Listeriosis Outbreaks and ECDC Surveillance Reports.pdf

Outbreaks of Listeriosis and ECDC Surveillance Reports Nur Kuş Hüseyin Barış Şahin Şule Ordulu  OUTLINE Listeria monocytogenes Escherichia coli Salmonella spp. Foodborne Illness and ECDC Surveillance Definition of O...

Outbreaks of Listeriosis and ECDC Surveillance Reports Nur Kuş Hüseyin Barış Şahin Şule Ordulu  OUTLINE Listeria monocytogenes Escherichia coli Salmonella spp. Foodborne Illness and ECDC Surveillance Definition of Outbreak Reported Outbreaks Report Brief information on the Brief explanation on key Number of cases Important points in the bacterium terms reported around the report world  Foodborne Illness and ECDC Surveillance Listeria monocytogenes Definition of Outbreak Reported Outbreaks Report Brief information on the Brief explanation on key Number of cases Important points in the bacterium terms reported around the report world Listeria monocytogenes Gram positive, non-spore forming, psychrotropic bacteria A pathogenic bacterium that causes listeriosis. Commonly found in soil, water, and contaminated food. Characteristic Foods: Milk, cheese, fruits, vegetables, meat, poultry, egg, ready to eat foods, fish, shellfish. Infectious Dose: ⚬ For immunocompromised individuals 10^2-10^4 cells ⚬ For healthy individuals 10^8-10^10 cells Tolerance Policy for L. monocytogenes In Turkey and USA, zero tolerance policy is applied for Listeria monocytogenes. However, in EU and Canada, regulations suggest a tolerance of 100 cells / 25 gram of product.  Foodborne Illness and ECDC Surveillance Listeria monocytogenes Definition of Outbreak Reported Outbreaks Report Brief information on the Brief explanation on key Number of cases Important points in the bacterium terms reported around the report world Foodborne Illness Foodborne illnesses, or food poisoning, are illnesses caused by consuming contaminated food, leading to symptoms like nausea, diarrhea, and fever. Definition of Outbreak An outbreak is defined as an increase in the number of cases of a disease in a short period of time. An outbreak might affect only a single village or a large area, in other words more than one country or all over the world. It may last for a few days or for months and years.  Foodborne Illness and ECDC Surveillance Listeria monocytogenes Definition of Outbreak Reported Outbreaks Report Brief information on the Brief explanation on key Number of cases Important points in the bacterium terms reported around the report world Outbreaks of L. monocytogenes Listeriosis Linked to Soft Cheeses Distributed by Karoun Dairies Case Count: 30 Stemmed from the consumption of soft States: 10 cheeses distributed by Karoun Dairies, with Deaths: 3 genetic analysis linking the strains to samples Hospitalizations: 28 from the manufacturing facility. The company initiated a voluntary recall, but ongoing risks persisted as recalled cheeses may still be present in homes, restaurants, or retail locations. (Listeria Outbreaks | Listeria | CDC, n.d.) Prevention To prevent Listeria contamination from soft cheeses, ensure they are made with pasteurized milk, store them at proper temperatures (below 40°F) Consume them before their expiration dates, and avoid cross-contamination with other foods. Stay informed about recalls and heed any warnings from health authorities regarding specific brands or products. Listeria cluster in 5 EU/EEA countries linked to ready-to-eat fish products (2016-2023) Case Count: 64 A genomic cluster of Listeria monocytogenes 5 EU/EEA and UK infections in the EU/EEA and the UK has been Deaths: 10 linked to ready-to-eat fish products. Sequencing analysis identified the outbreak strain in processing plants in Lithuania, with contaminated products reaching retail markets in Germany and Italy. (Listeria Cluster in 5 EU/EEA Countries Linked to Ready-to-eat Fish Products, 2023) Prevention Ensure processing plants maintain stringent hygiene standards Store them in the fridge below 40°F Check expiration dates regularly Keep them separate from raw meats to prevent cross- contamination Maintain cleanliness by washing hands and surfaces, and stay updated on recalls issued by health authorities. EU Multi-Country Outbreak linked to Frozen Corn and Other Frozen Vegetables (2015-2018) The outbreak was linked to frozen vegetables Case Count: 47 that included a blanching step before freezing. Multiple countries across the EU Deaths: 9 Environmental contamination at a freezing plant was identified as the source, where the Listeria strain persisted over the years. It is suggested that the strain was able to persist due to its presence in the environment of the plant, likely surviving routine cleaning and disinfection processes. Prevention Purchase from reputable brands with strict safety protocols, and store items below 0°F (-18°C) to inhibit bacterial growth. Adhere to cooking instructions on packaging to thoroughly heat and eliminate harmful bacteria. Maintain good hygiene by thoroughly washing hands, utensils, and surfaces before and after handling frozen foods to avoid cross-contamination. Stay updated on recalls and safety alerts for frozen products to take timely preventative actions against Listeria exposure.  