The European Union One Health 2021 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 and surveillance activities carried out in 2021 in 27 MSs, the United Kingdom (Northern Ireland) and nine non-MSs. Key statistics on zoonoses and zoonotic agents in humans, food, animals and feed are provided and interpreted historically. In 2021, the first and second most reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. Cases of campylobacteriosis and salmonellosis increased in comparison with 2020, but decreased compared with previous years. In 2021, data collection and analysis at the EU level were still impacted by the COVID-19 pandemic and the control measures adopted in the MSs, including partial or total lockdowns. Sixteen MSs and the United Kingdom (Northern Ireland) achieved all the established targets in poultry populations for reduction in Salmonella prevalence for the relevant serovars. Salmonella samples from carcases of various animal species and samples for Campylobacter quantification from broiler carcases were more frequently positive when performed by the competent authorities than when own-checks were conducted. Yersiniosis was the third most reported zoonosis in humans, followed by Shiga toxin-producing Escherichia coli (STEC) and Listeria monocytogenes infections. L. monocytogenes and West Nile virus infections were the most severe zoonotic diseases, with the most hospitalisations and highest case fatality rates. Overall, MSs reported more foodborne outbreaks and cases in 2021 than in 2020. S. Enteritidis remained the most frequently reported causative agent for foodborne outbreaks. Salmonella in 'eggs and egg products' and in 'mixed foods' were the agent/food pairs of most concern. Outbreaks linked to 'vegetables and juices and products thereof' rose considerably compared with previous years. This report also provides updates on brucellosis, Coxiella burnetii (Q fever), echinococcosis, rabies, toxoplasmosis, trichinellosis, tuberculosis due to Mycobacterium bovis or M. caprae, and tularaemia.

Keywords: Campylobacter; Listeria; Salmonella; foodborne outbreaks; monitoring; parasites; zoonoses.

Figure 1

Reported numbers of cases and notification rates for confirmed human zoonoses in the EU, 2021

1. Data on congenital toxoplasmosis are not shown since 2021 data are not available yet.

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

   (a) Regarding West Nile virus infection, the total number of locally acquired cases was used (includes probable and confirmed cases).

Figure 2

Trends in reported confirmed human cases of campylobacteriosis in the EU, by month, 2017–2021

1. Source: Austria, Cyprus, Czechia, Denmark, Estonia, Finland, France, Germany, Hungary, Ireland, Italy, Latvia, Luxembourg, Malta, the Netherlands, Poland, Romania, Slovenia and Sweden.

Figure 3

Trend in reported confirmed human cases of non‐typhoidal salmonellosis in the EU by month, 2017–2021


1. Source: Austria, Belgium, Cyprus, Czechia, Denmark, Estonia, Germany, Greece, Finland, France, Hungary, Ireland, Italy, Luxembourg, Latvia, Malta, the Netherlands, Poland, Portugal, Romania, Sweden, Slovenia and Slovakia.

Figure 4

Prevalence of poultry flocks (breeding flocks of Gallus gallus, laying hens, broilers, breeding turkeys and fattening turkeys) positive for target Salmonella serovars, EU MSs and non‐MS countries, 2021


1. Vertical bars indicate the target to be reached, which was set at 1% for all poultry populations with the exception of laying hens, for which it was 2%.

Figure 5

Trend in the estimated prevalence of poultry flocks positive for Salmonella spp. and target Salmonella serovars, at EU level for different poultry populations, 2007–2021

Figure 6

Trend in reported confirmed human cases of S. Enteritidis infections acquired in the EU, by month, 2017–2021


1. Source: Austria, Belgium, Czechia, Germany, Denmark, Estonia, Greece, Finland, Hungary, Ireland, Italy, Latvia, Malta, the Netherlands, Portugal, Sweden and Slovakia.

Figure 7

Sankey diagram of the distribution of the top five EU‐level Salmonella serovars involved in human salmonellosis cases acquired in the EU, reported from specified food–animal categories, by food–animal source, EU, 2021


1. The left side of the diagram shows the five most commonly reported Salmonella serovars involved in human salmonellosis cases acquired in the EU: S. Enteritidis (blue), S. Infantis (green), S. Typhimurium (orange), monophasic S. Typhimurium (1,4,[5],12:i:‐) (violet) and S. Derby (magenta). 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 from 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 (broilers, bovines, pigs, turkeys and layers). The width of the coloured bands linking the sources and serovars is proportional to the percentage of isolates of each serovar from each source.

Figure 8

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

Figure 9

Trends in reported confirmed human cases of listeriosis in the EU by month, 2017–2021

1. Source: Austria, Belgium, Czechia, Cyprus, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Malta, Netherlands, Poland, Romania, Slovakia, Slovenia and Sweden.

Figure 10

Trends in reported confirmed human cases of STEC infection in the EU by month, 2017–2021


1. Source: Austria, Cyprus, Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Lithuania, Luxembourg, Malta, Netherlands, Poland, Romania, Slovenia and Sweden.

Figure 11

Map of the number of confirmed tuberculosis cases due to Mycobacterium bovis and Mycobacterium caprae in individuals of EU origin, and national herd prevalence of tuberculosis in the bovine population in EU MS and non‐MS countries, 2021

Figure 12

Status of countries for infection with the Mycobacterium tuberculosis complex (M. bovis, M. caprae and M. tuberculosis) in the bovine animal population, EU MSs and non‐MSs, 2021

Figure 13

Prevalence of cattle herds infected with Mycobacterium tuberculosis complex in disease‐free (DFS) zones, EU, 2012–2021


1. (*): In contrast to years 2012–2019, the year 2020 does not include United Kingdom data. Since 1 February 2020, the United Kingdom has withdrawn from the EU and has become a third country.
(**): In accordance with the agreement on the withdrawal of the United Kingdom from the EU, and in particular with the Protocol on Ireland/Northern Ireland, the European Union requirements on data sampling also apply to Northern Ireland.

Figure 14

Prevalence of cattle herds infected with Mycobacterium tuberculosis complex in non‐disease‐free (non‐DFS) zones, EU, 2012–2021


1. (*): In contrast to years 2012–2019, the year 2020 does not include the United Kingdom data. Since 1 February 2020, the United Kingdom has withdrawn from the EU and has become a third country. No data were reported from Bulgaria.
(**): In accordance with the agreement on the withdrawal of the United Kingdom from the EU, and in particular with the Protocol on Ireland/Northern Ireland, the European Union requirements on data sampling also apply to Northern Ireland.

Figure 15

Prevalence of bovine tuberculosis‐infected herds in non‐disease‐free zones of five MSs and the United Kingdom (Northern Ireland), 2005–2021

Figure 16

Trends in reported confirmed human cases of brucellosis in the EU, by month, 2017–2021

1. Source: Austria, Cyprus, Czechia, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Lithuania, Latvia, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia and Sweden.

Figure 17

Number of confirmed, domestically acquired brucellosis cases in humans and national prevalence of Brucella‐positive cattle herds, and sheep and goat herds, in EU MSs and non‐MS countries, 2021

Figure 18

Status of countries as regards brucellosis in bovine animal population (Bison ssp., Bos ssp., Bubalus ssp.), MSs and non‐MSs, 2021

Figure 19

Prevalence of Brucella‐positive cattle herds, in non‐DF zones, EU, 2012–2021

Figure 20

Prevalence of Brucella‐positive cattle herds, in two MSs with non‐DFS zones (Italy and Portugal) and in one non‐DFS MS (Greece), 2005–2021

Figure 21

Status of countries as regards ovine and caprine brucellosis, MSs and non‐MS countries, 2021

Figure 22

Prevalence of Brucella‐positive sheep and goat herds, in non‐DFS zones, EU, 2012–2021

Figure 23

Prevalence of Brucella‐positive sheep and goat herds, in two MSs with non‐DFS zones (Italy and Portugal) and in one non‐DFS MS (Greece), 2005–2021

Figure 24

Trend in reported confirmed human cases of trichinellosis in the EU by month, 2017–2021

1. Source: Austria, Cyprus, Czechia, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Poland, Portugal, Romania, Slovakia, Slovenia, Spain and Sweden.

