The European Union One Health 2018 Zoonoses Report

Abstract

This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring activities carried out in 2018 in 36 European countries (28 Member States (MS) and 8 non-MS). The first and second most commonly reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The European Union (EU) trend for confirmed human cases of these two diseases was stable during 2014-2018. The proportion of human salmonellosis cases due to Salmonella Enteritidis was at the same level in 2018 as in 2017. Of the 27 reporting MS, 16 met all Salmonella reduction targets for poultry, whereas 11 MS failed meeting at least one. The EU flock prevalence of target Salmonella serovars in breeding hens, laying hens, broilers and fattening turkeys decreased during recent years but stalled in breeding turkeys. Salmonella results from Competent Authorities for pig carcasses and for poultry tested through National Control Programmes were more frequently positive compared with food business operators. Shiga toxin-producing Escherichia coli (STEC) infections in humans were the third most commonly reported zoonosis in the EU and increased from 2014 to 2018. Yersiniosis was the fourth most frequently reported zoonosis in humans in 2018 with a stable trend in 2014-2018. The number of reported confirmed listeriosis cases further increased in 2018, despite Listeria rarely exceeding the EU food safety limit tested in ready-to-eat food. In total, 5,146 food- and waterborne outbreaks were reported. Salmonella was the most commonly detected agent with S. Enteritidis causing one in five outbreaks. Salmonella in eggs and egg products was the highest risk agent/food pair. A large increase of human West Nile virus infections was reported in 2018. The report further updates on bovine tuberculosis, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, Coxiella burnetii (Q fever) and tularaemia.

Keywords: Campylobacter; Listeria; Salmonella; food‐borne outbreaks; monitoring; parasites; zoonoses.

Figure 1

Reported numbers and notification rates of confirmed human zoonoses in the EU, 2018

1. Note: The total number of confirmed cases is indicated between parentheses at the end of each bar.

2. ¹Exception: West Nile fever where the total number of cases was used.

Figure 2

Trend in reported confirmed human cases of campylobacteriosis in the EU/EEA, by month, 2009–2018

1. Source(s): Austria, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom. Belgium, Bulgaria, Croatia, Greece and Portugal did not report data to the level of detail required for the analysis.

Figure 3

Salmonella summary infographic, EU/EEA, 2018

1. On the left side of the infographic are shown: a) Map of the salmonellosis notification rates per 100,000 population in the EU/EFTA; b) the single Member States’ prevalence in the context of NCP in poultry compared to the European reduction target for laying hens (2%) and other poultry species (1%); c) the trends of the prevalence of poultry flocks positive for Salmonella target serovars in the context of NCP, and d) the comparisons between the results of the CA and FBOp data in the context of the NCP; on the right side: e) the geographical distribution of the human top‐5 Salmonella serovars isolates coming from food and animal matrices, and f) the distribution of human top‐5 Salmonella serovars isolates according to different food and animal matrices.

Figure 4

The surveillance and monitoring of Salmonella in food, food‐producing animals and feed according to the sampling stage, the sampler, the objective of the sampling, the quality of data and the degree of harmonisation

Figure 5

Trend in reported confirmed human cases of non‐typhoidal salmonellosis in the EU/EEA, by month, 2009–2018

1. Source: Austria, Belgium, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Lithuania, Luxembourg, Latvia, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom. Bulgaria and Croatia did not report data to the level of detail required for the analysis.

Figure 6

Summary of Salmonella monitoring results, by major meat and meat products categories and by sampling stage in the food chain, EU, 2018

Figure 7

Prevalence of poultry flocks (breeding flocks of Gallus gallus, laying hens, broilers, breeding turkeys and fattening turkeys) positive for target Salmonella serovars, EU, 2018

1. Red vertical bars indicate the target to be reached, which was fixed at 1% for all categories with the exception of laying hens for which it was 2% for all MS with the exception of Poland, for which it was 3.1%.

Figure 8

Prevalence of S. Enteritidis‐positive breeding flocks of Gallus gallus during the production period, 2018

1. AL: Albania; BA: Bosnia and Herzegovina; ME: Montenegro; MK: the Republic of North Macedonia; and SR: Serbia.

Figure 9

Prevalence of S. Infantis‐positive breeding flocks of Gallus gallus during the production period, 2018

1. AL: Albania; BA: Bosnia and Herzegovina; ME: Montenegro; MK: the Republic of North Macedonia; and SR: Serbia.

Figure 10

Prevalence of S. Typhimurium‐positive (including monophasic variants) breeding flocks of Gallus gallus during the production period, 2018