Foodborne Illness and ECDC Surveillance Listeria monocytogenes Definition of Outbreak Reported Outbreaks Report Brief information on the Brief explanation on key Number of cases Important points in the bacterium terms reported around the report world Surveillance Report The ECDC collects and analyzes data on communicable diseases from EU Member States and two EEA countries, publishing annual reports that include information on outbreaks. Listeriosis - Annual Epidemiological Report for 2022 Confirmed listeriosis cases per 100,000 Number of listeriosis cases in Europe population by country, EU/EEA, 2022 is recorded as highest ever. 2018-2022 increasing trend in cases is spotted. Figure 1: Number of cases by country, EU/EEA Whole Genome Sequencing (WGS) By Whole Genome Sequencing (WGS) data obtained from EU countries and UK, understanding the spread and evolution of the disease is possible. Interralation between human clusters and corresponding matches in non-human data to better understand the transmission pathways. Public Health Implications of the Report Raising awareness on listeriosis is at utmost importance for risky groups. Compliance with the EU standards does not imply safety for immuno- compromised people. So, such consumers in EU region shall beware of the risks in ready-to-eat products.  Outbreaks of Escherichia coli and ECDC Surveillance Reports  ECDC Surveillance Escherichia coli Reported Outbreaks Report Brief information on the Number of cases Important points in the bacterium reported around the report world Escherichia coli Gram-negative, rod-shaped bacteria Pathogenic strains can cause gastrointestinal infections, urinary tract infections, and in severe cases, bloodstream infections. Commonly found in the intestines of humans and animals, as well as in contaminated water and food, particularly undercooked ground beef, unpasteurized milk, and fresh produce. Characteristic Foods: Undercooked ground beef, unpasteurized milk, fresh produce (such as spinach and lettuce), raw fruits, vegetables, and sprouts. Infectious Dose: Generally, for most pathogenic strains, the infectious dose is relatively low, around 10-100 cells. However, this can vary based on the strain and the health status of the individual. Tolerance Policy for Escherichia coli In Turkey and the USA, a zero tolerance policy is applied for pathogenic strains of Escherichia coli. In the EU and Canada, regulations typically suggest a tolerance level of 0 colony-forming units (CFU) per gram of product for certain strains of pathogenic Escherichia coli, such as E. coli O157:H7.  ECDC Surveillance Escherichia coli Reported Outbreaks Report Brief information on the Number of cases Important points in the bacterium reported around the report world E. coli Outbreak Linked to Frozen Falafel (2022) Case Count: 24 A multistate outbreak of E. coli O121 infections States: 6 occurred, linked to Earth Grown brand frozen falafel Deaths: 0 sold at ALDI stores. Hospitalizations: 5 Genetic analysis confirmed the bacteria in the falafel matched those from sick individuals. One person developed hemolytic uremic syndrome, but no deaths were reported. Cuisine Innovations recalled the affected falafel products. (E.coli Outbreaks | E.coli | CDC,  Prevention Ensuring thorough cooking. Using hygienic food handling practices. Employing proper sanitation in production. Sourcing ingredients from reputable suppliers. Regularly testing for bacterial contamination. Implementing rapid recall procedures if contamination is suspected. Germany E. coli O104:H4 Outbreak (2011) Case Count: 3,950 First outbreak: Aachen, Germany Location: Germany,Western and Northern Europe, the United Statesand Initially thought to be enterohemorrhagic E. Canada coli (EHEC), it was later identified as an Deaths: 53 enteroaggregative E. coli (EAEC) strain with Severe cases: 800 acquired Shiga toxin genes. Epidemiological evidence pointed to fresh vegetables, particularly organic fenugreek sprouts, as the source of infection. The outbreak originated from an organic farm in Lower Saxony, Germany, producing sprouted foods. (Burger, 2012)  Prevention Enhanced farm hygiene, particularly in farms producing sprouted foods. Safety measures should include rigorous seed quality control and testing protocols to ensure imported seeds are free from contamination. Safe sprouting practices Regular testing of sprouts and fresh produce for contamination Outbreak of E. coli Infections Linked to Flour (2019) The outbreak stemmed from multiple brands Case Count: 21 including Brand Castle Mixes, Pillsbury Best States: 9 Bread Flour, King Arthur Flour, and ALDI Deaths: 0 Baker’s Corner All Purpose flour were Hospitalizations: 3 affected. Consumption of raw dough or batter made with contaminated flour posed a risk of E. coli infection. Thorough cleaning of baking utensils and surfaces, along with avoidance of raw dough consumption, was advised to prevent illness. (E.coli Outbreaks | E.coli | CDC, Prevention Specific measures focused on flour and dough safety. Flour producers should implement stringent testing protocols to detect and eliminate any presence of E. coli Maintaining impeccable hygiene standards during flour processing To prevent E. coli from raw dough, ensure thorough cooking.  ECDC Surveillance Escherichia coli Reported Outbreaks Report Brief information on the Number of cases Important points in the bacterium reported around the report world Listeriosis - Annual Epidemiological Report for 2022 In 2022, 29 EU/EEA countries reported 8,565 confirmed cases of Confirmed STEC infection cases per Shiga toxin-producing Escherichia coli 100,000 population by country, EU/EEA, (STEC) infection, representing a 25% 2022 increase compared to 2021. Children under five years old had the highest notification rate. Confirmed cases of haemolytic- uremic syndrome (HUS) increased in 2022, with the majority occurring in younger age groups. However, the majority of deceased HUS cases were Figure 1: Number of cases by country, EU/EEA over 60 years old.  ECDC Surveillance Salmonella Reported Outbreaks Report Brief information on the Number of cases Important points in the bacterium reported around the report world  Salmonella G(-) bacteria non-spore forming rod More than 2500 serotypes Sources: human carriers,pets (dogs, cats, turtles) feed animals (swine, cattle, poultry, poultry products) Pests (rats, cockroaches, birds)  What are the disturbances ? Fever, diarrhea, abdominal pain, nausea, vomiting Mortality: