The European Food Safety Authority (EFSA) and EU Commission’s Inter-European Union Reference Laboratories (EURL) Working Group on Next Genome Sequencing (NGS) organized the second Science Meets Policy conference this week. More than 100 people from 20 countries attended in-person while online viewers peaked at 257.

Stefano Morabito, from the Italian National Institute of Health (ISS); George Haringhuizen, at the Dutch National Institute for Public Health and the Environment (RIVM); João André Carriço, of bioMérieux; Katja Alt, from the German Federal Ministry of Food and Agriculture and Coen van der Weijden, from the Netherlands Food and Consumer Product Safety Authority (NVWA) were featured on a panel discussion.

Panelists highlighted the need for flexibility, especially as there are 27 countries in Europe at different stages in use of Whole Genome Sequencing and as outbreaks can involve nations outside the EU. They discussed the types of data needed, data quality and comparability, resource issues, how to build trust and the role of different parties including regulators and industry.

EFSA and ECDC’s One Health WGS system has been operating since July 2022 and while things are going well, not all member states are contributing equally.

Data sharing dilemmas

Bernhard Url, EFSA’s executive director, said genomic data sharing is now at a turning point.

“We believe that from a technological and methodological point of view we are ready to use WGS data more widely and with more impact. Many of the problems have been solved and the technical infrastructure has been built. There is no doubt, at least within the community, that data sharing adds value, because it leads to faster outbreak detection and better tracing. It increases the likelihood of connecting sporadic cases to clusters and to detect outbreaks and there is measurable economic impact,” he said.

However, despite the knowledge that sharing data helps, there are still some obstacles that prevent wider use, said Url.

“There are technological gaps as not all member states or organizations use WGS on a routine basis. There is also a worry that people and countries say we don’t have a robust legal basis to share data. There is a fear that people lose control of data, they produce the data, share it but don’t know what happens afterwards. There is a concern that if this technology would be used widely, many more clusters would be detected, which is good from a public health point of view, but it also would increase the workload of national authorities to follow-up and deal with these clusters.”

Url said it would be “unwise” to wait for legislators to define the rules of the game.

“The WGS community must do our part to create the conditions for success. We think there is a lot we can do to move data sharing forward in the current legislative framework. We still have to work on creating a mutual understanding about benefits and limitations of this technology. We have to agree on common guidelines, processes and procedures, otherwise we wouldn’t know how to compare different outcomes,” he said.  

“We want to act as openly as possible but as confidential as needed, there is a fine line that we have to find. EFSA has invested resources in creating a technological infrastructure for enabling WGS data sharing, mainly to tackle foodborne threats. We will continue to do our part to move genomic data sharing forward.”

United States perspective

Eric Stevens, from the U.S. Food and Drug Administration, said the GenomeTrakr network is the result of 12 years of work. At the end of 2021, there were 600,000 genomes in the public database, today it is more than 1,000,000 sequences.

“After more than a decade of experience, it is not the sequencing that is the challenge when transitioning to this data, it is how you are going to analyze it, train staff, gain the skills and enable the entire system to utilize it effectively,” he said.  

“Metadata helps to tell a complete picture, without it you have a DNA sequence, which can only tell you some stuff. Contextual data gives that data life, it tells you where those bacteria came from, how they were living and when we are starting to think about the interventions we can make, we need that information to understand the complete picture.

“For us, the best use is making it open data available to anyone because somebody maybe interested in Salmonella, somebody else in E. coli and sometimes they overlap with interventions you can make for preventive controls and reducing contamination.”

Stevens said once data is in the database, a variety of things can be looked at.

“When you start thinking of the global food chain you can think where do we need more data from and start doing some projects to tackle those problems to better understand how food becomes contaminated in the first place. You wouldn’t know any of this unless you had the data that can help point the way,” he said.

“GenomeTrakr is responsible for almost 100,000 food and environmental isolates to tell a more complete picture of linking clinical isolates back to their sources, so we can not only respond to foodborne outbreaks but then try to prevent them. When you start looking at where your sources of food and environmental isolates linked to human illnesses come from, you can start doing source attribution and more preventive targeting. If we can get to a point where we can upload data in real time we can start to make those connections as early as possible to get a contaminated product out of the market.”

It can also help in moving from responding to outbreaks to trying to prevent contamination occurring.

“In a facility for example, you are not going to do WGS to identify a pathogen, you can do a quick culture method to see presence or absence. But if you have a facility that is concerned about whether they have a resident pathogen you would 100 percent like this information from WGS. You could expand that further to farms and potential water sources,” said Stevens.  

“When you start doing projects in different parts of the world you start understanding that everybody has issues that maybe aren’t issues for you. We’ve done a lot of work in Latin America and the big problem in getting started in sequencing is availability of reagents. We hear it costs five to seven times more than what we pay. When we talk about this being utilized by the world we have to start focusing on those issues that are going to make the most impact.”

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From August 2022 to mid-July 2023, 92 cases of Salmonella Senftenberg have been reported, 12 people have been hospitalized, and one person died in Germany. Most patients are female, while 28 are male. Infections have occurred in all age groups.

Germany is the most affected country, with 26 patients, followed by France with 16, Finland with 12, and Sweden with 11. The United States has recorded two patients.

The first U.S. case is a 47-year-old female reported in October 2022. The second is an immunocompromised 42-year-old male with disease onset in April 2023. This person had a liver transplant in 2022.

In April 2023, Santé publique France was informed by the national food reference laboratory that Salmonella Senftenberg had been isolated from a mixed salad containing cherry tomatoes and green leafy vegetables, which was prepared in mid-August 2022. However, it was not served as intended to airline customers.

Thirteen affected countries
Sick people also live in Austria, Belgium, the Czech Republic, Estonia, Ireland, the Netherlands, Norway and the United Kingdom.

Most cases were reported between October 2022 and March 2023, according to the European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA).

Detection of the first case in France, with an isolation date in August, suggests suspected contaminated food entered the French market around mid-August and other countries later.

Salmonella Senftenberg is a relatively uncommon serotype in cases of salmonellosis. In 2020 and 2021, 36 and 75 cases respectively were reported to ECDC.

Link to tomatoes
Among 21 patients interviewed in Austria, France, Germany and Sweden, 20 reported consumption of tomatoes and 12 said they had eaten iceberg lettuce.

Tomatoes were suspected as the vehicle of infection by national authorities in France and Austria and were traced back to wholesalers in Germany, the Netherlands and Spain, and to growers in the Netherlands, Spain and Morocco. However, there is no microbiological evidence from tomatoes, so the source of infection has not been confirmed.

Intermittent reporting of patients between August 2022 and June 2023 indicates prolonged distribution of contaminated food from a common source for about 10 months in the EU and UK. Finding linked cases in the U.S. suggests a possible common source of infection or travel to Europe, said ECDC.

Contamination of cherry tomatoes may have occurred at pre-harvest on farms during growing via different sources, such as use of contaminated water, including re-used irrigation water.

“Identifying the nature and source (root cause) of microbial contamination of vegetables in the food chain remains crucial to ensure appropriate handling and activities by growers, producers, wholesalers, retailers, and consumers and to prevent the risk of foodborne illness deriving from exposure to Salmonella-contaminated vegetables,” said ECDC.

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Glyphosate is a chemical used in some herbicide products. It is currently approved for use in the EU until mid-December 2023.

EFSA did not identify any critical areas of concern in its peer review of the risk assessment of glyphosate in relation to the risk it poses to humans and animals or the environment. However, some data gaps were highlighted.

Full conclusions are expected by the end of July 2023 and background documents are expected to be published between late August and mid-October.

The European Commission will analyze EFSA’s conclusions before putting forward a renewal report and draft regulation proposing renewal or non-renewal for the authorization of glyphosate.

Mixed reaction

The Glyphosate Renewal Group (GRG) welcomed the findings, which it said are consistent with assessments of health regulators around the world, as well as evidence from nearly 50 years of science.

The GRG is a group of companies seeking renewal of the EU authorization of the active substance glyphosate. Members include Albaugh Europe, Bayer Agriculture, Nufarm, and Syngenta Crop Protection.

Greenpeace said the move toward renewed market authorization puts people’s health at risk.

Eva Corral, Greenpeace EU pesticides campaigner, said: “For years the evidence of glyphosate’s toxicity for people and the environment has been stacking up, but EFSA has once again decided to sweep it under the carpet.”

“When it comes to health effects, robust scientific evidence overwhelmingly supports concerns about glyphosate’s carcinogenic potential as well as other impacts for human development, or the reproductive system – some of them with the ability to be transmitted across generations,” said Natacha Cingotti, health and chemicals program lead at the Health and Environment Alliance (HEAL).

EU Green Deal developments
The announcement comes days after the European Commission adopted a package for sustainable use of key natural resources, which it said would strengthen the resilience of EU food systems and farming.

Measures include a soil monitoring law, new genomic techniques for plants to enable development of climate-resilient crops and reduce use of chemical pesticides, and targets for food waste reduction. Proposals will next be discussed by the European Parliament and European Council. 