1. AL: Albania; BA: Bosnia and Herzegovina; ME: Montenegro; MK: the Republic of North Macedonia; and SR: Serbia.

Figure 11

Prevalence of S. Enteritidis‐positive laying hen flocks of Gallus gallus during the production period, 2018

1. AL: Albania; BA: Bosnia and Herzegovina; ME: Montenegro; MK: the Republic of North Macedonia; and SR: Serbia.

Figure 12

Prevalence of S. Typhimurium‐positive (including monophasic variants) laying hen flocks of Gallus gallus during the production period, 2018

1. AL: Albania; BA: Bosnia and Herzegovina; ME: Montenegro; MK: the Republic of North Macedonia; and SR: Serbia.

Figure 13

Prevalence of S. Typhimurium‐positive (including monophasic variants) broiler flocks of Gallus gallus before slaughter, 2018

1. AL: Albania; BA: Bosnia and Herzegovina; ME: Montenegro; MK: the Republic of North Macedonia; and SR: Serbia.

Figure 14

Prevalence of S. Enteritidis‐positive broiler flocks of Gallus gallus before slaughter, 2018

1. AL: Albania; BA: Bosnia and Herzegovina; ME: Montenegro; MK: the Republic of North Macedonia; and SR: Serbia.

Figure 15

Prevalence of S. Typhimurium‐positive (including monophasic variants) turkey breeding flocks during the production period, 2018

1. AL: Albania; BA: Bosnia and Herzegovina; ME: Montenegro; MK: the Republic of North Macedonia; and SR: Serbia.

Figure 16

Prevalence of S. Enteritidis and/or S. Typhimurium‐positive (including monophasic variants) flocks of fattening turkeys before slaughter, 2018

1. AL: Albania; BA: Bosnia and Herzegovina; ME: Montenegro; MK: the Republic of North Macedonia; and SR: Serbia.

Figure 17

Overall reported prevalence of poultry flocks positive for Salmonella target serovars relevant for public health in different poultry animal populations, reporting MS, EU, 2007–2018

Figure 18

Percentage of laying hen flocks positive for S. Enteritidis and number of human salmonellosis cases due S. Enteritidis infection acquired in the EU, 2012–2018

Figure 19

Estimates of the prevalence (represented as a probability taking any value between 0 and 1) of poultry flocks positive for Salmonella target serovars, at the EU level and in different poultry animal populations, 2007–2018

Figure 20

Trend in reported confirmed human cases of S. Enteritidis acquired in the EU, by month, 2009–2018

1. Source(s): Austria, the Czech Republic, Denmark, Estonia, Finland, Germany, Greece, Hungary, Ireland, Italy, Latvia, Malta, the Netherlands, Portugal, Slovakia, Spain, Sweden and the United Kingdom. Belgium, Bulgaria, Cyprus, Croatia, France, Lithuania, Luxembourg, Poland, Romania and Slovenia did not report data to the level of detail required for the analysis.

Figure 21

Sankey diagram of the distribution of the human EU top‐five Salmonella serovars, across different food and animal sources (broiler, cattle, pig, turkey and layers), EU, 2018

1. The left side of the diagram shows the five commonest reported Salmonella serovars from human salmonellosis cases acquired in the EU: S. Infantis (blue), S. Typhimurium (green), S. Enteritidis (pink), monophasic S. Typhimurium (yellow) and S. Derby (violet). Animal and food data from the same source were merged: ‘broiler’ includes isolates from broiler flocks and broiler meat, ‘cattle’ includes isolates from bovines for meat production and bovine meat, ‘pig’ includes isolates from fattening pigs and pig meat, ‘turkey’ includes isolates from fattening turkey flocks and turkey meat and ‘layers’ includes laying hen flocks and eggs. The right side shows the five sources considered (broiler, cattle, pig, turkey and layers). The width of the coloured bands linking sources and serovars is proportional to the percentage of isolation of each serovar from each source.

Figure 22

Sankey diagram of the distribution of the human EU top‐five Salmonella serovars found in food and animal matrices by reporting MSs, EU, 2018

1. The left side of the diagram shows the five commonest reported Salmonella serovars from human salmonellosis cases acquired in the EU: S. Infantis (blue), S. Typhimurium (green), S. Enteritidis (pink), monophasic S. Typhimurium (yellow) and S. Derby (violet). The right side shows the reporting MS. The width of the coloured bands linking MSs and serovars is proportional to the percentage of isolation of each serovar reported from each MS.

