgements

BIOCONTAM Unit

ECDC

DG SANTE

MSs

Contacts in EFSA

Valentina.Rizzi@efsa.europa.eu

zoonoses@efsa.europa.eu