Nearly 59 million tons of food are wasted in the EU each year with estimated market value of €132 billion ($144 billion). The Commission proposed that, by 2030, member states reduce food waste by 10 percent, in processing and manufacturing, and by 30 percent, jointly at retail and consumption (restaurants, food services and households).

“We want to give our farmers the tools to produce healthy and safe food, adapted to our changing climatic conditions, and with respect for our planet. This includes new rules on the use of new genomic techniques and modernized rules on plants and forest seeds to boost diversity, sustainable practices, food security and drive EU competitiveness,” said Stella Kyriakides, Commissioner for Health and Food Safety.

“We are also stepping up our action against food waste to minimize food losses and reinforce our food security. We have an opportunity now to plan for the future, redesign the way we produce and consume our food and offer a larger choice of safe, sustainable and nutritious products to our citizens.”

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France has the most patients in the Salmonella Ball outbreak but two people from the U.S., aged 44 and 62, were ill in August 2022. They both reported travel to France.

Salmonella Ball is very rare in Europe. Between 2007 and 2021, only 52 cases were reported from 14 countries, with an average of three per year.

Information was shared in a Joint Notification Summary (JNS). These are not made public but Food Safety News has seen a copy. It is prepared by the European Food Safety Authority (EFSA), European Centre for Disease Prevention and Control (ECDC) and affected countries.

An ECDC spokesman said this week that the agency had not received any updates on the number of people or countries affected since the JNS was produced.

France hit hardest and meat link
In September 2022, France reported a cluster of Salmonella Ball cases. As of November, 38 confirmed infections including 24 women and 14 men had been recorded between July and October 2022. The median age of patients was 26 years old.

Sick people came from 10 regions in France. Three were hospitalized but no deaths were reported. Of the 20 patients interviewed, 13 reported travel in France prior to symptom onset, but no common destination was identified. Ground beef, hamburgers, and eating at restaurants or fast food outlets during the summer were commonly mentioned.

By November 2022, 69 patients, of which 54 were confirmed and 15 were possible, had been reported in nine EU countries, the UK and the United States.

The first patient was in France with an isolation date of mid-July 2022 and the last patient was in Finland in mid-October 2022. Sick people range in age from 1 to 87 years old and 43 men and 26 women fell ill.

Some patients reported traveling a week before onset of symptoms, with destinations mainly including Ibiza in Spain and France.

Confirmed and probable cases
Denmark has three confirmed cases, Norway has two while the Netherlands and Czech Republic both have one each. Germany has one confirmed and two probable patients.

Countries reporting probable cases include Greece with eight, Belgium with four and Finland has one. The outbreak in Greece in mid-October 2022 involved a kindergarten. A total of 22 children under the age of 3 and staff became ill.

Four cases in England, one in Scotland and one in Wales fell sick between August and October 2022. They are aged between 1 and 44 years old. One case was discovered in the UK in 2021.

Analysis of the outbreak and reported cases indicates frequent consumption of beef or pork products, as well as hamburgers, suggesting that meat is the main source of infection. Detection of Salmonella Ball in poultry in 2019 points to possible spread in the production chain.

EFSA and ECDC said new cases and outbreaks are likely to occur in multiple countries until the sources of infection are identified and control measures implemented. The agencies added greater efforts are needed by public health and food safety authorities to investigate outbreaks of Salmonella Ball and to identify specific sources of infection.

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Thirteen potential emerging issues were assessed in 2020 and six were judged to be emerging issues, according to the European Food Safety Authority (EFSA).

EFSA networks contributing to the topic include the Emerging Risks Exchange Network (EREN), the Stakeholder Discussion Group on Emerging Risks, EFSA’s scientific units, scientific panels and the Scientific Committee.

EREN includes the 27 EU member states, Norway and Switzerland, and observers from the World Health Organization (WHO), the UN Food and Agriculture Organization (FAO), Food Standards Australia New Zealand (FSANZ), the U.S. Food and Drug Administration (FDA) and DG Sante.

In 2020, EREN members raised 35 potential emerging issues that had been identified by their own horizon-scanning work.

Data on 2021 is expected to be published in mid-July and the 2022 report should also be coming out later this year.

Issues were classified by hazard or driver with five being microbiological, two chemical and one a new process or technology.

TBE and collagen powder
Tick-borne encephalitis (TBE) is caused by the tick-borne encephalitis virus (TBEV). The disease is characterized by acute and chronic neurological infections in humans. Vaccination campaigns have led to a significantly decreased incidence in some areas of Europe.

The virus can be transmitted by consumption of unpasteurized milk products from infected animals, primarily goats, and foodborne outbreaks have been reported in central and eastern European countries, including Germany. In France, foodborne transmission of TBEV had not been reported until mid-2020, when 44 cases of lymphocytic meningitis, encephalitis and infectious syndromes were identified in the Ain department in the Rhone-Alpes region and TBE infection was confirmed for these patients.

The EREN recommended that the EFSA update two of its scientific panels and discuss the human health implications with the European Centre for Disease Prevention and Control (ECDC).

The consumption of collagen powder as a dietary supplement is increasing in Europe. This is because of claimed anti-aging properties. The powder is consumed either in pure form or added to smoothies and coffee.

Not much is known about the long-term effects of high collagen intake, but certain properties of collagen powder raise potential concerns. With the high content of hydroxyproline, collagen may increase the risk of kidney stones. Most collagen powder products are made from marine sources and include large amounts of calcium, so allergies are another potential risk. Experts said there was a need for consumption data on collagen powder as food supplements but a risk assessment had been started.

Other issues covered were related to COVID-19, selective androgen receptor modulators (SARMs) in food supplements, novel animal feed, and the possibility of Chagas disease in Europe due to climate change.

National horizon scanning activities raised topics such as Shiga toxin-producing E. coli (STEC) surviving storage in wheat flour for two years; Hepatitis E in pork meat products; a rise in Vibrio infections due to climate change and an increase in the anisakis fish parasite.

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EFSA’s aim was to ensure that it is taking into account all the latest scientific and risk assessment developments in setting standards for evaluating the safety of these new food technologies. We also want to engage with producers and wider society, officials said. 

As an appetizer to the event, which was streamed online live, EFSA spoke to experts in this field to illustrate some of the scientific issues involved and the social and economic backdrop. 

What are tissue engineering and precision fermentation?
Ramiro Alberio, one of the panelists at the EFSA colloquium, is a professor of developmental biology at the University of Nottingham in the UK. 

Alberio said: “Cell and tissue engineering allows the cultivation of cells and tissues separately from an entire organism. For example, starting from only a few cells sourced from a muscle or another organ, these cells can be grown under controlled conditions without the other parts of the organ.

“Cellular engineering is already being used in medicine to regenerate tissues or replace damaged or diseased cells. The technologies are advanced now and could be applied in other areas, such as the agri-food sector.”

So-called precision fermentation is a technology that uses microorganisms to produce specific products such as proteins, human-identical milk oligosaccharides, vitamins or fibre. 

“Precision fermentation has been in use already for years to produce medicine such as insulin and food enzymes, for example in cheese production. The science behind this technology is constantly evolving, increasing the array of potential food applications,” Alberio said. 

Are foods and food ingredients produced with these technologies safe?
It is EFSA’s role to evaluate the safety of novel foods in the EU, including those derived from new technologies such as cell culture and tissue engineering.

Wolfgang Gelbmann is a senior scientific officer at EFSA in the novel foods area and overall rapporteur for the colloquium.

He said: “So far EFSA has not been asked to evaluate any food derived from cultured animal cells, what people might call ‘lab-grown meat.’ But we have assessed several novel food ingredients produced through precision fermentation.

“We expect to receive novel food applications on cell-culture-derived foods in the coming months and years. So, we are keeping pace with the science to stay prepared when such applications arrive.”

Experts from EFSA’s Panel on Nutrition, Novel Foods and Food Allergens (NDA Panel), particularly its Novel Foods Working Group, will carry out these evaluations. 

“We are confident,” said Dr. Gelbmann, “that the novel foods guidance prepared by our experts together with EFSA’s other applicable cross-cutting guidance documents are fit for this purpose. Indeed, we’ve evaluated over a hundred applications covering a wide diversity of novel foods using these guidelines in recent years. Nevertheless, we routinely review them to keep them up to date with advances in science and technology. 

“We regularly meet with stakeholders on novel foods in scientific events and workshops to discuss technical challenges and safety aspects. The colloquium is an important ingredient in this ongoing dialogue.” 

Who decides if cell culture-derived food is ready for the market? 
The actual production of cell culture-derived food in the EU is in its infancy but rapidly growing, as in the rest of the world, but no application has been received yet. 

As an independent scientific advisory body, EFSA has no say in EU decision-making and is neither for nor against the use of a new food technology such as cell culture-derived food. Our assessments provide scientific input on the safety of such products for European consumers, officials said. 

Decisions on the market authorization of novel food products and labeling requirements are made by the EU regulators, i.e. the European Commission together with EU Member States. Safety for consumers is also the priority for regulators, but they may also consider economic, animal welfare, social and/or other aspects in their decisions.

The Commission has previously stated that cell culture technology is a potential contributor to help achieve the objectives of the EU’s farm-to-fork strategy for fair, safe, healthy, and environmentally sustainable food systems.