Figure 23

Stacked bar plots showing the percentages of the EU top‐five Salmonella serovars in human salmonellosis acquired in the EU, by food‐animal category with isolates, EU, 2018

1. The percentages were calculated on the total number of isolates serotyped for each of the five animal/food categories (bovine, broiler, layers, pig and turkey). The values at the top of each box are the numbers of Salmonella serovar isolates and the numbers in parentheses are the number of reporting MS, for animal matrices (grey) and food matrices (black). Each plot shows the percentage of isolates belonging to the reported serovar out of the total number of serotyped isolates.

Figure 24

Overview of L. monocytogenes testing along the food chain according to the sampling stage, the sampler and the objective of the sampling

1. CA: Competent Authority; FBOp: Food business operator; Lm: Listeria monocytogenes; MS: Member State; RTE: ready‐to‐eat.

Figure 25

Trend in reported confirmed human cases of listeriosis in the EU/EEA, by month, 2009–2018

1. Source: Austria, Belgium, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Malta, the Netherlands, Norway, Poland, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom. Bulgaria, Croatia, Luxembourg and Portugal did not report data to the level of detail required for the analysis.

Figure 26

Proportion of L. monocytogenes‐positive sampling units (all sampling stages) in RTE fish and fishery products, in the EU, in 2016 (blue), 2017 (red) and 2018 (green)

1. (a): Number of sampling units tested by the MS for the corresponding category and year.

2. (b): Number of MS which have reported tested sampling units for the corresponding category and year.

3. Over the period 2016–2018, testing was reported by the following countries: for RTE fish products: AT, BE, BG, HR, CY, CZ, DK, EE, DE, GR, HU, IR, IT, LV, LU, LT, NL, PL, PT, SK, SI, ES, SE, ME, IS and MK; for RTE fishery products: AT, BE, BG, HR, CY, CZ, DK, EE, DE, GR, HU, IT, IR, LU, LT, NL, PL, PT, RO, SK, ES, SE, IS, ME and MK.

4. ‘fish, RTE’ includes data on ‘fish’ of the following types: ‘chilled’, ‘cooked‐chilled’, ‘gravad/slightly salted’, ‘marinated’ and ‘smoked – cold‐smoked’, ‘smoked – hot‐smoked’, ‘smoked’.

5. ‘fishery products, RTE’ includes the following types: ‘crustaceans – prawns – cooked’, ‘crustaceans – lobsters – cooked’, ‘crustaceans – unspecified – cooked’, ‘crustaceans – shrimps – shelled, shucked and cooked’, ‘crustaceans – unspecified – shelled, shucked and cooked’, ‘crustaceans – shrimps – cooked’, ‘fish – fishery products from fish species associated with a high amount of histidine – not enzyme maturated’, ‘fish – fishery products from fish species associated with a high amount of histidine – which have undergone enzyme maturation treatment in brine’, ‘fishery products, unspecified – cooked’, ‘fishery products, unspecified – RTE – chilled’, ‘fishery products, unspecified – smoked’, ‘fishery products, unspecified – RTE’, ‘molluscan shellfish – shelled, shucked and cooked’, ‘molluscan shellfish – cooked’, ‘molluscan shellfish – cooked – frozen’, ‘Surimi – frozen’, ‘surimi – chilled’, ‘surimi’.

Figure 27

Proportion of L. monocytogenes‐positive sampling units (all sampling stages) in RTE meat and meat products (pork, turkey, broiler and beef), in the EU, in 2016 (blue), 2017 (red) and 2018 (green)

1. (a): Number of samples tested by the MS for the corresponding category and year.

2. (b): Number of MS which have reported tested samples for the corresponding category and year.

3. Over the period 2016–2018, meat and meat products testing was reported by the following countries: pig meat: AT, BE, BG, HR, CY, CZ, DK, EE, DE, GR, IT, LV, PL, PT, RO, SK, ES and MK; turkey meat: AT, CY, DE, GR, PL, PT, SK and ES; broiler meat: BG, CZ, EE, DE, PL, RO, ES and MK; bovine meat: AT, BE, BG, CZ, DK, EE, DE, GR, LU, NL, PL, RO, SK and MK.

4. Since data were mostly reported by a limited number of MS and are of a heterogeneous nature as these include various diverse subcategories, the findings presented in this figure may not be representative of the EU level or directly comparable across years. RTE pig meat products includes ‘Meat from pig, meat products’ of the following types: ‘cooked ham’, ‘cooked, RTE’, ‘fermented sausages’, ‘pâté’, ‘raw and intended to be eaten raw’, ‘raw ham’, ‘unspecified, ready‐to‐eat’ and ‘ready‐to‐eat’ and ‘meat from pig – meat preparation’ of the following type ‘intended to be eaten raw’. ‘RTE turkey meat’ includes turkey ‘meat products’ of the following types: ‘cooked, RTE’, ‘ready‐to‐eat’ and ‘raw and intended to be eaten raw’. ‘RTE broiler meat’ includes broiler ‘meat products’ of the following types: ‘cooked, RTE’. ‘RTE bovine meat’ includes ‘meat from bovine animals, meat products’ of the following types: ‘cooked, RTE’, ‘fermented sausages’, ‘raw and intended to be eaten raw’, ‘pâté’; ‘ready‐to‐eat’; and ‘unspecified, RTE’; ‘meat from bovine animals, meat preparation’ of the following types: ‘intended to be eaten raw’ and ‘meat from bovine animals, minced meat’ of the following types: ‘intended to be eaten raw’.

