In 2023, there was a decrease in foodborne outbreaks in Europe, but the number of sick and hospitalized people increased.
In total, 27 European Union member states and Northern Ireland reported 5,691 outbreaks, 52,127 cases, 2,894 hospitalizations and 65 deaths. There was one more death than in 2022, making this the highest number reported in the past decade. In 2022, there were 5,763 outbreaks, 48,605 cases and 2,783 hospitalizations.
Data from the One Health Zoonoses report, published by the European Food Safety Authority (EFSA) and the European Center for Disease Prevention and Control (ECDC), shows that seven non-member countries recorded 100 outbreaks, 1,158 illnesses, 125 hospital admissions and eight deaths have been reported.
France recorded more than 2,000 outbreaks, while the Netherlands had 911, Belgium 722, Spain 614 and Poland more than 400.
In total, 51 very large outbreaks had more than 100 cases each. In the largest incident, 740 people became ill in France. Dairy products were suspected, but the officer was not identified. A cottage cheese dessert with mixed berries contaminated with norovirus in Germany involved 538 cases and was linked as a place of exposure to a canteen or workplace catering.
Major Salmonella burden
Salmonella has been identified in more than 1,100 outbreaks and has been linked to the highest number of cases, hospitalizations and 16 deaths. Salmonella Enteritidis was the most commonly reported serovar, followed by Salmonella Typhimurium and monophasic Salmonella Typhimurium. Salmonella was also responsible for the most multi-country outbreaks in the EU in 2023.
Poland had 269 outbreaks of Salmonella, Spain 252, France 143 and Slovakia 120. Salmonella was the main cause of outbreaks in 14 Member States and three non-EU Member States. Salmonella and egg products caused 83 outbreaks, 44 of which in Spain, and more than 1,100 patients.
Campylobacter caused 229 outbreaks and was the leading pathogen in Malta. Nineteen outbreaks were due to Listeria monocytogenes, with eleven deaths. One outbreak was reported by Italy with 38 people sick. All cases were hospitalized and two died. The food involved was table olives.
Shiga toxin-producing E. coli (STEC) was responsible for 66 outbreaks. It ranked first in Ireland and Northern Ireland. An E. coli other than STEC was reported in 20 outbreaks.
Viruses, parasites and unknown causes
Seventeen outbreaks were caused by Yersinia and seven by Vibrio parahaemolyticus. Eleven were due to Hepatitis A and three to Hepatitis E. Cryptosporidium, norovirus, Anisakis, Trichinella, histamine, mushrooms and marine biotoxins such as Ciguatera also caused epidemics. One was due to atropine in Portugal and lectins in Denmark.
One histamine outbreak involved 154 cases in Spain. It was linked to a canteen or company catering setting and to fish and fish products. Three outbreaks caused by tick-borne encephalitis virus (TBE) have been reported by Slovakia. They were associated with the consumption of fresh cheeses made from sheep’s milk.
Outbreaks caused by bacterial toxins were reported by 19 countries, but France had the most with 769. Bacillus cereus toxins were the main agents in this group with 474 outbreaks, followed by Staphylococcus aureus with 207 and Clostridium perfringens toxins with 140. Clostridium botulinum toxins were responsible for five outbreaks reported by Bulgaria, Italy, Romania and Spain.
The share of outbreaks caused by unknown pathogens was at the highest level since 2014. The Netherlands (880), France (759) and Belgium (661) contributed the most to this report. The largest was reported by France in a workplace canteen or catering, involving 740 cases. Consumption of milk or milk products was the likely food vehicle involved.
There were 20 outbreaks involving travel-related cases, which is the highest number ever reported to EFSA. There were 96 cases, 19 hospital admissions, but no deaths. Salmonella was the main cause with eleven outbreaks, followed by Campylobacter with seven, and hepatitis A virus and the toxigenic Vibrio cholera, with one each.
Inadequate heat treatment or improper refrigeration were the main factors contributing to outbreaks. Other issues mentioned included unprocessed contaminated ingredient, cross-contamination, misuse of time storage/temperature and an infected food handler.
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