The technologies are advanced, though the capacity to produce and market these foods is likely to increase if producers believe the products have a future. Ultimately, consumers will decide if they do. 
 

What do consumers think?
Professor Michael Siegrist leads ETH Zurich’s research group on food and consumer behavior and has studied consumer perceptions of new technologies including cell culture-derived foods.

He said: “The perceived naturalness of food or food technologies is a critical factor for consumers. If either is perceived as unnatural, consumer acceptance is usually difficult to achieve. 

“Cell culture-derived meat is a good example. In many studies, most participants indicated a low willingness to even try it.

“This reliance on ‘naturalness’ is a mental shortcut, called a ‘heuristic’, that all people take: ‘if it’s natural, it can’t harm me, in fact, it must be good for me’. The opposite applies to what is not natural.”

Communication about the potential social and economic benefits also plays a role in consumer acceptance of new foods. For example, many consumers are unaware of the environmental impact of meat production, which may help to explain their unwillingness to reduce their meat consumption or eat alternatives.

“In the end,” said Siegrist, “price and taste are the main drivers for most consumers. In the distant past, novel foods in Europe such as tomatoes and potatoes became important staples, more recently chia seeds and quinoa. It remains to be seen if people will overcome the psychological and information barriers to cell culture-derived food. But it will certainly only be the case if products like cell culture-derived meat tastes as good and is cheaper than the traditional alternatives.”

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Almost 88,000 samples were collected in Europe in 2021. Overall, 96 percent of them fell within legally permitted levels. Almost 35,000 samples contained residues not exceeding legal limits.

More than 2,000 samples triggered legal sanctions or enforcement action as they exceeded the Maximum Residue Level (MRL) after accounting for measurement uncertainty. This rate decreased from 5.1 percent in 2020 to 3.9 percent in 2021.

Findings come from a report on pesticide residues in food published by the European Food Safety Authority (EFSA).

Results from monitoring programs provide information for estimating the dietary exposure of EU consumers to pesticide residues. EFSA found that food commodities analyzed in 2021 were unlikely to pose a concern for public health.

Samples from non-EU countries showed a 5-fold MRL exceedance rate of 10.3 percent and a non-compliance rate of 6.4 percent compared with food produced within the EU.

Ethylene oxide, glyphosate, and organics

Non-approved chlorpyrifos and fluazifop were mainly found in wheat and broccoli, grown in the EU and randomly sampled, at levels above the legal limit.

Out of 2,011 samples where ethylene oxide was analyzed, 133 exceeded the MRL. Of these, 25 were sesame seeds from India. The issue was detected in late 2020 and controls of sesame seeds from India at borders were increased to 50 percent. EFSA also recommended that countries monitor the substance in curcuma, rice, and chili peppers from India.

Of all samples analyzed, 44 percent contained one or several pesticides in quantifiable concentrations. Multiple residues were reported in 23,177 samples and in one raisin sample of unknown origin, up to 39 different pesticides were reported.

In almost 15,000 samples glyphosate was not quantified. In 209 samples it was found but was below the MRL and in 23 samples residues were above the MRL. The non-compliance rate was lower than in 2020.

Overall, 5,408 organic samples did not contain quantifiable residues; 1,005 contained residues below or at the MRL, and 117 had residues above the MRLs, of which 68 samples were non-compliant. The substance exceeding the MRL the most was ethylene oxide on 18 occasions. Imazalil and chlorpyrifos, which are not authorized in organic farming, were found in some crops.

For honey, 894 samples had no quantifiable levels of residues and 119 were within legally permitted limits. MRLs were exceeded in 22 samples, of which 17 were non-compliant. In total, 28 different pesticides were found. The most frequent were thiacloprid and acetamiprid.

In 1,475 samples of baby food, no residues were quantified. Samples with residues below the MRL were found 182 times. In 29 samples, the MRL was exceeded and 10 led to non-compliant results, based on measurement uncertainty.

Tests of selected products

Of nearly 14,000 samples analyzed as part of the EU-coordinated control program, 98 percent were within legal limits. MRLs were exceeded in 295 samples, of which 184 were non-compliant based on measurement uncertainty. More than 5,500 samples had pesticide residues within legally permitted levels.

This program covered samples randomly collected from 12 products. For 2021, these were aubergines, bananas, broccoli, cultivated fungi, grapefruits, melons, sweet peppers, table grapes, virgin olive oil, wheat, bovine fat, and chicken eggs.

There were no non-compliant samples of chicken eggs for fipronil. Overall, from more than 55,000 fipronil results, 32 were above the legal limit.

The exceedance rate was impacted by a problem with grapefruits from Turkey. This prompted the level of official controls on such consignments to be increased to 10 percent.

In sweet/bell peppers from Cambodia, 28 different pesticides were quantified and in table grapes from Turkey, 19 pesticides were detected.

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Risk classification and management of STEC isolated from food has been hampered by gaps in knowledge about how different types can cause severe disease. 

In 2019, a joint FAO/WHO Expert Meeting on Microbiological Risk Assessment (JEMRA) proposed the pathogenic potential of a STEC strain is categorized based on virulence genes. JEMRA presented a ranking of strains with various virulence genes into five levels based on their potential to cause diarrhea, bloody diarrhea and hemolytic uremic syndrome (HUS).

In 2020, the European Food Safety Authority (EFSA) said STEC serogroup cannot be used as a predictor of clinical outcome. EFSA also concluded that any STEC types can be associated with severe illness, but strains with the gene for producing the toxin subtype Stx2a showed the highest rates of HUS, hospitalization and bloody diarrhea, and presence of the eae gene is not essential but was an aggravating factor.

Improving reaction to STEC findings
The new approach combines estimated probability of the strain to cause severe illness with the public health burden associated with sickness in terms of disability adjusted life years (DALY) per case, according to the study published in the journal Microbial Risk Analysis.

STEC strains isolated from food or human HUS cases, characterized in terms of the stx- and eae-genes present, and for which clinical data were reported in the EFSA dataset were used to illustrate the approach.

Researchers evaluated this method by ranking and classification of STEC food strains collected during surveys and one outbreak in Sweden.

From a risk management perspective, setting the limit between a satisfactory or not result of a food sample, is a trade-off between the potential health impact and the cost of declaring the result unsatisfactory, according to the study.

A cost-benefit analysis was done using the proportion of food samples classed as satisfactory or not based on the cost in terms of proportion of food being rejected and the benefit in terms of the proportion of strains causing severe illness that are captured.

A limit of 500 mDALY, targeting genotypes stx2a+eae+other stx genes, would lead to 14 percent or less of food samples being considered unsatisfactory and about 85 percent of STEC strains having caused HUS in Sweden would be captured.

The method is risk-based in terms of the probability and consequences of severe illness following infection.

“It is not risk-based in terms of the risk associated with the presence of a STEC genotype in the food since this would involve genotype specific risk assessments considering exposure which would involve more work and data that are not always available,” said researchers.

E. coli in imported meat
Another study has looked at E. coli O157 in samples of imported raw meat from the ports of Saudi Arabia. Products from India and Brazil were the most frequently contaminated.

According to the Saudi Food and Drug Authority, in 2017, at least 562, 280, and 50 samples of beef, chicken and sheep meat, were tested for E. coli O157:H7, said the study published in the journal Scientific Reports.

E. coli O157 was detected in 29 of 428 beef samples imported from India, two of 91 from Brazil and one of 15 from the UAE. It was found in 16 of 230 chicken samples from Brazil and one of 28 from Ukraine. The pathogen was also detected in one of 47 sheep meat samples from India. Positive products came from several different companies.

In Saudi Arabia, no E. coli O157:H7 outbreak has been reported to date, and prevalence is unknown. However, it has been isolated from several local cattle farms.

“The presence of E. coli O157:H7 in samples of imported raw meat highlights the need for more regular surveillance at the borders of Saudi Arabia before the products are made available on the market for consumption by the public. Our results underscore the necessity of more stringent control protocols for the approval of imported food products, particularly from India and Brazil, which are the major suppliers of meat to Saudi Arabia,” said researchers.

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The Salmonella Virchow outbreak started in June 2017 and most cases have been linked to local restaurants serving kebab meat. At least one person in the United States had gotten sick. A female patient from California had a travel history to Paris in 2019 and needed hospital treatment. 

The European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA) said the number of confirmed cases represents only a small proportion of all infections in Europe, partly due to the varying sequencing capacities of countries.

A total of 210 cases have been reported with 111 from France, 34 in the Netherlands, 32 in the UK, 26 in Germany, four in Ireland, two in Denmark, and one in the U.S. 

Kebab meat products containing contaminated chicken are the likely vehicles of infections, and the bacteria has been circulating in the EU poultry meat production chain in France, Germany, Ireland, and the Netherlands.

Among interviewed cases, 10 people were hospitalized in Germany, five in France, four in Ireland, and two in the UK. No deaths have been reported. Patients range in age from younger than 1 to 92 years old with the median age from 22 to 80 depending on the country.

Johanna Takkinen, ECDC principal expert on food- and waterborne diseases, said: “ECDC encourages countries to sequence Salmonella Virchow isolates from domestically acquired human infections and interview cases with Salmonella Virchow sequence type 16 infections. Investigations should be focused on the consumption of poultry meat and related products and be carried out in close collaboration with food safety authorities.”

New infections are likely in the EU affecting all age groups until further investigations identify the sources and points of contamination along the chicken meat production chain, said ECDC and EFSA.

Spike of infections in late 2022
In January 2023, France reported 52 cases of Salmonella Virchow infection between August and December 2022 to the European surveillance portal for infectious diseases, called EpiPulse. In the following weeks, Denmark, Germany, the Netherlands, the UK, and the US reported cases belonging to the same microbiological cluster. The French outbreak strain is genetically similar to a previous multi-country outbreak of Salmonella Virchow in the Netherlands in 2020, with chicken meat as the suspected vehicle of infection.

Data shows multi-country peaks at irregular intervals since 2017, with the highest peak in the final quarter of 2022. The latest cases were reported in France and the Netherlands in February 2023.

A French outbreak in 2022 was linked to local kebab restaurants in one region. Forty-two sick people were involved. In 2021, an outbreak caused by the same strain was associated with a kebab restaurant in a different region.

In France, a questionnaire found consumption of kebabs with chicken meat, in the days before the onset of symptoms, by 19 of 24 cases interviewed, and 14 cited the same kebab outlet in one region.

Five French restaurants had been supplied with kebab meat by different German suppliers and a Polish company. Some of the involved German firms received raw materials from Belgian, Italian, Dutch, and Polish businesses. The outbreak strain was also detected in French broiler farms.

A lack of information, such as batch numbers, meant the role of the producers of kebab products, their meat suppliers, and the possible involvement of other operators, as sources of infections could not be established or ruled out, said ECDC and EFSA.

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EFSA assessed the public health risk related to nitrosamines. Ten nitrosamines in food are carcinogenic, meaning they can cause cancer, and genotoxic, which means they may damage DNA.

Nitrosamines have been found in foodstuffs like cured meat products, processed fish, cocoa, beer, and other alcoholic beverages. They may also be present in other foods such as cooked meat, processed vegetables, cereals, milk, and dairy products, or fermented, pickled, and spiced foods. 

Dieter Schrenk, chair of the panel on Contaminants in the Food Chain, said the assessment revealed that for all age groups across the EU, the level of exposure to nitrosamines in food is a concern.

“Based on animal studies, we considered the incidence of liver tumors in rodents as the most critical health effect. To ensure a high level of consumer protection, we created a worst-case scenario for our risk assessment. We assumed that all nitrosamines found in food had the same potential to cause cancer in humans as the most harmful nitrosamine, although that is unlikely,” he said.

Evaluation of data and past work
Nitrosamines are formed by a reaction between nitrites and certain amines. Cured meats often contain detectable levels of nitrosamines due to the use of nitrite as a preserving agent and are affected by additional factors, such as temperature, pH, and processing conditions.

Food consumption data from an EFSA database was used for the dietary exposure assessment. Analytical results from the EFSA contaminant database and the literature on Nitrosamine concentrations in food were used to assess dietary exposure. Information relevant for hazard identification and characterization was identified by a literature review.

EFSA evaluated the potential harm caused by nitrosamines to humans and animals and assessed consumer exposure.

When assessing genotoxic and carcinogenic substances in the food chain, EFSA calculates a margin of exposure for consumers. The MOE is a ratio of the dose at which a small but measurable adverse effect is observed, and the level of exposure to a substance for a population. In general, a ratio above 10,000 indicates a low concern for consumers. In this assessment, the panel concluded that calculated MOEs are below 10,000 in two scenarios, which raises a health concern.

EFSA held a public consultation on the draft opinion in late 2022 and 12 comments were received including from the UK Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT), German Federal Institute for Risk Assessment (BfR) and French Agency for Food, Environmental and Occupational Health & Safety (Anses).

In 2017, another EFSA panel published a risk assessment of nitrates and nitrites as food additives. It found consumer exposure was within safe levels.

There is no EU regulation on the presence of Nitrosamines in food or drinking water. EFSA’s opinion will now be shared with the European Commission, which will discuss with national authorities what if any, risk management measures are needed.

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The European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA) said resistance of Salmonella and Campylobacter to commonly used antimicrobials is frequent in humans.

“Antimicrobial resistance is one of the greatest threats we face worldwide, affecting humans, animals, and the environment. In our work, we embody the One Health approach, recognizing the close links and interdependency of the health of humans, animals, plants, and the wider environment,” said ECDC and EFSA chief scientists Mike Catchpole and Carlos Das Neves.

Antimicrobial resistance data on bacteria from humans, animals, and food are collected annually by 27 EU countries. Northern Ireland, Albania, Iceland, Norway, Switzerland, and North Macedonia also shared data. The report has the main findings of 2020 to 2021 AMR monitoring in Salmonella, Campylobacter jejuni, and Campylobacter coli in humans and food-producing animals.

In 2020, it was mandatory to report AMR data from poultry flocks and derived meat, while in 2021, the focus was on fattening pigs and calves and their meat.

In Salmonella from human cases in 2021, resistance to ampicillin, sulfonamides, and tetracyclines was at high levels, while resistance to third-generation cephalosporins was low for both cefotaxime and ceftazidime. A moderate level of resistance to ciprofloxacin was observed in human cases; however, an extremely high proportion of resistant isolates was noted in Salmonella Kentucky.

Combined resistance to ciprofloxacin and cefotaxime, classed as high priority critically important antimicrobials, was very low in Salmonella isolates from humans.

Multidrug resistance (MDR) was high for Salmonella in human cases, ranging from low in Salmonella Enteritidis to very high among Salmonella Kentucky and extremely high for monophasic Salmonella Typhimurium. MDR is resistant to three or more antimicrobial classes.

Campylobacter findings
Data showed high levels of resistance to fluoroquinolones, which are critically important antimicrobials used to treat Campylobacter infections in humans.

High to extremely high resistance levels to ciprofloxacin were also observed in human Campylobacter jejuni and coli isolates. The level of resistance is now so high, it is no longer recommended in the treatment of severe infections in humans.

Macrolides, including erythromycin, are the main class of antibiotics used as the first-line treatment of campylobacteriosis. Resistance to erythromycin, another critically important antimicrobial, was at low levels in Campylobacter jejuni from humans. However, higher levels were observed in Campylobacter coli isolates from people. The level of resistance to tetracycline was high in Campylobacter jejuni and extremely high in Campylobacter coli from humans.

Combined resistance to ciprofloxacin and erythromycin was lower in Campylobacter jejuni isolates than in Campylobacter coli isolates for humans.

Portugal had the highest prevalence of resistance to erythromycin in Campylobacter coli from fattening pigs in 2021 and the top level of resistance in humans, suggesting that pigs could be a reservoir of erythromycin-resistant Campylobacter coli. This is of public health concern because macrolides, such as erythromycin and azithromycin, have become the first-line treatment of human campylobacteriosis, said EFSA and ECDC.

A higher-than-expected level of resistance to ertapenem was found in Campylobacter coli isolated from calves in 2021. This is also worrying for public health as carbapenems, alongside aminoglycocides, are the antimicrobial classes recommended for treating invasive Campylobacter infections in people.

Data revealed the prevalence of Extended-spectrum Beta-lactamases and AmpC beta-lactamases producing E. coli is decreasing. Resistance of E. coli to carbapenem remains rare in food-producing animals and humans. Carbapenem is a class of last-resort antimicrobials.

Another key finding from the 2021 monitoring was the detection of rifampicin resistance in isolates from dairy cows and bovine meat. Vancomycin and rifampicin are important compounds in human medicine for the treatment of methicillin-resistant Staphylococcus aureus (MRSA).

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Data from the annual report for 2021, published by the European Food Safety Authority (EFSA), includes pigs, sheep, poultry, milk, eggs, game meat, and honey.

Notable findings were fipronil in eggs, clenbuterol in bovines, amitraz in honey, and phenylbutazone (bute) in horses.

More than 621,000 samples were reported to the European Commission by the 27 EU member states, Iceland, Norway, and Northern Ireland. They consisted of mainly targeted tests and sampling as part of national controls but also suspect samples and those collected at import.

Overall, the percentage of non‐compliant samples in 2021 was lower than in past years.

Examples of violations
The level of non-compliance in targeted samples, which are taken to detect illegal uses or check maximum compliance against permitted levels, also decreased. In 2021, 4,562 suspect samples were reported of which 119 were non-compliant, compared to 200 in 2020.

The report covers hormones, antibacterials, environmental contaminants, prohibited substances, and other veterinary drugs. The presence of unauthorized substances, residues of veterinary medicinal products, or chemical contaminants in food may pose a risk to public health.

Fipronil in eggs was found in one sample from Slovenia while amitraz was detected in three of 17 honey samples from Cyprus. Non-compliant results for phenylbutazone came from Ireland and Germany. In targeted sampling, clenbuterol was found in one bovine sample from Germany and two suspect samples from Portugal.

In 2021, the frequency of non‐compliant results was down for antithyroid agents, while for steroids and resorcylic acid lactones, it was higher than in 2020. For prohibited substances, the level of non‐compliance in 2021 was up from the year before. Decreases compared to previous years were noted for environmental contaminants and chemical elements including metals and dyes.

For mycotoxins, non-compliant targeted samples were reported for bovines, milk, and pigs due to zearalenone and aflatoxin M1. For dyes, non-compliant samples were recorded for aquaculture. Substances found were the sum of crystal violet and leucocristal violet and the sum of malachite green and leucomalachite green.

Animal welfare work
EFSA has also published two scientific opinions with advice on space, the density of animals, lighting, dust, noise, litter, and structures such as elevated platforms for farmed broiler chickens and laying hens.

Scientists recommend avoiding the practice of mutilation, feed restriction, and the use of cages to improve poultry welfare. Revision of the EU’s animal welfare legislation is ongoing.

EFSA is organizing an online event to present findings from its two opinions on broiler chickens and laying hens on March 28. A second event on the upcoming opinions on calves, dairy cows, ducks, geese, and quail will be held on May 23.

A joint statement from the European Forum of Farm Animal Breeders (EFFAB); AVEC, which represents the EU poultry meat sector, and Copa-Cogeca said the opinion contains “unprecedented recommendations” which would severely impact the sector.

Of the recommendations put forward by EFSA, the most shocking is the proposal to lower the stock density for conventional broilers. If applied, this would mean the EU will request conventional poultry producers to make major on-farm investments while the number of birds in a barn will have to be decreased by 72 percent, said the groups.

Implementing such extreme proposals would result in closing small and medium enterprises in rural areas, losing competitiveness, and increasing imports, while facing an increase in the price of poultry meat for consumers, they added.

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The impact of dry-aging of beef and wet-aging of beef, pork, and lamb on microbiological hazards and spoilage bacteria was examined.

Wet aging is used for meat stored and refrigerated in a vacuum package, while dry-aged beef is refrigerated without packaging for weeks or months which results in a dry surface that is cut off before preparation.

“Aged meat has risen in popularity in recent years among the food industry and restaurants yet until now there has been a lack of knowledge about its safety. EFSA’s advice contributes to filling that gap and provides a solid scientific basis for the food business operators to produce aged meat that is safe,” said Kostas Koutsoumanis, chair of EFSA’s Scientific Panel on Biological Hazards (BIOHAZ).

Time and temperature
EFSA’s experts looked at current practices and identified pathogens and spoilage bacteria that might develop and survive during the aging process. These include Shiga toxin-producing E.coli (STEC), Salmonella, Staphylococcus aureus, Listeria monocytogenes, enterotoxigenic Yersinia, Campylobacter, and Clostridium.

They described the conditions, using combinations of time and temperature in the aging process, under which the production of dry-aged and wet-aged meat would result in the same level of safety as fresh meat.

For dry-aged meat, experts said the surface temperature should not exceed 3 degrees C (37.4 degrees F) during the aging process. This is because at higher temperatures mold might grow on the meat surface and some of these molds produce mycotoxins. Dry aged beef can be considered as safe as fresh beef if aging is done for up to 35 days at 3 degrees C (37.4 degrees F) or lower.

Fresh meat has not undergone any preserving process other than chilling, freezing, or quick-freezing, and most fresh beef, pork, and lamb are matured in vacuum packaging under chilled conditions. Wet-aged meat has been vacuum packed and stored chilled for more than 14 days for beef and longer than four days for pork and lamb. Standard fresh beef was matured in vacuum packs for 14 days or less, while pork and lamb it was typically matured for up to four days.

There is a demand from certain EU countries to allow the use of dry and wet-aged meat for the production of minced (ground) meat and mechanically separated meat (MSM). Currently, the use of meat aged for more than 15 days is not allowed to make ground meat or MSM. Experts could not conclude on the safety of ground meat and MSM prepared from dry or wet-aged meat, compared to fresh meat because of several issues including a lack of data.

Use of defined and controlled conditions
Data on key parameters such as the surface pH, water activity, and temperature of the meat, that could influence the survival or growth of pathogenic and spoilage bacteria as well as molds and mycotoxin production was provided. Predicted growth was simulated by using microbiology models, with different aging scenarios covering factors associated with the aging processes.

Based on predicted growth, the main microbiological hazard is Listeria monocytogenes for all meat types and Yersinia enterocolitica for pork.

Information on temperature, relative humidity, airflow, and time was collected about the processes and practices used by meat plants, butchers, and restaurants. Replies to questionnaires were received from two industry associations and eight food companies.

Under current practices, the aging of meat impacts a load of microbiological hazards and spoilage bacteria compared to the standard fresh meat preparation. The extent depends on the conditions of aging, the properties of the meat, and the presence of competing microorganisms said scientists.

They found aging under defined and controlled conditions can achieve the same or lower levels of microbial hazards and spoilage bacteria than increases predicted during fresh meat production.

The safety of meat is assured through hazard analysis and critical control points (HACCP) and prerequisite programs (PRP), including good hygiene practices and good manufacturing practices. As standard fresh meat preparation and wet-aged meat differ only in the time applied, controls are similar.

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A study by scientists from the University of Bath and the University of Exeter looked at Fusarium head blight (FHB) from 2010 to 2019. Findings were published in the journal Nature Food.

Mycotoxins occur when fungal pathogens infect crops and contaminate their products. They can harm human and animal health and impact farmers’ income.

The European Food Safety Authority (EFSA) and Biomin mycotoxin survey data for the FHB mycotoxins deoxynivalenol (DON), fumonisin (FUM), zearalenone (ZEN), and T-2 were analyzed for a 10-year period.

Potential health impact
Neil Brown, from Bath University, said: “Contaminated crops and Fusarium toxins are always a worry, as they pose a significant threat to our health, especially as we only partially understand their effects on our wellbeing.

“But on top of these health concerns, we must remember that wheat is a hugely important global crop, so it’s essential for us to maintain high yields along with safe food production — not least because of climate change, and now the war in Ukraine (the world’s fourth largest exporter of wheat), are already impacting on wheat yields and grain prices.”

Half of the wheat intended for human food in Europe contained DON, while in the United Kingdom, 70 percent was contaminated. However, 95 percent met the safety limits for DON concentration. The highest 10-year mean DON concentrations were in Hungary and the Netherlands.

DON was the most common FHB mycotoxin in European food and feed wheat. Occurrence and levels were lower in wheat for food than in the feed. This suggests that supply chain management, such as the postharvest downgrading of grain exceeding the limit for human consumption to animal feed, works to reduce DON entering the food stream for humans, said researchers.

DON occurrence was relatively stable in most countries over the decade. Sweden, Denmark, and the UK showed a high occurrence but at low concentrations. Scientists said this raises concerns about the health effects of chronic dietary exposure.

A quarter of food and 45 percent of feed wheat containing DON tested positive for other FHB mycotoxins. ZEN and T-2 were the most common co-contaminants.

“We don’t understand the health implications of being exposed to multiple toxins at the same time, especially when that exposure is chronic. We’re worried about growing levels of co-contamination and possible synergies between toxins,” said Brown.

Estimated downgrading costs
The team put a price on the impact of Fusarium head blight mycotoxins by estimating the value lost by wheat being too contaminated with DON for human consumption.

“Across Europe, we estimate that 75 million tons of wheat (5 percent of food wheat) exceeded the limit allowed for human consumption between 2010 and 2019. Downgrading this to animal feed equates to a loss of around €3 billion ($3.2 billion) over the last 10 years,” said Louise Johns, a Ph.D. student.

The scale of Fusarium head blight fluctuates from year-to-year but high disease years appear to be getting more severe.

“We don’t know what’s causing the increase in Fusarium mycotoxins, which is why we need more research, but we suspect that changes in farming such as soil preservation practices that provide a home for the Fusarium fungus and climate change such as warmer, more humid weather which favors the Fusarium fungus are playing an important role,” said Johns.

Sarah Gurr, chair of food security at the University of Exeter, said: “We need to be vigilant in testing for mycotoxins in grain. We each eat around 66 kilograms of wheat flour per year – for example, in pasta and bread – and it’s important for wheat to be protected from Fusarium infection so as to mitigate this risk.”

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Salmonella accounted for almost 20 percent of all outbreaks. The top sources of salmonellosis outbreaks were eggs, egg products, and mixed foods, which are meals composed of various ingredients.

Outbreaks caused by Listeria monocytogenes were at the highest level ever but the number of sick people and deaths did not rise. This might be linked to the increased use of whole genome sequencing, which allows scientists to better detect outbreaks, according to the report.

Outbreaks in 2021 went up compared to 2020 but were below pre-COVID-19 pandemic years, said the European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control (ECDC).

More than 4,000 foodborne outbreaks, 32,543 illnesses, 2,495 hospitalizations, and 31 deaths were recorded in 2021. Also, 83 outbreaks, 1,270 patients, 65 hospitalizations, and two deaths were reported in Bosnia and Herzegovina, Iceland, Montenegro, Norway, North Macedonia, Serbia, and Switzerland.

The largest outbreak was in Finland, and most deaths were in France
Belgium, France, the Netherlands, and Poland accounted for almost 75 percent of all outbreaks. France had 1,286, the Netherlands had 838, Belgium had 547, and Poland had 299.

Finland reported an outbreak caused by Salmonella Typhimurium in pre-cut vegetables involving 728 patients. This outbreak was the largest in 2021 and the biggest caused by this pathogen since data collection began in 2004.

With 17 fatalities, France accounted for more than half of all deaths in the EU. This is the highest from a single country since 2012. At the EU level, 15 deaths were linked to health care and residential facilities, which emphasizes the risks of foodborne hazards to vulnerable people, researchers reported.

The agent was unknown for 1,831 outbreaks, with more than 10,100 patients and three deaths. Salmonella was responsible for the majority of outbreaks, cases, and hospitalizations. Unspecified bacterial toxins were behind 484 outbreaks and norovirus caused 251. Listeria monocytogenes was associated with the most deaths with 12.

France reported 176 Salmonella outbreaks while Poland had 165, Slovakia 154 and Spain 93. Salmonella Enteritidis was the top serovar, followed by Typhimurium. Salmonella was the main cause of outbreaks in 17 EU countries.

Shiga toxin-producing E. coli (STEC) was the third most common bacterial agent with 31 outbreaks and 275 patients. It was the top cause in Ireland. Identified serogroups in 24 outbreaks were O157, O26, O103 and once each for O12, O145, O146 and O91.

Campylobacter was the fourth most reported agent in outbreaks with 249. Germany was top with 64, followed by France and Slovakia both with 55. Six severe outbreaks leading to deaths or hospitalizations were reported by Denmark, France, Spain, and Sweden. The six deaths were the highest number reported since 2007.

Yersinia was detected in 21 outbreaks from 12 countries with 125 patients. Six countries reported 11 outbreaks caused by Shigella with 63 cases. Six were due to Shigella sonnei.

One outbreak was caused by Cronobacter sakazakii in Germany. It involved four newborns and caused one death. The implicated food was a hospital-mixed probiotic formula for infants. This was the first outbreak since EFSA began collecting data in 2004. Vibrio cholera was also reported for the first time with 47 cases. It was detected in Spain, in a residential institution (nursing home, prison or boarding school) and was linked to mixed food.

Contributing factors and food links
France recorded 90 percent of all outbreaks caused by bacterial toxins with more than 600. Three epidemics led to 708 cases and 97 hospitalizations. Seven deaths involved people living in health care and residential facilities. Bacillus cereus was associated with the most outbreaks among bacterial toxins, Clostridium perfringens caused the highest number of cases and deaths, and Staphylococcus aureus was top for hospitalizations.

Norovirus was the leading agent in Belgium, the Czech Republic, Denmark, Finland, Latvia, and Sweden. Thirteen outbreaks involved more than 100 people. France had the most with 112 outbreaks. 

Czech Republic reported a major outbreak of hepatitis A, involving 199 cases, of which 195 needed hospitalization. Mixed food was the suspected vehicle. Hepatitis E in Switzerland affected 105 people with 29 hospitalizations and two deaths. Slovakia reported an outbreak with five cases caused by tick-borne encephalitis virus linked to raw goat’s milk.

Almost 50 outbreaks and more than 200 cases were due to histamine and Scombrotoxin, often caused by fish products. Marine biotoxins such as Ciguatera were behind 17 outbreaks and mushrooms were linked to six. Two lectin outbreaks were reported in Denmark and one atropine incident linked to vegetables was noted in Italy.  

Foods of animal origin were implicated in 202 outbreaks, 2,221 cases, 316 hospitalizations, and 11 deaths. There was an increase in outbreaks linked to vegetables and juice products. Salmonella in this product category caused the most illnesses with more than 1,100.

Salmonella in mixed foods was responsible for the most hospitalizations, followed by Salmonella in egg products and in vegetables and juice products. Listeria in fish products was responsible for the most deaths followed by Clostridium perfringens toxins in pig meat products.

Cross-contamination was reported as a contributing factor in 34 outbreaks. An infected food handler was identified in 26 outbreaks. Time or temperature storage abuse, inadequate heat treatment, and inadequate chilling were also reported.

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The drop compared to pre-pandemic years is probably linked to COVID-19 control measures, which were still in place in 2021, said the European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control (ECDC).

Campylobacter remained the most frequently reported agent, with cases increasing to 127,840 compared to 120,946 in 2020. Meat from chicken and turkeys was the most common source.

Salmonella was second, affecting 60,050 people compared to 52,702 in 2020. Followed by Yersinia with 6,789 cases, Shiga toxin-producing E. coli (STEC) with 6,084 cases, and listeriosis with 2,183 cases. Almost 200 people died from listeriosis, 71 from salmonellosis, 26 from campylobacteriosis, and 18 from STEC infections.

Stats by pathogen

Campylobacter infection accounted for more than 62 percent of all confirmed cases. The highest proportion of reported cases was in the youngest age group from 0 to 4 years old.  

The top country-specific notification rates were in the Czech Republic, Slovakia, Luxembourg, and Malta. The lowest was in Poland, Romania, Bulgaria, Greece, and Cyprus. Germany had the most infections with almost 48,000. Nearly 10,500 people were hospitalized. The highest rates were in Latvia, Cyprus, and Poland.

A regulatory limit applies for Campylobacter from broilers. Countries reported 8,063 results from official controls, with nearly 1,500 over the limit of 1,000 Colony Forming Units per gram (CFU/g). More than 53,000 results from the monitoring of food companies found 8,759 above this level. The number of samples exceeding the limit was much higher in official samples than in own-checks.

“This discrepancy, observed for the second year, deserves more thorough investigation in order to identify the critical parameters and factors explaining these differences. The aim is to stimulate action to lower Campylobacter counts on broiler carcasses and to reduce the number of human campylobacteriosis cases caused by the consumption or handling of contaminated chicken/broiler meat,” said the report.

Salmonella and Listeria

Salmonella infections climbed from 2020 but are still down from 2019 levels. In 2021, the top notification rates were reported by the Czech Republic and Slovakia while the lowest was in Bulgaria, Cyprus, Greece, Ireland, Romania, and Portugal. More than 10,000 cases were recorded in the Czech Republic and above 9,000 in France.

The most affected age groups were 0 to 4 years old, those 5 to 9, and people older than 65.

The highest proportions of hospitalized cases were reported, as in previous years, in Cyprus, Greece, and Lithuania.

The top five Salmonella types causing infections were Enteritidis, Typhimurium, monophasic Typhimurium, Infantis, and Derby. Salmonella Braenderup, Montevideo, Oranienburg and Rissen, entered the top 20 list of the most frequent serovars in 2021.

Listeria monocytogenes infections were most common in the age group over 64 years old and particularly in people older than 84. More than 900 people were hospitalized.

The highest notification rates were in Finland, Denmark, Sweden, and Slovenia, while the lowest was reported by Bulgaria, Croatia, Cyprus, Greece, and Romania. Germany had the most infections with 560 followed by France with 435. France noted the most deaths with 75, followed by 34 in Spain, 25 in Poland and 20 in Germany.

E. coli and Yersinia

STEC was the fourth most common foodborne disease in Europe. The main serogroups were O157 and O26.

The highest country-specific notification rates were seen in Ireland, Denmark and Malta while the lowest were in Romania, Portugal, Greece, Slovakia and Poland. Germany had the most infections with 1,635 followed by Denmark with more than 900 and Ireland with just below 900.

A total of 362 Hemolytic Uremic Syndrome (HUS) cases were reported in almost all age groups, with the highest proportion of patients in the youngest age groups from 0 to 4 and 5 to 14 years old. The main serogroups were O26, O157, O80 and O145.

Yersinia infections increased to almost 6,800 from 5,661 in 2020. Germany had the most cases with 1,912, followed by France with 1,451. The highest notification rates were in Denmark, Finland, Lithuania and Latvia. More than 500 people were hospitalized. Yersinia enterocolitica was the most commonly reported species and the top serotype was O3.

Three of 1,205 single samples and three of 404 batches of infant formula-type products were positive for Cronobacter sakazakii. Testing by Estonia and Spain at the processing plant detected one positive out of 32 official control samples.

The Netherlands tested 750 samples or batches of crustaceans, fish, bivalve mollusks and leafy vegetables for Vibrio. Vibrio cholerae was detected in 21 samples and Vibrio parahaemolyticus in 45 samples. No positives for Hepatitis A were found in 153 tests of non-pre-cut fruit and leaf vegetables.

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The event, coordinated this past month by Sciensano, the national public health institute, covered a fictional Salmonella outbreak.

The simulated exercise was developed by the One Health European Joint Program (OH-EJP), the European Center for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA).

Practice from actual outbreak
About 30 representatives of organizations that play a role in the management of such outbreaks in Belgium met for two days to follow step by step a fake, but realistic, national salmonellosis incident.

It involved SPF Santé publique, the Agency for Care and Health (Zorg en Gezondheid) and the Federal Agency for the Safety of the Food Chain (FASFC).

The meeting covered data exchange to quickly detect the source of the outbreak and take action. Attention also was given to clear and uniform communication.

“During the exercise, it became clear that each partner knows their own role, as well as that of the others and the collaboration, is going well. The partners have already worked very effectively together earlier this year during the real outbreak of salmonellosis in a chocolate factory in Arlon,” said Jorgen Stassijns, crisis coordinator at Sciensano.

“The exercise allowed participants to understand that using a shared digital platform for data exchange and communication can further improve collaboration. The importance of systematically assembling an outbreak management team was also highlighted.”

The real outbreak caused by monophasic Salmonella Typhimurium from Ferrero’s Kinder chocolate sickened more than 450 people between December 2021 and June 2022. Operations at the plant were suspended in April but restarted in September.

At least one training exercise takes place every year involving simulation of an incident or a crisis situation with participation of the European Commission, EFSA and national authorities.

African example
Such workshops also occur in other countries. In March and April this year, the Veterinary Services agency in Côte d’Ivoire organized a national simulation exercise to improve the handling of a foodborne outbreak.

It was part of the process to strengthen the response of the Veterinary Services and other stakeholders in the event of an outbreak of collective food poisoning in the country.

The event aimed to boost the coordination of stakeholders in response to food poisoning of animal origin, test response capacities, clarify the roles and responsibilities of the different actors during a crisis and make recommendations to close gaps and respond effectively to a foodborne illness.

Forty professionals participated including administrative staff of the Direction of Veterinary Services, the General Directorate of Health, the National Laboratory of Support to Agricultural Development, the Veterinary Service of the Armed Forces, and local authorities.

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The Eurobarometer survey was conducted in March and April this year and included more than 26,500 respondents. Results were published by the European Food Safety Authority (EFSA).

Cost is the most important of seven factors when buying food, taste comes second, followed by food safety. The proportion indicating food safety as a driver decreased since the question was last asked in April 2019.

Seven in 10 in Cyprus select food safety as one of the main factors when buying food and this is also important in Romania, Greece and Croatia but less so in Estonia, Sweden and Denmark.

In 23 countries, respondents are less likely to mention food safety than in 2019. Malta shows the largest decline, followed by Luxembourg, Belgium, Germany and Portugal. It has gone up slightly in Austria, Greece and Ireland.

Bernhard Url, EFSA’s executive director, said: “Much has happened since our last survey in 2019, not least a global pandemic and the outbreak of war in Europe. Such events have dramatic consequences and unsurprisingly we see that for many Europeans a rise in the cost of living is affecting their food choices more than before. On the other hand, food safety remains important for many EU citizens and it is encouraging to see that almost half of them care about eating healthily as much as they do about food risks.”

Seven in 10 respondents across the EU are “personally interested” in the topic of food safety. This varies widely across member states, with the most interest in Greece, Cyprus and Luxembourg and the least in Poland, Czech Republic, Estonia and Sweden. Women are more likely than men to be interested in food safety and people aged 15 to 24 are the least likely to say they are interested.

Food poisoning awareness and concern
About one in five have a very high level of awareness of food safety topics listed in the survey. This means they have heard about at least 13 of the 15 areas mentioned.

More than half of respondents are aware of food poisoning from items contaminated by bacteria, viruses, and parasites. However, awareness declined slightly from the 2019 survey.

People in Greece, Portugal and France are the most likely to have heard about food poisoning while those in Czech Republic, Hungary and Croatia are the least likely. Awareness declined in 19 countries, most notably in Sweden, Finland and Croatia. However, it increased in Greece, Bulgaria and Cyprus.

Food poisoning from food or drinks contaminated by bacteria, viruses, and parasites was fourth in a list of 15 issues. It is the main concern for people in Ireland and Romania.

Portugal sees more than half of its citizens concerned about food poisoning, followed by Greece and Spain. One-fifth or less indicate it as a problem in Sweden, Estonia, Czech Republic and Finland.

Concern about food poisoning has declined in 13 countries and increased in 12. Greece stands out for the largest rise, followed by Bulgaria and Cyprus, while the biggest decreases are in Croatia, Sweden and Czech Republic.

Action in event of food scare
About four in 10 said they take it for granted that food sold is safe as a reason for not paying attention to information about food safety. The highest proportions indicating this are in Sweden, Finland and Portugal, while the lowest are in France, Greece and Romania.

Three in 10 indicate they know enough to avoid or mitigate food risks and more than one quarter find food safety information often highly technical and complex.

Almost eight in 10 Europeans indicate they are likely to change their food preparation or consumption behavior if a food poisoning incident is reported and authorities advise precautionary measures.

A quarter of respondents said all kinds of foods involve some risk and it is impossible to check and avoid them. One in five said they would be able to tell from the look, smell, or taste if the food was contaminated, which is not the case according to food safety experts.

More than eight in 10 respondents trust general practitioners and specialist doctors, scientists working at a university or publicly-funded research organization and consumer groups as sources of information on food risks. More than six in 10 trust EU institutions, national authorities and scientists working at an industrial or privately funded research organization.

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They found such techniques are ready to substitute current methods despite some limitations.

Bivalve molluscan shellfish (BMS) contamination with norovirus is a significant public health risk. Contaminated foods, such as oysters, may harbor concentrations of viral genomes and a large diversity of sequences when contaminated by human sewage.

“Based on results presented here, it is clear that too many European shellfish samples are exposed to sewage pollution as evidenced by the multiple sequences detected in shellfish samples, highlighting that we still need to enhance coastal water quality,” said researchers.

Using laboratory‐prepared samples of known norovirus composition, scientists evaluated the sensitivity, reproducibility, repeatability, and selectivity of metabarcoding, capture‐based metagenomics, and long amplicon sequencing. 

The three methods allowed sequencing of norovirus in most tested samples, however, performance in retrieving the expected diversity differed. Experts also compared the advantages and disadvantages of each method, the cost per sample and of equipment, the time for results, and whether they were suitable for surveillance or outbreak sequencing.

The consortium of the Institut Français de Recherche pour l’Exploitation de la Mer (Ifremer), Centre for Environment, Fisheries and Aquaculture Science (Cefas), Technical University of Denmark (DTU), and Erasmus University Medical Center focused on norovirus-contaminated oyster samples. Findings were published by the European Food Safety Authority (EFSA).

Method potential and issues
Metabarcoding with separate amplification of polymerase and capsid gene segments followed by Illumina sequencing was the most sensitive method. However, due to the amplification steps and high sensitivity of NGS, the methods are prone to contamination and false positive results.

Work covered norovirus in shellfish and patient samples, from routine monitoring and surveillance and a survey of contamination in oysters in the European Economic Area from November 2016 to December 2018.

There were two artificially created sample sets, 212 oyster samples from the survey, pairs of human and shellfish samples from 16 foodborne outbreaks in France and Denmark from 2012 to 2019, and human norovirus sequences submitted to the global surveillance network Noronet.

One metabarcoding approach used Illumina technology and the other is based on long amplicon sequencing with Oxford Nanopore technology. Metabarcoding is highly sensitive and allows better capture of the diversity of noroviruses present in shellfish.

Experts said metabarcoding seems to be the more reliable method, with high sensitivity and reproducibility, and is easy to use for sequence analysis.

Other methods such as metagenomics show promise, but require further improvements regarding sensitivity. Metagenomic sequencing is sensitive enough to investigate the human outbreak samples but not those from shellfish. The VirCapSeQ metagenomics method requires optimization and should be used on samples with high levels of contamination or that was collected recently.

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“What we say about food safety matters, what we write about food safety matters but most important is what we do,” said Frank Yiannas at the ONE – Health, Environment, Society – Conference in Brussels and online.

The event, from June 21 to 24, is organized by the European Food Safety Authority (EFSA), European Centre for Disease Prevention and Control (ECDC), the European Chemicals Agency, European Environment Agency, European Medicines Agency and the European Commission’s Joint Research Centre (JRC).

Yiannas gave two examples of what the FDA is doing to increase consumer trust.

“The first one is food traceability, we are in the process of issuing a final rule later this year. We know from a food safety perspective, if there is a food scare, tracing that food back to source quickly can allow us to remove product from the market and shorten the epidemic curve, perform a secondary intervention and prevent additional illnesses. We believe better food traceability is about transparency and increasing this in the food system will breed trust,” he said.

“What’s the opposite of transparency in food? To me it’s what we have in today’s food system, too much anonymity, we really don’t know where those products come from, under what conditions were they produced, what certifications have they truly got and consumers also don’t know this.”

Data and consumer trust issues

The second action involves data, said Yiannas.

“I often say better food safety will begin and end with better quality data. We have the possibility of using tools to convert large volumes of big data that exists into actionable, preventive information. There is this big divide but new tools such as artificial intelligence, machine learning and the Internet of Things are causing this divide to close,” he said.

“In the data age, collaboration will increasingly involve public to public and private and public organizations sharing data and converting that into information and the entire food system getting smarter together. At FDA we are working on data trusts and have started a few projects to do just that.”

Yiannas said we are living through a “mega consumer trust bust”.

“Social scientists tell us consumers are less trusting of institutions, governments, companies, corporations and even of non-profits. On top of that people are increasingly polarized on issues of politics, climate change and how to deal with the pandemic. What about food? Do you think we, as a society, are increasingly polarized on food? I think the answer is yes,” he said.