Figure 28

Proportion of L. monocytogenes‐positive sampling units (all sampling stages) in cheeses, in the EU, in 2016 (blue), 2017 (red) and 2018 (green)

1. LHT: low heat treated. ‘Overall’ and the number of MS correspond to data across all major sampling stages (‘retail’ + ‘processing’ + ‘farm’ + ‘border inspection activities’ + ‘unspecified’). ‘Retail’ corresponds to data obtained from catering, hospital or medical care facilities, retail, wholesale and restaurants or cafes or pubs or bars or hotels or catering services. For each sampling stage (‘overall’, ‘retail’ and ‘processing’), data are pooled across both types of sampling units (‘single’ and ‘batch’). ‘Processing’ corresponds to data obtained from packing centres, cutting plants and processing plants. Since data were mostly reported by a limited number of MS, the findings presented in this figure may not be presentative of the EU level.

2. ‘Hard cheeses pasteurised milk’ and ‘hard cheeses from raw or low heat‐treated milk’ includes cheeses made from cows’ milk, sheep's milk, goats’ milk, mixed milk from cows, sheep and/or goats and unspecified milk or other animal milk.

3. ‘Soft and semi‐soft cheeses’ includes both soft and semi‐soft and fresh cheese made from cows’ milk, sheep's milk, goats’ milk, mixed milk from cows, sheep and/or goats and unspecified milk or other animal milk.

Figure 29

Trend in reported confirmed cases of human STEC infection in the EU/EEA, by month, 2009–2018

1. Source: Austria, Cyprus, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom. Belgium, Bulgaria, the Czech Republic, Croatia and Portugal did not report data to the level of detail required for the analysis.

Figure 30

Frequency distributions of reported STEC serogroups in food and animals, in reporting MSs and non‐MSs, during 2013–2018

1. Note: The presence (red boxes) and absence (white boxes) of STEC serogroups in foods (left) and animals (right). The E. coli O104:H4 stx2+eae‐ was isolated from sprouted seeds in 2015.

Figure 31

Relative presence of reported STEC serogroups in foods, in reporting MS and non‐MS, 2018

1. Proportions of STEC serogroups: red boxes > 1%, orange boxes > 0.1% and ≤ 1%, yellow boxes > 0.0001% and ≤ 0.1% of positive samples. White boxes indicate absence of the serogroup.

2. The category ‘other ruminants meat’ includes meat from deer; ‘other meat’ includes meat from animals other than ruminants; ‘milk and dairy products’ include any type of dairy product, cheese and milk other than raw milk; ‘raw milk’ includes raw milk from different species, but most tested samples were from cows; ‘seeds’ includes mostly sprouted seeds, but dry seeds are also included.

3. Source: Twenty‐two MS plus one non‐MS.

Figure 32

Relative presence of reported STEC serogroups in animals, in reporting MS and non‐MS, 2018

1. Proportions of STEC serogroups: red boxes > 1%, orange boxes > 0.1% and ≤ 1%, yellow boxes > 0.0001% and ≤ 0.1% of positive samples. White boxes indicate absence of the serogroup. The category ‘other ruminants’ includes deer; ‘other animals’ comprises pigeons, cats, chinchillas, dogs, ferrets, foxes, Gallus gallus, guinea pigs, hedgehogs, mice, rabbits, rats solipeds, water buffalos, weasels and wild boars.

2. Source: six MS.

Figure 33

Number of confirmed tuberculosis cases due to M. bovis in individuals of EU origin and country‐level aggregated herd prevalence of bovine tuberculosis, EU/EEA and Switzerland, 2018. Data for EU/EEA human cases provided by ECDC.

Figure 34

Proportion of cattle herds infected with bovine tuberculosis in OTF regions, EU, 2010–2018

1. OTF: Officially bovine tuberculosis free in cattle.

Figure 35

Proportion of cattle herds positive for bovine tuberculosis in non‐OTF regions, EU, 2010–2018

1. OTF: Officially bovine tuberculosis free in cattle.

Figure 36

Prevalence of bovine tuberculosis test‐positive cattle herds in non‐OTF regions of five co‐financed non‐OTF MSs and of one not co‐financed non‐OTF Member State Greece, 2004–2018

Figure 37

Trend in reported confirmed human cases of brucellosis in the EU/EEA, by month, 2014–2018

1. Source: Austria, Cyprus, the Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain and Sweden. Belgium, Bulgaria, Croatia, Luxembourg and the United Kingdom did not report data to the level of detail required for the analysis. Denmark does not have a surveillance system for this disease.

Figure 38

Number of domestically acquired confirmed brucellosis cases in humans and prevalence of Brucella test‐positive cattle, sheep and goat herds, EU, 2018

Figure 39

Proportion of Brucella–infected cattle herds, in OBF regions, EU, 2012–2018

1. OBF: Officially brucellosis free in cattle.

Figure 40

Proportion of Brucella‐positive cattle herds, in non‐OBF regions, EU, 2012–2018

1. Non‐OBF: Non‐officially brucellosis free in cattle.

Figure 41

Prevalence of Brucella test‐positive cattle herds, in Greece, Italy, Portugal and Spain, 2004–2018

Figure 42

Proportion of sheep flocks and goat herds infected with B. melitensis, in ObmF regions, EU, 2012–2018

1. ObmF: Officially B. melitensis free in sheep and goats.

Figure 43

Proportion of sheep flocks and goat herds positive for B. melitensis, in non‐ObmF regions, EU, 2012–2018

1. Non‐ObmF: Non‐officially B. melitensis free in sheep and goats.

Figure 44

Prevalence of Brucella melitensis test‐positive sheep and goat herds, in three co‐financed MS: Italy, Portugal and Spain, 2004–2018

Figure 45

Trend in reported confirmed human cases of trichinellosis in the EU/EEA by month, 2009–2018

1. Source: Austria, Cyprus, the Czech Republic, Estonia, Finland, Germany, France, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom. Belgium, Bulgaria, Croatia and Iceland did not report data to the level of detail required for the analysis. Denmark does not have any formal surveillance system for the disease.

Figure 46

Total human cases in EU, EEA and CH (ECDC data) and in Bosnia and Herzegovina (EFSA food‐borne outbreaks data), 2018

1. Countries in which human cases were reported due to FBO (EFSA data) are in colour according the food vehicle causing the outbreaks (‘pig meat’, ‘wild boar meat’ or ‘unknown’ food vehicle). The number of cases in each country indicates domestic trichinellosis cases (ECDC data); numbers in green box indicate the travel‐related trichinellosis human cases.

Figure 47

Trichinella spp. in domestic pigs and farmed wild boar of 28 MS and three non‐MS (Iceland (IC), Norway (NO) and Switzerland (CH)), 2012–2018

1. These distribution maps have been built based on data from reports (EFSA and ECDC, 2015a,b, 2016, 2017b, 2018a,b,c,d).

Figure 48

Pooled prevalence of Echinococcus multilocularis in red and Arctic foxes within the EU and adjacent countries at national level depicting current epidemiological situation in Europe (Oksanen et al., 2016)

Figure 49

Trend in reported confirmed human cases of E. multilocularis in the EU/EFTA, by month, 2009–2018

1. Source: Austria, the Czech Republic, Estonia, France, Germany, Hungary, Latvia, Lithuania, Norway, Poland, Sweden and Slovakia. Belgium, Bulgaria, Croatia, Cyprus, Denmark, Finland, Greece, Iceland, Italy, Ireland, Luxembourg, Malta, the Netherlands, Portugal, Romania, Slovenia, Spain and the United Kingdom did not report data to the level of detail required for the analysis.

Figure 50

Trend in reported confirmed human cases of E. granulosus s.l. in the EU/EFTA, by month, 2009–2018

1. Source: Austria, the Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Latvia, Lithuania, Malta, Norway, Malta, Poland, Portugal, Romania, Slovakia, Slovenia, Spain and Sweden. Belgium, Bulgaria, Croatia, Cyprus, Denmark, Iceland, Italy Luxembourg, the Netherlands and the United Kingdom did not report data to the level of detail required for the analysis.

Figure 51

Overall proportion (%) of Echinococcus granulosus s.l. positive cases, by intermediate host species, EU, 2014–2018

1. Number of positive animals: sheep (N = 507,432), goats (N = 166,661), pigs (N = 149,913), cattle (N = 63,874), sheep and goats (N = 7,427), wild boars (N = 452), water buffalos (N = 376), domestic solipeds (N = 228), deer (N = 92), reindeer (N = 24), moose (N = 6) and mouflons (N = 2). The total number of positive animals for E. granulosus s.l. reported in this period was 896,487. Positive pigs could be overestimated in co‐endemic countries with E. multilocularis.