Figure 25

Trichinella spp. in domestic pigs and farmed wild boar, in EU MSs and non‐MS countries, 2012–2021

1. These distribution maps have been built based on data from reports (EFSA and ECDC (European Food Safety Authority and European Centre for Disease Prevention Control), 2015a,b, 2016, 2017).In 2021, Bulgaria did not report data on pigs NRCHC.

Figure 26

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

Figure 27

Approximate geographical distribution of the Echinococcus granulosus sensu lato species causing human cystic echinococcosis in Europe (2000–2021) (Casulli et al., 2022)

Figure 28

Cumulative proportion (%) of test‐positive animals for Echinococcus granulosus sensu lato, by intermediate host species, in EU MSs and non‐MSs, 2017–2021

Figure 29

Map of the cumulative proportion (%) of test‐positive animals for Echinococcus granulosus sensu lato in MSs and non‐MSs, by country, 2017–2021

1. Intermediate hosts included on the map are cattle, deer, goats, horses, moose, mouflons, pigs, reindeer, sheep, water buffalos and wild boars. It should be stressed that pigs are intermediate hosts for both E. multilocularis and E. granulosus s.l. For this reason, data from pigs were excluded from co‐endemic countries – Poland, Romania, Slovakia and Slovenia – where Echinococcus species information was not reported.Spain (N = 302,433), Italy, (N = 248,530), United Kingdom (N = 71,861), Greece (N = 53,140), Bulgaria (N = 12,214), Poland (N = 2,630) and Slovakia (N = 995) were the countries with the highest endemicity for E. granulosus s.l. in the EU in 2017–2021.

Figure 30

Relative variations (%) in foodborne outbreaks reported in 2021 compared with 2020, and mean annual totals for the pre‐COVID‐19 pandemic period 2017–2019, by reporting country


1. * 2021/2020 relative variation for Portugal was 325% and for Iceland was 500%.
** The mean annual total of FBOs reported by Bosnia and Herzegovina was calculated considering only the years 2017–2018, since no FBO data were reported in 2019.

Figure 31

Trends in the number of strong‐evidence and weak‐evidence outbreaks (left axis) and the outbreak reporting rate (per 100,000) (right axis) in the EU and reporting EU MSs and non‐MS countries, 2012–2021

1. Note: * indicates countries with a statistically significant trend (p < 0.05) over the period.
Dark red and light red show strong‐ and weak‐evidence outbreaks, respectively. Black dots and lines show FBO reporting rates. The dots, lines and secondary Y‐axis in blue showing the outbreak reporting rates have been used for Latvia, Lithuania, Malta and Slovakia, in order to draw attention to a scale that is different to that of the other countries.
(a): Data on FBOs from the United Kingdom (Northern Ireland) are taken into account for 2021. In accordance with the agreement on the withdrawal of the United Kingdom from the EU, and in particular with the Protocol on Ireland/Northern Ireland, the EU requirements on data sampling are also applicable to Northern Ireland.
(b): Data on FBOs from the United Kingdom are taken into account for 2017–2019, because the United Kingdom was an EU MS, but it became a third country on 1 February 2020.

Figure 32

Overview of EU MSs and non‐MS countries reporting data on foodborne outbreaks, by causative agent, 2021

1. The table may be read by column (country) or by row (causative agent). The number at the end of each row is the number of countries reporting a given causative agent for outbreaks in 2021, while the number at the top of each column indicates the number of causative agents identified in outbreaks by a given country in 2021.
‘Escherichia coli’ other than STEC includes Enteroinvasive E. coli (EIEC), Enterotoxigenic E. coli (ETEC) and E. coli, unspecified. ‘Bacillus toxins’ include Bacillus cereus, Bacillus cereus enterotoxins. ‘Staphylococcus aureus toxins’ include staphylococcal enterotoxins. ‘Norovirus (and other calicivirus)’ include norovirus (Norwalk‐like virus) and calicivirus unspecified. ‘Marine biotoxins’ include ciguatoxin and other unspecified marine toxins. ‘Other agents’ include atropine and lectin.

