Two recent reports produced jointly by the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC) highlight the ongoing need for improving food safety throughout food supply chains, especially basic hygiene practices to prevent bacterial cross-contamination.
The first report published the latest results of farm animal and food-borne disease monitoring across 28 EU member states and four non-member states (ECDC, EFSA, 2015). The main findings were that the number of human cases of Listeriosis and Campylobacteriosis infections across 32 European countries rose in 2014, continuing a trend shown every year since 2008. Salmonella cases increased slightly for the first time since 2008.
Listeriosis infections reported in humans increased by 16% compared with 2013, to 2,161 confirmed cases in 2014. Although this number is relatively low, the surveillance of listeriosis is focused on severe forms of the disease, which has higher death rates than for other food-borne diseases, particularly among the elderly and patients with a weak immune system.
Listeria monocytogenes, however, the bacterium that causes listeriosis in humans and animals, rarely exceeded the legal safety limits in ready-to-eat foods, which are the most common food borne infections.
Campylobacteriosis is still the most commonly reported food-borne disease in the EU and has been so since 2005. The number of confirmed cases in the EU in 2014 was 236,851, an increase of 22,067 cases (10%) compared with 2013.
The majority of EU Member States reported an increase in the number of campylobacteriosis cases in 2014, which could be partly explained by improvements in the surveillance system and/or improved diagnostics for campylobacteriosis in the several Member States in recent years. In food, Campylobacter was mostly found in raw chicken meat.
Salmonellosis is the second most common infection in the EU, with 88,715 confirmed cases in 2014. The number of cases increased slightly for the first time since 2008, partly due to changes in the number of Member States reporting. However, the long-term trend is positive.
The annual averages show that there has been a statistically significant downward trend for salmonellosis over the seven-year period of 2008–2014. This is mainly due to the successful Salmonella control programmes put in place for poultry by the EU Member States and the European Commission. The number of reported Salmonella outbreaks per year within the EU has decreased by 44% since 2008.
Need for more cooperation
Mike Catchpole, ECDC Chief Scientist said: “It is worrying that Campylobacter and Listeria infections are still rising in the European Union. This situation highlights the importance of enhancing listeriosis surveillance through molecular typing, work currently developed by ECDC and EFSA, and strengthening the Campylobacter control measures at EU level”.
Sampling levels and methods of testing vary between countries so some data is not directly comparable. In addition, there may be variations between years in sample sizes and the season of sampling for the same country. This can be particularly significant for some diseases, such as salmonellosis, which shows peaks of infections in the summer months.
Reporting of outbreaks or testing of strains of certain diseases is not mandatory in all countries, so some data is incomplete. The overall picture, however, gives a good indication of the situation and trends across Europe.
Marta Hugas, Head of EFSA’s Biological Hazards and Contaminants Unit added, “All main actors in the food chain need to act together to improve monitoring at EU level. Such cooperation is crucial to reduce the burden of these two diseases in Europe.”
The second report, published by ECDC and EFSA in February this year found that harmful bacteria found in humans, food and animals is showing resistance to the most commonly used antimicrobials, posing a significant risk to human and animal health (ECDC, EFSA, 2016).
Multi-drug resistant Salmonella is spreading across Europe and resistance of Campylobacter bacteria to the antimicrobial ciprofloxacin is very high, reducing the options for treatment of severe infections.
What is antimicrobial resistance?
The European Centre for Disease Prevention and Control state that antimicrobial resistance is the ability of microorganisms to withstand antimicrobial treatments. I.e. food-borne illnesses such as Salmonella showing a resistance to treatments using antibiotics.
Campylobacter bacteria, the most common food-borne infection in Europe, had high to extremely high levels of resistance (69.8%) to ciprofloxacin in broiler chickens and also to two other antibiotics, nalidixic acid, and tetracyclines. Bacteria sampled from people also showed high resistance to ciprofloxacin.
Around 30% of samples of Salmonella bacteria taken from humans showed high levels of resistance to several antimicrobials: tetracyclines, sulphonamides, ampicillin. Similar levels were found in broiler and turkey meat. Some strains of Salmonella — Kentucky and Infantis — showed high levels of resistance to ciprofloxacin and multi-drug resistance.
The report shows that there are differences in antimicrobial resistance between European regions. Eastern and southern Europe showed the highest levels of resistance while lower resistance was found in northern European countries with low levels of antimicrobial use.
Vytenis Andriukaitis, EU Commissioner for Health and Food Safety, said: “Every year in the EU, infections caused by antimicrobial resistance lead to about 25,000 deaths, but the threat is not confined to Europe. This is a global problem that requires a global solution.”
This is shown by the resistance to another antimicrobial, colistin, which was recently reported in China. Colistin is commonly used in some countries to control E. coli infections in pigs. A significant new finding was that resistance was conferred by a gene that can be transmitted between bacteria, whereas previously it was thought that it was unlikely to be transferred. This means that resistance can be rapidly spread between different bacterial strains and consequently lead to dissemination across large areas.
Practices in food production, especially the misuse of antimicrobials, are major factors in the spread of resistant bacteria and resistant genes. The report highlights the international food trade, animal movements, farming systems, animal husbandry and the pyramidal structure of some types of animal primary production as having an influence on the spread of resistance in Salmonella.
When these raw foods reach processing plants, retail and hospitality businesses, maintenance of basic hygiene such as handwashing, cleaning, food preparation and cooking practices play a major factor in preventing contamination and spread of diseases.
- ECDC, EFSA. (2015, December 17). The European Union summary report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in 2014. EFSA Journal, 191p.
- ECDC, EFSA. (2016, February 11). The European Union summary report on antimicrobial resistance in zoonotic and indicator bacteria from humans, animals and food in 2014. EFSA Journal, 207.