Figure 52

Map of Europe showing the pooled number of Echinococcus granulosus s.l. positive cases in intermediate animal hosts detected in each MS during 2014–2018

1. Intermediate hosts included in map are: cattle, deer, goats, horses, moose, mouflons, reindeer, sheep, water buffalos and wild boars.

2. Legend: black > 10,000 positive cases; dark blue < 1,000 positive cases; light blue < 100 cases; yellow = 0 cases reported; white = data not reported. Pigs were excluded from Poland and Germany because of the co‐endemicity with E. multilocularis.

Figure 53

Number of food‐borne and waterborne outbreaks in reporting MS, EU, 2010–2018

1. The number of reporting MS is mentioned in parentheses.

Figure 54

Number of illnesses due to food‐borne and waterborne outbreaks in reporting MS, EU, 2010–2018

1. Sweden reported one strong‐evidence listeriosis outbreak with one illness, which was due to a multicountry listeriosis outbreak.

Figure 55

Food‐borne and waterborne outbreaks reporting rate (per 100,000 population) in 2018 (in parentheses), by EU Member State and % of difference compared with 2017 (green bars)

Figure 56

Distribution of the extent of food‐borne and waterborne outbreaks, by Member State, EU, 2018

Figure 57

Frequency distribution of food‐borne and waterborne outbreaks (internal circle) and human cases involved in outbreaks (external circle), by reporting EU MS and non‐MS (bottom figure), by causative agent, 2018

1. Sweden reported one strong‐evidence listeriosis outbreak with one illness, which was due to a multicountry listeriosis outbreak.

2. Other bacterial agents include Aeromonas hydrophila, Escherichia coli, enteroinvasive Escherichia coli (EIEC), enterotoxigenic Escherichia coli (ETEC), Enterococcus, Leptospira spp., Shigella spp., Shigella flexneri, Shigella sonnei, Yersinia enterocolitica and other unspecified bacteria.

3. Other viruses include adenovirus, flavivirus, hepatitis E, rotavirus and other unspecified viruses.

4. Marine biotoxins include ciguatoxin and other unspecified toxins.

5. Other parasites include Giardia intestinalis (lamblia), Giardia spp., Taenia saginata and other unspecified parasites.

6. Other causative agent include atropine, lectin, monosodium glutamate, chemical agents unspecified.

Figure 58

Sankey diagrams of the distribution of Salmonella food‐borne including waterborne outbreaks in the EU (N = 1,581), by reporting MS, 2018

Figure 59

Sankey diagram of the distribution of food‐borne and waterborne outbreaks by causative agents other than Salmonella (N = 2,342), by reporting MSs, 2018. Outbreaks by Unknown/Unspecified causative agents (N = 1,223) are not shown

1. Escherichia coli includes Escherichia coli (unspecified), enteroinvasive E. coli (EIEC), enterotoxigenic E. coli (ETEC). Other bacteria include Aeromonas hydrophila and other unspecified bacteria. Marine biotoxins include ciguatoxin and other unspecified toxins. Other causative agent include atropine, lectine, monosodium glutamate, chemical agents unspecified.

Figure 60

Food‐borne and waterborne outbreaks reported in the EU in 2018, by reporting Member State and by type causative agent (bacteria) and % of difference compared with 2017

Figure 61

Food‐borne and waterborne outbreaks reported in the EU in 2018, by reporting Member State and by type causative agent (bacterial toxins) and % of difference compared with 2017

1. *Data from France are not shown because data on outbreaks by B. cereus, C. perfringens and Staphylococcus were differently coded in 2018 compared with 2017.

Figure 62

Food‐borne and waterborne outbreaks reported in the EU in 2018, by reporting Member State and by type causative agent (viruses) and % of difference compared with 2017

Figure 63

Food‐borne and waterborne outbreaks reported in the EU in 2018, by reporting Member State and by type causative agent (Other causative agents) and % of difference compared with 2017

Figure 64

Number of food‐borne and waterborne outbreaks in reporting MS, by causative agent, EU, 2010–2018

1. Other bacterial agents include Aeromonas hydrophila, Escherichia coli, enteroinvasive Escherichia coli (EIEC), enterotoxigenic Escherichia coli (ETEC), Enterococcus spp., Francisella spp., Leptospira spp., Shigella spp., Shigella flexneri, Shigella sonnei, Streptococcus spp.; Vibrio parahaemolyticus, Vibrio spp., Yersinia enterocolitica and other unspecified bacteria.

