The European Union One Health 2019 Zoonoses Report

Abstract

This report of the EFSA and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring activities carried out in 2019 in 36 European countries (28 Member States (MS) and eight non-MS). The first and second most reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The EU trend for confirmed human cases of these two diseases was stable (flat) during 2015-2019. The proportion of human salmonellosis cases due to Salmonella Enteritidis acquired in the EU was similar to that in 2017-2018. Of the 26 MS reporting on Salmonella control programmes in poultry, 18 met the reduction targets, whereas eight failed to meet at least one. The EU prevalence of Salmonella target serovar-positive flocks has been stable since 2015 for breeding hens, laying hens, broilers and fattening turkeys, with fluctuations for breeding turkey flocks. Salmonella results from competent authorities for pig carcases and for poultry tested through national control programmes were more frequently positive than those from food business operators. Shiga toxin-producing Escherichia coli (STEC) infection was the third most reported zoonosis in humans and increased from 2015 to 2019. Yersiniosis was the fourth most reported zoonosis in humans in 2019 with a stable trend in 2015-2019. The EU trend of confirmed listeriosis cases remained stable in 2015-2019 after a long period of increase. Listeria rarely exceeded the EU food safety limit tested in ready-to-eat food. In total, 5,175 food-borne outbreaks were reported. Salmonella remained the most detected agent but the number of outbreaks due to S. Enteritidis decreased. Norovirus in fish and fishery products was the agent/food pair causing the highest number of strong-evidence outbreaks. The report provides further updates on bovine tuberculosis, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, West Nile virus, 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, 2019

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

   ¹ Exception: West Nile virus infection for which the total number of cases was used.

Figure 2

Trend in reported confirmed human cases of campylobacteriosis in the EU/EEA, by month, 2015–2019

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

Figure 3

Salmonella summary infographic, EU/EFTA, 2019

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 national control programmes (NCP) in poultry compared with the European reduction target for laying hens (2%) and other poultry populations (1%); (c) the trends of the prevalence of poultry flocks positive for Salmonella target serovars in the context of NCP; (d) the comparisons between the results of the competent authorities (CA) and food business operators (FBOp) data in the context of the NCP; on the right side; (e) the distribution of the human top five Salmonella serovars coming from serotyped isolates from food and animal matrices reported by reporting MS, and (f) the distribution of human top five 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, 2015–2019

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

Figure 6

Summary of Salmonella monitoring results based on official control samples, by food category as defined by EU Regulation (EC) No 2073/2005 and by stage in the food chain, EU, 2019

1. The number at the end of the bar indicates the number of tested samples and the number between brackets indicates the number of reporting MS for each food category and sampling stage.

Figure 7

Summary of Salmonella monitoring results, by major meat and meat products categories and by sampling stage in the food chain, EU, 2019

Figure 8

Prevalence of poultry flocks (breeding flocks of Gallus gallus, laying hens, broilers, breeding turkeys and fattening turkeys) positive for Salmonella target serovars, EU/EFTA, 2019

1. Red vertical bars indicate the target to be reached, which was fixed at 1% for all poultry populations with the exception of laying hens for which it was 2% for all MS with the exception of Poland, for which it was 3.5%. Luxembourg met the target in laying hens (having less than 50 flocks with one positive for target serovars).

Figure 9

Prevalence of S. Enteritidis‐positive breeding flocks of Gallus gallus during the production period, EU/EFTA, 2019

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

   Luxembourg and Malta do not have breeding flocks of Gallus gallus.

Figure 10

Prevalence of S. Typhimurium‐positive (including monophasic variants) breeding flocks of Gallus gallus during the production period, EU/EFTA, 2019

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

   Luxembourg and Malta do not have breeding flocks of Gallus gallus.

Figure 11

Prevalence of S. Infantis‐positive breeding flocks of Gallus gallus during the production period, EU/EFTA, 2019

1. AL: Albania; BA: Bosnia and Herzegovina; ME: Montenegro; MK: Republic of North Macedonia; and SR: Serbia. Luxembourg and Malta do not have breeding flocks of Gallus gallus.

Figure 12

Prevalence of S. Enteritidis‐positive laying hen flocks of Gallus gallus during the production period, EU/EFTA, 2019

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

Figure 13

Prevalence of S. Typhimurium‐positive (including monophasic variants) laying hen flocks of Gallus gallus during the production period, EU/EFTA, 2019

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

Figure 14

Prevalence of S. Enteritidis‐positive broiler flocks of Gallus gallus before slaughter, EU/EFTA, 2019

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

Figure 15

Prevalence of S. Typhimurium‐positive (including monophasic variants) broiler flocks of Gallus gallus before slaughter, EU/EFTA, 2019

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

Figure 16

Prevalence of S. Typhimurium‐positive (including monophasic variants) turkey breeding flocks during the production period, EU/EFTA, 2019

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

   The following MS do not have turkey breeding flocks: Austria, Belgium, Cyprus, Czechia, Denmark, Estonia, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Portugal, Romania, Slovakia and Slovenia. Also the non‐MS Switzerland does not have such flocks.

Figure 17

Prevalence of S. Enteritidis‐positive and/or S. Typhimurium‐positive (including monophasic variants) flocks of fattening turkeys before slaughter, EU/EFTA, 2019

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

   The following MS do not have turkey breeding flocks: Estonia, Latvia, Luxembourg and Malta.

Figure 18

Overall reported percentage of poultry flocks positive for Salmonella target serovars relevant for public health in different poultry animal populations, reporting MS, EU, 2007–2019

Figure 19

Percentage of laying hen flocks positive for S. Enteritidis and number of human salmonellosis cases due S. Enteritidis infection acquired in the EU, 2010–2019

Figure 20

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 for different poultry populations, 2007–2019

Figure 21

Trend in reported confirmed human cases of S. Enteritidis infections acquired in the EU, by month, 2015–2019

1. Source(s): Austria, Czechia, 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 22

Sankey diagram of the distribution of the EU top five Salmonella serovars in human salmonellosis acquired in the EU, reported from specified food–animal categories, by food animal sources, EU, 2019

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

Figure 23

Sankey diagram of the distribution of the EU top five Salmonella serovars in human salmonellosis acquired in the EU and reported from specified food–animal categories, by reporting MS, EU, 2019

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

Figure 24

Percentages of the EU top‐five Salmonella serovars in human salmonellosis acquired in the EU and reported from specified food–animal categories, by food–animal category with isolates, EU, 2019

1. The percentages were calculated based 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 25

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 26

Trend in reported confirmed human cases of listeriosis in the EU/EEA, by month, 2015–2019

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

Figure 27

Proportion of L. monocytogenes‐positive sampling units (all sampling stages) in RTE fish and fishery products, EU, in 2016 (blue), 2017 (red) and 2018 (green) and 2019 (orange)

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

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

   ‘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’.

   ‘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 28

Proportion of L. monocytogenes‐positive sampling units (all sampling stages) in RTE meat and meat products (pork, turkey, broiler and beef), EU, in 2016 (blue), 2017 (red) and 2018 (green) and 2019 (orange)

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

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

   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 29

Proportion of L. monocytogenes‐positive sampling units (all sampling stages) in cheeses, EU, in 2016 (blue), 2017 (red) and 2018 (green) and 2019 (orange)

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

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

   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.

   ‘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.

   ‘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 30

Proportion of L. monocytogenes‐positive sampling units (all sampling stages) in fruit and vegetables, EU, in 2016 (blue), 2017 (red) and 2018 (green) and 2019 (orange)

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

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

   The fruit and vegetables group data provided included fruit juice, mixed juice, pre‐cut fruit and/or vegetables, fruit or vegetable products and the edible part of fruit.

Figure 31

Trend in reported confirmed cases of human STEC infection in the EU/EEA, by month, 2015–2019

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, Sweden and the United Kingdom. Belgium, Bulgaria, Czechia, Croatia, Portugal and Spain did not report data to the level of detail required for the analysis.

Figure 32

Number of confirmed tuberculosis cases due to M. bovis and to M. caprae in individuals of EU origin and national herd prevalence of bovine tuberculosis in cattle (ignoring OTF regions), EU/EFTA, 2019

1. Data for EU/EEA human cases provided by ECDC.

Figure 33

Status of countries on bovine tuberculosis, EU/EEA, 2019

Figure 34

Proportion of cattle herds infected with bovine tuberculosis in OTF regions, EU, 2010–2019

1. OTF: Officially bovine tuberculosis free in cattle.

Figure 35

Proportion of cattle herds positive for bovine tuberculosis in non‐OTF regions, EU, 2010–2019

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 MS and of one not co‐financed non‐OTF Member State Greece, 2004–2019

Figure 37

Trend in reported confirmed human cases of brucellosis in the EU/EEA, by month, 2015–2019

1. Source: Austria, Cyprus, Czechia, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia and Sweden. Belgium, Bulgaria, Croatia, Luxembourg, Spain 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 herds and sheep and goat flocks, EU/EFTA, 2019

Figure 39

Status of countries on bovine brucellosis, EU/EEA, 2019

Figure 40

Proportion of Brucella‐positive cattle herds, in non‐OBF regions, EU, 2012–2019

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

Figure 41

Prevalence of Brucella test‐positive cattle herds, in non‐OBF regions of three co‐financed non‐OBF MS (Italy, Portugal and Spain) and of one not co‐financed non‐OBF MS Greece, 2004–2019

Figure 42

Status of countries on ovine and caprine brucellosis, EU/EEA, 2019

Figure 43

Proportion of brucellosis‐positive sheep flocks and goat flocks, in non‐ObmF regions, EU, 2012–2019

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

Figure 44

Prevalence of brucellosis test‐positive sheep and goat flocks, in non‐ObmF regions of five co‐financed non‐ObmF MS, 2004–2019

Figure 45

Trend in reported confirmed human cases of trichinellosis in the EU/EEA by month, 2015–2019

1. Source: Austria, Cyprus, Czechia, Estonia, Finland, Germany, France, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Sweden and the United Kingdom. Belgium, Bulgaria, Croatia, Spain 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/EFTA and Serbia (ECDC data and EFSA food‐borne outbreaks data), 2019

1. Countries that reported food‐borne human trichinellosis cases are coloured according the food vehicle causing the outbreaks (‘pig meat and products thereof’, ‘other or mixed red meat and products thereof’ or ‘unknown’ food vehicle) (data reported to EFSA). The numbers without green box indicate the number of domestic trichinellosis human cases and the numbers in a green box indicate the number of travel‐related trichinellosis human cases (data reported to ECDC except for Serbia (*) data reported to EFSA).

Figure 47

Trichinella spp. in domestic pigs and farmed wild boar, in EU/EFTA, 2012–2019

1. These distribution maps have been built based on data from reports (EFSA and ECDC, 2015a, 2015b, 2016, 2017a, 2018b, 2019c).

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 alveolar echinococcosis in the EU/EEA, by month, 2015–2019

1. Source: Austria, France, Germany, Lithuania, Norway, Poland, Slovakia and Sweden. Belgium, Bulgaria, Croatia, Czechia, Cyprus, Denmark, Estonia, Finland, Greece, Hungary, Iceland, Italy, Ireland, Latvia, 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 cystic echinococcosis in the EU/EEA, by month, 2015–2019

1. Source: Austria, Czechia, 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

Proportion (%) Echinococcus granulosus s.l. test‐positive animals, by intermediate host species, EU, 2015–2019

1. Total number of animals reported positive for Echinococcus granulosus s.l. was 977,697: number of positive sheep (N = 630,915), goats (N = 86,948), pigs (N = 165,572), cattle (N = 84,003), sheep and goats (N = 9,260), wild boars (N = 428), water buffalos (N = 406), domestic solipeds (N = 33), deer (N = 98), reindeer (N = 25), moose (N = 7) and mouflons (N = 2). Positive pigs could be overestimated in co‐endemic countries with Echinococcus multilocularis.

Figure 52

Proportion (%) Echinococcus granulosus s.l. test‐positive animals, by intermediate host species, EU, 2015–2019

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

   Legend: dark blue ≥ 500 positive cases; light blue < 500 cases; yellow = 0 cases reported; white = data not reported. Because of the co‐endemicity with Echinococcus multilocularis, pigs were excluded from Latvia, Hungary, Poland, Germany, Slovakia and Switzerland when Echinococcus species information was not reported.

Figure 53

Distribution of food‐borne outbreaks, by type of outbreak and country, in reporting EU MS and non‐MS, 2019

1. Note: both strong‐evidence outbreaks and weak‐evidence outbreaks are considered in the figure.

Figure 54

Number of food‐borne outbreaks, by strength of evidence, in reporting EU MS, 2010–2019

1. Note: the number of MS reporting outbreaks is indicated in the bottom (N).

   Data on food‐borne outbreaks for 2018 differ from those published in the European Union One Health 2018 Zoonoses Report, due to a delay in reporting from one MS (the Netherlands).

Figure 55

Number of illness cases in food‐borne outbreaks in reporting EU MS, 2010–2019

1. Note: the number of MS reporting outbreaks is indicated in the bottom (N).

   Cases involved in both strong‐evidence outbreaks and weak‐evidence outbreaks are counted in the figure.

   Data on food‐borne outbreaks for 2018 differ from those published in the European Union One Health 2018 Zoonoses Report, due to a delay in reporting from one MS (the Netherlands).

Figure 56

Yearly relative variation (%) of food‐borne outbreaks reporting rate (per 100,000 population) in 2019 compared with 2018, by country, in reporting EU MS and non‐MS

1. For Slovenia the % variation cannot be calculated due to missing data reporting for 2018. Slovakia did not report data on outbreaks in 2019.

Figure 57

Trends of number of strong‐evidence and weak‐evidence outbreaks (left axis) and outbreak reporting rate (per 100,000) (right axis) in reporting EU MS and non‐MS, 2010–2019

1. Note: * indicates countries with a statistical significant trend (P < 0.05) over years.

   Blue colour for both the trend line and the secondary Y‐axis representing the FBO reporting rate was adopted for Latvia, Lithuania and Malta to highlight that the scale was different from the other countries. Slovakia did not report data on outbreaks in 2019.

Figure 58

Distribution of strong‐ and weak‐evidence food‐borne outbreaks, per causative agent, in reporting EU MS, 2019

1. Note: Only FBOs reported by EU Member States are visualised in the figure. FBOs are sorted by number of strong‐evidence outbreaks.

   ‘Hepatitis A’ includes also FBOs with causative agent encoded as ‘hepatitis virus, unspecified’. ‘Bacillus cereus’ includes FBOs with causative agent encoded as B. cereus enterotoxins. ‘Clostridium perfringens’ includes FBOs with causative agent encoded as Clostridium unspecified. ‘Staphylococcus aureus’ includes FBOs with causative agent encoded as Staphylococcus, unspecified’ or Staphylococcal enterotoxins. ‘Other bacteria’ includes Arcobacter butzleri, enteropathogenic Escherichia coli (EPEC), Enterotoxigenic Escherichia coli (ETEC), Escherichia coli, unspecified, Vibrio parahaemolyticus and other unspecified bacteria. ‘Other bacterial toxins’ includes FBOs by unspecified toxin‐producing bacteria.

   ‘Other viruses’ includes adenovirus, flavivirus, hepatitis E virus, rotavirus and other viruses, unspecified. ‘Other causative agents’ includes atropine, mushroom toxins/mycotoxins and unspecified toxins.

Figure 59

Overview of countries reporting data on food‐borne outbreaks, reporting EU MS and non‐MS, 2019

1. Note: the table may be read by column (country) or by row (causative agent). The number at each row end is the number of countries that reported for 2019 a given causative agent in outbreaks while the number at each column end are the numbers of causative agents identified in outbreaks by a given country in 2019. Luxembourg is not shown because no outbreaks were detected in 2019. Slovakia did not report data on outbreaks in 2019.

   ‘Hepatitis A’ includes also FBOs with causative agent encoded as ‘hepatitis virus, unspecified’.

   ‘B. cereus’ includes FBOs with causative agent encoded as B. cereus enterotoxins. ‘C. perfringens’ includes FBOs with causative agent encoded as Clostridium unspecified. ‘S. aureus’ includes FBOs with causative agent encoded as Staphylococcus, unspecified’ or Staphylococcal enterotoxins. ‘Other bacteria’ includes Arcobacter butzleri, enteropathogenic Escherichia coli (EPEC), enterotoxigenic Escherichia coli (ETEC), Escherichia coli, unspecified, Vibrio parahaemolyticus and other unspecified bacteria. ‘Other bacterial toxins’ includes FBOs by unspecified toxin‐producing bacteria.

   ‘Other viruses’ includes adenovirus, flavivirus, hepatitis E virus, rotavirus and other viruses, unspecified. ‘Other causative agents’ includes atropine, mushroom toxins/mycotoxins and unspecified toxins.

Figure 60

Frequency distribution of food‐borne outbreaks (internal circle) and human cases involved in outbreaks (external circle), by reporting EU MS and non‐MS (bottom figure), by causative agent, 2019

1. Causative agents are differently coloured. The size of each sector is proportional to the number of outbreaks (internal circle) and human cases (external circle) involved in outbreaks.

   ‘Hepatitis A’ also includes FBOs with causative agent encoded as ‘hepatitis virus, unspecified’.

   ‘B. cereus’ includes FBOs with causative agent encoded as B. cereus enterotoxins. ‘C. perfringens’ includes FBOs with causative agent encoded as Clostridium unspecified. ‘S. aureus’ includes FBOs with causative agent encoded as Staphylococcus, unspecified’ or Staphylococcal enterotoxins. ‘Other bacteria’ includes Arcobacter butzleri, Enteropathogenic Escherichia coli (EPEC), Enterotoxigenic Escherichia coli (ETEC), Escherichia coli, unspecified, Vibrio parahaemolyticus and other unspecified bacteria. ‘Other bacterial toxins’ includes FBOs by unspecified toxin‐producing bacteria.

   ‘Other viruses’ includes adenovirus, flavivirus, Hepatitis E virus, rotavirus and other viruses, unspecified. ‘Other causative agents’ includes atropine, mushroom toxins/mycotoxins and unspecified toxins.

Figure 61

Food‐borne outbreaks reported in 2019, by country and by causative agent and % of difference compared with 2018, reporting EU MS and non‐MS

1. Note: Both strong‐evidence outbreaks and weak‐evidence outbreaks are considered in the figure. Outbreaks caused by parasites are not shown due to paucity of data. Luxembourg is not shown since no outbreaks were detected in 2019. Slovakia did not report data on outbreaks in 2019.

   * % of variation could not be calculated as no outbreaks were reported in 2018. For Lithuania, the % of difference of FBOs by ‘norovirus and other calicivirus’ is + 2000%.

   ‘Hepatitis A’ includes also FBOs with causative agent encoded as ‘hepatitis virus, unspecified’. ‘B. cereus’ includes FBOs with causative agent encoded as ‘B. cereus enterotoxins’. ‘C. perfringens’ includes FBOs with causative agent encoded as ‘Clostridium unspecified’. ‘S. aureus’ includes FBOs with causative agent encoded as ‘Staphylococcus, unspecified’ or ‘Staphylococcal enterotoxins’.

Figure 62

Frequency distribution of causative agents associated with strong‐evidence food‐borne outbreaks, by food vehicle, in reporting EU MS, 2019

1. Note: N = number of strong‐evidence outbreaks by food type.

   ‘Hepatitis A’ includes also FBOs with causative agent encoded as ‘hepatitis virus, unspecified’. ‘B. cereus’ includes FBOs with causative agent encoded as ‘B. cereus enterotoxins’. ‘C. perfringens’ includes FBOs with causative agent encoded as ‘Clostridium unspecified’. ‘S. aureus’ includes FBOs with causative agent encoded as ‘Staphylococcus, unspecified’ or ‘Staphylococcal enterotoxins’. ‘Other bacteria’ includes enteropathogenic Escherichia coli (EPEC), enterotoxigenic Escherichia coli (ETEC), Escherichia coli, unspecified, Shigella, Vibrio parahaemolyticus, Yersinia and other unspecified bacteria. ‘Other bacterial toxins’ includes FBOs caused by unspecified toxin‐producing bacteria.