Figure 33

Number of foodborne outbreaks by causative agent, reported to the EU by MSs, 2012–2021

1. Note: Outbreaks reported by the United Kingdom are included for the years 2012–2019. However, data from United Kingdom (Northern Ireland) are taken into account for 2021. In accordance with the agreement on the withdrawal of the United Kingdom from the EU, and in particular with the Protocol on Ireland/Northern Ireland, the EU requirements on data sampling are also applicable to Northern Ireland.

   ‘Marine biotoxins’ include ciguatoxin, muscle‐paralysing toxin, okadaic acid.

   ‘Norovirus (and other calicivirus)’ include norovirus (Norwalk‐like virus), sapovirus (Sapporo‐like virus) and calicivirus unspecified.

   ‘Other bacterial agents’ include Aeromonas, Arcobacter, Cronobacter sakazakii, E. coli other than STEC, Enterococcus, Francisella, Leptospira, Shigella, Streptococcus, non‐toxigenic Vibrio cholerae, Vibrio parahaemolyticus and other unspecified bacterial agents.

Figure 34

Trends in reported confirmed human cases of yersiniosis in the EU, by month, 2012–2021

1. Source: Austria, Czechia, Denmark, Estonia, Finland, Germany, Hungary, Ireland, Italy, Latvia, Luxembourg, Malta, Poland, Romania, Slovakia, Slovenia and Sweden.

Figure 35

Choropleth map of the number of tested and positive foxes, and the geographical distribution of the rabies cases reported in foxes in EU MSs and non‐EU countries, 2021

Figure 36

Choropleth map of the number of tested and positive bats, and the geographical distribution of the rabies cases reported in bats in EU MSs and non‐EU countries, 2021


1. For Germany and Spain, the geographical distribution of reported cases was not provided.

Figure 37

Choropleth map of the number of tested and positive pets, and the geographical distribution of the rabies cases reported in pets in EU MSs and non‐EU countries, 2021


1. For Germany, the geographical distribution of the reported case was not provided.

Figure 38

Choropleth map of the number of tested and positive farmed animals, and the geographical distribution of the rabies cases reported in farmed animals in EU MSs and non‐EU countries, 2021

Figure 39

Trend in reported confirmed human cases of Q fever in the EU by month, 2017–2021

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

Figure 40

Geographical distribution of locally acquired West Nile virus infections among humans (NUTS 3 level) and outbreaks notified to ADIS among equids and birds (XY coordinates) across the EU, 2021 transmission season

Figure 41

Trend in locally acquired human WNV infections reported in EU MSs, by month, 2017–2022

1. Source: Austria, Belgium, Bulgaria, Cyprus, Czechia, Estonia, Greece, Spain, Finland, France, Hungary, Ireland, Italy, Lithuania, Luxembourg, Latvia, Malta, Netherlands, Poland, Portugal, Romania, Sweden, Slovenia, Slovakia.

Figure 42

Reported human cases of West Nile virus infection in the EU MSs, by month, 2017–2021

1. The data set includes only locally acquired WNF cases and only countries that consistently reported cases (or reported zero cases) over the whole reporting period (last 5 years) and to the level of detail required for trend analysis (not aggregated).

Figure 43

Outbreaks of West Nile infection in animals in the EU MSs, by month, 2017–2021

1. Data source: ADIS for animal outbreaks. Outbreaks in birds or equids that were not notified to ADIS are not included.

   The dataset includes only locally acquired WNF cases and only countries that consistently reported cases (or reported zero cases) over the whole reporting period (last 5 years) and to the level of detail required for trend analysis (not aggregated).

Figure 44

Trends in reported confirmed human cases of tularaemia in the EU, by month and year, 2017–2021

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