2. Bacterial toxins other than Clostridium botulinum include toxins produced by Bacillus, Clostridium other than Clostridium botulinum and Staphylococcus and other unspecified bacterial toxins.

3. Other viruses include adenovirus, flavivirus, hepatitis E, rotavirus, sapovirus and other unspecified viruses.

4. Other parasites include Anisakis, Giardia intestinalis (lamblia), Giardia spp., Taenia saginata and other unspecified parasites.

5. Marine biotoxins include ciguatoxin and other unspecified toxins.

Figure 65

Number of food‐borne and waterborne outbreaks, by reporting MS and causative agents, 2014–2018

Figure 66

Reporting rate per 100,000 population of Salmonella food‐borne and waterborne outbreaks, by reporting Member State, 2010–2018

1. Intensity of the line is proportional to the magnitude of outbreak reporting rate. Red boxes indicates statistically significant (p < 0.05) trends over years.

Figure 67

Distribution of strong‐ and weak‐evidence food‐borne and waterborne outbreaks, per causative agent, EU, 2018

1. Other bacterial agents include Aeromonas hydrophila, Escherichia coli, enteroinvasive Escherichia coli (EIEC), enterotoxigenic Escherichia coli (ETEC), Enterococcus, Leptospira spp., Shigella spp., Shigella flexneri, Shigella sonnei, Yersinia enterocolitica and other unspecified bacteria.

2. Other viruses include adenovirus, flavivirus, Hepatitis E, rotavirus and other unspecified viruses.

3. Marine biotoxins include ciguatoxin and other unspecified toxins.

4. Other parasites include Giardia intestinalis (lamblia), Giardia spp., Taenia saginata and other unspecified parasites.

5. Other causative agent include atropine, lectin, monosodium glutamate, chemical agents unspecified.

Figure 68

Frequency distribution of causative agents associated with strong‐evidence food‐borne and waterborne outbreaks, by food vehicle, in reporting MSs, EU, 2018

1. Other bacterial agents include Aeromonas hydrophila, Escherichia coli, enteroinvasive Escherichia coli (EIEC), enterotoxigenic Escherichia coli (ETEC), Enterococcus, Leptospira spp., Shigella spp., Shigella flexneri, Shigella sonnei, Yersinia enterocolitica and other unspecified bacteria.

2. Bacterial toxins other than Clostridium botulinum include toxins produced by Bacillus, Clostridium other than Clostridium botulinum and Staphylococcus and other unspecified bacterial toxins.

3. Other viruses include adenovirus, flavivirus, hepatitis E, rotavirus and other unspecified viruses.

4. Other parasites include Giardia intestinalis (lamblia), Giardia spp., Taenia saginata and other unspecified parasites.

5. Marine biotoxins include ciguatoxin and other unspecified toxins.

6. Other causative agent include atropine, lectin, monosodium glutamate, chemical agents unspecified.

7. Meat and meat products include: bovine meat, pig meat, poultry meat, sheep meat, other or mixed red meat and products thereof, meat and meat products, unspecified.

8. Fish and fishery products include: crustaceans, shellfish, molluscs and products thereof, fish and fish products.

9. Other foods include: canned food products, cereal products and legumes, drinks, including bottled water, other foods, unspecified.

10. Food of non‐animal origin include: fruits (and juices), herbs and spices, sweets and chocolate, vegetables (and juices).

11. Milk and milk products include: cheese, dairy product (other than cheeses), milk.

Figure 69

Sankey diagrams of the distribution of food vehicles implicated in strong‐evidence food‐borne and waterborne outbreaks caused by Salmonella (N = 296), EU, 2018

1. One outbreak by Salmonella Paratyphi has been excluded.

Figure 70

Sankey diagrams of the distribution of food vehicles implicated in strong‐evidence food‐borne and waterborne outbreaks caused by bacterial agents other than Salmonella (N = 53), in the EU, 2018

1. Escherichia coli include Escherichia coli (unspecified), enteroinvasive E. coli (EIEC), enterotoxigenic E. coli (ETEC).