   ‘Other viruses’ includes flavivirus and other unspecified viruses. ‘Other causative agents’ includes atropine, mushroom toxins/mycotoxins and unspecified toxins. ‘Fish and fishery products’ include ‘crustaceans, shellfish, molluscs and products thereof’, as well as ‘fish and fish products’. ‘Meat and meat products’ include bovine meat and products thereof, broiler meat (Gallus gallus) and products thereof, other or mixed red meat and products thereof, other, mixed or unspecified poultry meat and products thereof, pig meat and products thereof, sheep meat and products thereof, turkey meat and products thereof.‘Food of non‐animal origin’ includes cereal products including rice and seeds/pulses (nuts, almonds), fruit, berries and juices and other products thereof, herbs and spices, sweets and chocolate, vegetables and juices and other products thereof.’ ‘Milk and milk products’ include cheese, dairy products (other than cheeses), milk. ‘Other foods’ includes canned food products and other foods, unspecified.‘Water’ includes Tap water, including well water.

Figure 63

Distribution of food vehicles implicated in strong‐ and weak‐evidence food‐borne, by causative agents, in reporting EU MS, 2019

1. ‘Hepatitis A’ includes also FBOs with causative agent encoded as ‘hepatitis virus, unspecified’.

   ‘B. cereus’ includes FBOs with causative agent encoded as B. cereus enterotoxins. ‘C. perfringens’ includes FBOs with causative agent encoded as Clostridium unspecified. ‘S. aureus’ includes FBOs with causative agent encoded as Staphylococcus, unspecified’ or Staphylococcal enterotoxins.

Figure 64

Distribution of the number of strong‐ and weak‐evidence food‐borne outbreaks, by place of exposure (setting), in reporting EU MS, 2019

1. Note: Data on other settings (287) include: Camp or picnic (28), Farm (7), Others (243), Temporary mass catering (fairs or festivals) (9).

   N = number of outbreaks.

Figure 65

Distribution of the number of cases involved in strong‐ and weak‐evidence food‐borne outbreaks, by place of exposure (setting), in reporting EU MS, 2019

1. Note: Data on cases who became infected in other settings (6,252 cases) include: camp or picnic (776), farm (118), others (4,565), temporary mass catering (fairs or festivals) (793).

   N = number of cases.

Figure 66

Distribution of strong‐evidence food‐borne outbreaks, by place of exposure (setting) and by causative agent, in reporting EU MS, 2019

1. Note: ‘Hepatitis A’ includes also FBOs with causative agent encoded as ‘hepatitis virus, unspecified’. ‘B. cereus’ includes FBOs with causative agent encoded as B. cereus enterotoxins. ‘C. perfringens’ includes FBOs with causative agent encoded as Clostridium unspecified. ‘S. aureus’ includes FBOs with causative agent encoded as Staphylococcus, unspecified’ or Staphylococcal enterotoxins. Other bacterial agents include enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), Vibrio parahaemolyticus, Shigella and Yersinia.

   Other viruses include flavivirus (tick‐borne Encephalitis virus) and other unspecified viruses.

   Other causative agents include atropine, mushrooms toxins and other toxins, unspecified.

   ‘Restaurant, pub, street vendors, take‐away, etc.’ includes: restaurant or café or pub or bar or hotel or catering service, mobile retailer or market/street vendor, take‐away or fast‐food outlet.

   ‘Canteen or catering at workplace, school, hospital, etc.’ includes: school or kindergarten, residential institution (nursing home or prison or boarding school), canteen or workplace catering, hospital or medical care facility, catering on aircraft or ship or train.

   ‘Other settings’ includes: camp or picnic, farm, multiple places of exposure in one country, multiple places of exposure in more than one country, other settings unspecified, temporary mass catering (fairs or festivals).

Figure 67

Frequency distribution of contributing factors in strong‐evidence food‐borne outbreaks, by place of exposure (setting), in reporting EU MS, 2019

1. Note: ‘Restaurant, pub, street vendors, take‐away, etc.’ includes; restaurant or café or pub or bar or hotel or catering service, mobile retailer or market/street vendor, take‐away or fast‐food outlet.

   ‘Canteen or catering at workplace, school, hospital, etc.’ includes; school or kindergarten, residential institution (nursing home or prison or boarding school), canteen or workplace catering, hospital or medical care facility, catering on aircraft or ship or train.

   ‘Other settings’ includes; camp or picnic, farm, multiple places of exposure in one country, multiple places of exposure in more than one country, other settings unspecified, temporary mass catering (fairs or festivals).

Figure 68

Number of food‐borne outbreaks, by causative agent, in reporting EU MS, 2010–2019

1. Note: other bacterial agents include Aeromonas, Arcobacter, enteroaggregative E. coli (EAEC), enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC), E. coli unspecified, Francisella tularensis, Leptospira spp., Shigella spp., Streptococcus spp., Vibrio parahaemolyticus, Yersinia enterocolitica and other unspecified bacteria. ‘Hepatitis A’ includes also FBOs with causative agent encoded as ‘hepatitis virus, unspecified’. Other parasites include Anisakis, Cysticercus, Giardia and other unspecified parasites. Other causative agents include atropine, lectin, wax ester and other unspecified toxins.

Figure 69

Trends of number of Salmonella outbreaks (left axis) and Salmonella outbreak reporting rate (per 100,000 population) (right axis), reporting EU MS and non‐MS, 2010–2019

1. Note: The orange line (right axis) in the graphs represents the Salmonella outbreak reporting rate and was measured on the same scale for all MS, to allow a direct comparability among countries. The blue bars present the trend over years in terms of absolute numbers of Salmonella outbreaks, using for each country the most appropriate scale (left axis).

   * indicates countries with a statistically significant trend (p < 0.05) over several years.

Figure 70

Trends in number of outbreaks (left axis) and outbreak reporting rate (per 100,000 population) (right axis) by causative agent, in reporting EU MS, 2010–2019. Only MS and causative agents with a statistically significant temporal trend are shown

1. Note: only causative agents and countries with statistically significant trends and more than five outbreaks reported per year, on average, are visualised. ‘B. cereus’ includes FBOs with causative agent encoded as B. cereus enterotoxins. ‘Hepatitis A’ includes also FBOs with causative agent encoded as ‘hepatitis virus, unspecified’.

Figure 71

Trends for number of strong‐evidence outbreaks (left axis) and outbreak reporting rate (per 100,000 population) (right axis), by food vehicle, in reporting EU MS, 2010–2019

1. Note: only food vehicles and countries with statistically significant trends and more than five outbreaks reported per year, on average, are shown.

   ‘Fish and fishery products’ include ‘crustaceans, shellfish, molluscs and products thereof’, as well as ‘fish and fish products’. ‘Meat and meat products’ include bovine meat and products thereof, broiler meat (Gallus gallus) and products thereof, other or mixed red meat and products thereof, other, mixed or unspecified poultry meat and products thereof, pig meat and products thereof, sheep meat and products thereof, turkey meat and products thereof. ‘Milk and milk products include cheese, dairy products (other than cheeses), milk. ‘Other foods’ includes canned food products and other foods, unspecified.

Figure 72

Choropleth map of the number of tested foxes and number and geographical distribution of the reported rabies cases in foxes, by reporting country, EU/EFTA, 2019

Figure 73

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/EFTA, 2019

Figure 74

Trend in reported confirmed human cases of Q fever in the EU/EEA by month, 2015–2019

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

Figure 75

Trend in reported locally acquired human WNV infections in the EU/EEA, by month, 2015–2019

1. Source: Austria, Belgium, Cyprus, Czechia, 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 76

Distribution of West Nile virus infections among humans and outbreaks among equids and/or birds in the EU, transmission season 2019

1. Source: TESSy and ADNS.

Figure 77

Geographical distribution of WNF outbreaks in equids (blue triangle) and birds (red rhombus) according to the notifications from the Veterinary Authorities, EU, 2019

1. Source: ADNS, extracted on 1 September 2020.

Figure 78

Monthly number of WNF outbreaks in all animal species based on notified date of confirmation, by month by year, 2013–2019, EU

1. Source: ADNS, extracted on 1 September 2020.

Figure 79

Monthly number of WNF outbreaks in all animal species based on notified date of confirmation, 2013–2109, EU

1. Source: ADNS, extracted on 1 September 2020.

Figure C.1

Frequency distributions of reported STEC serogroups in food and animals, in reporting MS during 2014–2019

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

Figure C.2

Relative presence of reported STEC serogroups in foods and animals, in reporting MS, 2019

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 food 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.

   Source: Twenty‐two MS.

   The animal 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.

   Source: nine MS.