2. Other bacteria include Aeromonas hydrophila and other unspecified bacteria.

Figure 71

Sankey diagrams of the distribution of food vehicles implicated in strong‐evidence food‐borne and waterborne outbreaks caused by bacterial toxins (N = 120), in the EU, 2018

Figure 72

Sankey diagrams of the distribution of food vehicles implicated in strong‐evidence food‐borne and waterborne outbreaks caused by viruses (N = 105), in the EU, 2018

1. Outbreaks by viruses, Unspecified have been excluded.

Figure 73

Sankey diagrams of the distribution of food vehicles implicated in strong‐evidence food‐borne and waterborne outbreaks caused by parasites (N = 13), in the EU, 2018

Figure 74

Sankey diagrams of the distribution of food vehicles implicated in strong‐evidence food‐borne and waterborne outbreaks caused ‘other causative agents’ (N = 68), in the EU, 2018

1. Marine biotoxins include ciguatoxin and other unspecified toxins.

2. Other causative agent include atropine, lectin, monosodium glutamate, chemical agents unspecified.

Figure 75

Number of food‐borne and waterborne outbreaks, by food vehicle implicated in strong‐evidence food‐borne and waterborne outbreaks, in reporting MS, 2010–2018

Figure 76

Distribution of food vehicles implicated in strong‐ and weak‐evidence food‐borne and waterborne outbreaks, by causative agents, in the EU, 2018

Figure 77

Distribution of the number of strong‐ and weak‐evidence food‐borne and waterborne outbreaks, by place of exposure (setting), EU, 2018

1. Other settings and multiple settings include Camp or picnic, Farm, Multiple places of exposure in more than one country, Multiple places of exposure in one country, Others unspecified, Temporary mass catering (fairs or festivals).

Figure 78

Distribution of the number of cases involved in strong‐ and weak‐evidence food‐borne and waterborne outbreaks, by place of exposure (setting), EU, 2018

1. Other settings and multiple settings include Camp or picnic, Farm, Multiple places of exposure in more than one country, Multiple places of exposure in one country, Others unspecified, Temporary mass catering (fairs or festivals).

Figure 79

Distribution of strong‐evidence food‐borne and waterborne outbreaks, by place of exposure (setting) and by causative agent, in reporting MS, EU, 2018

1. Canteen or Catering to Workplace, school, hospital etc. include: canteen or workplace catering, catering on aircraft or ship or train.

2. Hospital or medical care facility, residential institution (nursing home or prison or boarding school), school or kindergarten.

3. Restaurant, pub, street vendors, take‐away etc. include: mobile retailer or market/street vendor, restaurant or cafe or pub or bar or hotel or catering service, take‐away or fast‐food outlet.

4. Other settings and multiple settings include: camp or picnic, farm, multiple places of exposure in more than one country, multiple places of exposure in one country, others, temporary mass catering (fairs or festivals).

Figure 80

Frequency distribution of contributory factors in strong‐evidence food‐borne and waterborne outbreaks, by place of exposure (setting), in reporting MS, EU, 2018

1. Canteen or Catering to Workplace, school, hospital etc. include: canteen or workplace catering, catering on aircraft or ship or train.

2. Hospital or medical care facility, residential institution (nursing home or prison or boarding school), school or kindergarten.

3. restaurant, pub, street vendors, take‐away etc. include: mobile retailer or market/street vendor, restaurant or cafe or pub or bar or hotel or catering service, take‐away or fast‐food outlet.

4. Other settings and multiple settings include: camp or picnic, farm, multiple places of exposure in more than one country. Multiple places of exposure in one country, Others, Temporary mass catering (fairs or festivals).

Figure 81

Choropleth map of the number of tested foxes and number and geographical distribution of the reported rabies cases in foxes, by reporting country, EU, 2018

1. Note: Norway reported four positive Arctic (polar) foxes on the Svalbard and Jan Mayen Islands.

Figure 82

Choropleth map of the number of tested bats and number and geographical distribution of the reported rabies cases in bats (unspecified, EBLV‐1 and EBLV‐2), by reporting country, EU, 2018

Figure 83

Trend in reported confirmed human cases of Q fever in the EU/EEA by month, 2014–2018

1. Source(s): Cyprus, Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom. Austria, Belgium, Bulgaria, Croatia, Denmark, Italy and Switzerland did not report data to the level of detail required for the analysis.

Figure 84

Trend in reported locally acquired human WNV infections in the EU/EEA, by month, 2009–2018

1. Source: Austria, Belgium, Cyprus, Czech Republic, Estonia, Finland, France, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom. Bulgaria, Croatia, Denmark, Germany, Iceland and Portugal did not report data to the level of detail required for the analysis.

Figure 85

Number of affected equids reported to the EU Animal Disease Notification System (ADNS), by reporting MS, EU, 2013–2018

Figure 86

Distribution of West Nile virus infections among humans and outbreaks among equids in the EU, transmission season 2018. (Source: TESSy and ADNS)

Figure 87

Geographical distribution of the WNF outbreaks during 2018 in EU, in equids (blue triangle) and birds (red rhombus) according to the notifications from the Veterinary Authorities submitted to the ADNS. There was one outbreak in dogs (green bullet). Source: ADNS, 2018