“After three decades in the profession, I am sad to say I increasingly see food dividing us. I think food should unite us. We hear people talk about I want local food, others say they are ok with global food. Some people want organic and others are ok with conventional food, it tends to be more affordable. Some eat only natural and others are ok with processed foods. Today, we have an issue in many countries with too much food being as harmful as too little food.

“Never before in history has the responsibility to provide safe, available and sustainable food to so many rested on the shoulders of so few and never before have the consequences for not getting this right been more important.”

More than 4,200 participants registered online for the four day event, and around 1,000 signed up to attend in person. Of the latter, almost 90 percent come from Europe, with the rest from Africa, Asia and North America.

EFSA viewpoint on One Health and collaboration

Bernhard Url, EFSA’s executive director, said the speed of change creates widespread uncertainty and anxiety.

“The food system is in a state of crisis: hunger, obesity, food waste, resource depletion and biodiversity losses. With this conference, we would like to explore how food safety and more integrated health assessments can contribute to the transformation of food systems,” he said, when opening the conference.

“The One Health concept aims at balancing and improving the health of humans, animals and the environment. We think the principles of One Health make it ideal to support our work on addressing the complexity and urgency of the health challenges ahead. At EFSA, we think by applying these features, our food safety work will advance and be more fit for purpose and better inform policies which aim to transform the food system. One Health acts as a stepping stone, it connects food safety to sustainable food systems.”

Url said there is a need to see faster innovation in science methodologies to confront the challenges ahead.

“There is a trust issue – how can we anchor our scientific advice in a society that is ready to accept it. Even if the outcome is not liked because of value differences, people trust the process,” he said, during a later panel discussion.

“Everybody talks about collaboration and says yes we need to collaborate more, it’s a no-brainer but it’s not done enough, so what are the obstacles? I think here something is fundamentally wrong, so lets rectify it. Collaboration adds a layer complexity, you lose autonomy and give something for the bigger purpose which means it takes longer. There can be cultural or language differences, budgetary cycles and objectives of organizations are different. Maybe we have to put collaboration as an objective of organizations and not just something that could help us from the sidelines.”

EU Commission on regulation and EFSA’s role

Stella Kyriakides, EU Commissioner for Health and Food Safety, said trust in the food safety system underpins more sustainable food systems.

“The COVID-19 pandemic and Russia’s invasion of Ukraine have highlighted how we need a robust and resilient food system supplying sufficient, affordable food at all times,” she said.

“It has also brought home to us how our health, ecosystems, supply chains, consumption patterns and planetary boundaries are all interlinked. The increasing recurrence of droughts, floods, forest fires and new pests are a constant reminder that our food system is under threat and must become more sustainable and resilient.”

Kyriakides also mentioned the 20 year anniversary of the General Food Law Regulation and creation of EFSA. 

“The regulation’s common definitions, aims and general principles have redefined and shaped EU food law and policy. Chief among them is the risk analysis principle, under which food law must be science-based,” she said.

“EFSA’s scientific excellence has served to give EU measures a solid scientific basis. It has maintained confidence in the EU food supply. It has raised EU food safety and standards and it has definitely helped raise international standards in the process. Thanks to EFSA and the General Food Law, the European Union can pride itself on having one of the most robust and efficient food safety systems in the world.”

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Researchers gathered information on risk perception and attitudes in the Portuguese population to contamination of fish with Anisakis and their knowledge of methods to prevent infection.

Parasitic nematodes of the genus Anisakis are the causative agent of anisakiosis. Humans are infected through consumption of raw or undercooked fish contaminated with the parasite. Infection can result in both gastrointestinal and allergic symptoms. There are few reports of anisakiosis in Portugal, but evidence of Anisakis allergy exists, indicating that exposure is occurring.

Portugal has one of the highest levels of fish consumption in the world and European hake is among the most popular. There is no tradition of consuming raw or undercooked fish in Portugal, however these products are becoming increasingly popular, and common cooking methods such as grilling do not always reach sufficient temperatures to kill parasite larvae.

There has been an increase in reports of anisakiosis in the past few decades. This is probably because of factors including increased inspection measures for fishery products leading to higher detection rates of contaminated seafood, and improved diagnostic techniques finding more human infections.

Forty-five European hake of mixed age were measured, weighed and the viscera and muscle were examined for Anisakis larvae. A total of 473 Anisakis stage 3 larvae were found.

From 746 survey respondents, most cited “transmission of parasites” as a risk associated with consumption of raw fish. Many people had not heard of Anisakis or prevention methods. Of those who were aware of such methods, the majority cited “cooking thoroughly” and “freezing” as the most important.

Only 7 percent of people have avoided buying or eating fish because of the presence of worms. A total of 35 percent of respondents would be willing to pay between €1 and €2.5 ($1.1 to $2.7) extra for a fish product that was treated to remove Anisakis larvae and allergens.

Other published assessments
Work was done as part of the European Food Safety Authority’s (EFSA) Fellowship Program (EU-FORA), which provides scientists at food safety organizations across Europe with the opportunity to increase their knowledge and gain experience in food risk assessment.

One project looked at the prevalence of Salmonella in swine carcasses. It was carried out at a slaughterhouse in Italy between October 2018 and October 2021 and 757 pig carcasses were sampled.

Overall, 19 positive samples were found. The type was Salmonella Derby eight times; Salmonella typhimurium and Salmonella London three times; Salmonella Give and Salmonella Brandenburg twice and Salmonella Goldcoast once.

Salmonella prevalence was higher in samples that came from farms with a distance greater than 200 kilometers. Possible reasons could be the longer stay of animals in transport vehicles with inadequate hygiene and their close contact. The positivity rate also increased for heavier animals, but to a lesser extent.

Another study assessed antimicrobial resistance (AMR) in Campylobacter from Italy over a decade. More than 2,734 Campylobacter jejuni strains isolated from domestic and wild animals and humans, during 2011 to 2021 were analyzed.

The proportion of completely susceptible strains was very similar in isolates from humans and domestic animals, while strains from wild animals had a significantly higher prevalence. Poultry samples showed a high level of resistance to nalidixic acid, ciprofloxacin and tetracycline.

Analysis found a better knowledge of the resistance levels of Campylobacter jejuni was necessary, and mandatory monitoring of Campylobacter in different animals was suggested.

Other work evaluated health risks associated with the consumption of botanical preparations of kratom. It is available via online platforms as food supplements. Kratom has been considered a botanical of possible health concern by the FDA and EFSA.

The assessment indicated that consumption has the potential to lead to adverse neurological effects, including addiction and withdrawal syndrome and other manifestations of toxicity, such as liver toxicity.

Actual risk characterization is made difficult by considerable uncertainties, including variability in composition of kratom preparations, insufficient information on dose-response relationships or the effects of long-term use.

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A total of 324 cases have been reported from Austria, Belgium, Denmark, France, Germany, Ireland, Italy, Luxembourg, Netherlands, Norway, Spain, Switzerland, Sweden and the United Kingdom. Canada and the United States are also affected.

The number of people sick has more than doubled since a previous assessment in April by the European Centre for Disease Control and Prevention (ECDC) and European Food Safety Authority (EFSA).

Hundreds of people, mainly children, sick
The UK is the main country affected with 109 monophasic Salmonella Typhimurium patients, France has 81, Belgium has 64 and Switzerland has 43. The United States and Canada both have one each. The Canadian case is a child under the age of 10 with a symptom onset date of Feb. 19. The U.S. patient was reported from the state of Illinois.

Almost 200 people have been interviewed and 170 reported consumption of chocolate products made by Ferrero.

However, eight cases cannot be explained by chocolates manufactured at the Arlon, Belgium factory, suggesting there may be other sources of infection, said ECDC and EFSA. These patients did eat different products made by Ferrero but it is not known where they were made.

Most cases are children under the age of 10 and females are more affected than males. From those with available data, almost half have been hospitalized but no deaths have been recorded.

Positive Salmonella results
Belgian authorities reported 81 samples from finished and semi-finished products, intermediate products, raw materials, environmental swabs and rinse oil samples taken in company checks at the plant from early December 2021 to late January 2022 tested positive for Salmonella. In April, seven samples from finished products tested positive for Salmonella.

Production was stopped on Dec. 16, restarted on Jan. 3, stopped again on Jan. 7 and resumed a few days later.

Belgian officials stopped production at the facility in early April but it could reopen next month with provisional authorization which would be evaluated after three months.

Salmonella positive items were destroyed, the production line was cleaned and an internal investigation launched. Production restarted after negative tests for Salmonella, and all final products were released after a negative result of the tested batch.

A recall has been issued but potentially contaminated products have still been found on sale. Cost of the Ferrero recall could exceed $60 million, according to insurance firm Lockton.

Buttermilk from Italian company
The average time from production to retail is 60 days so the first sampled case in the UK on Dec. 21, 2021, is very unlikely to be explained by contamination detected in the plant in December 2021. This suggests that contamination in the factory occurred earlier than December 2021, said EFSA and ECDC.

Two types of monophasic Salmonella Typhimurium matching the outbreak strains were identified in the buttermilk line at Ferrero’s plant between December 2021 and January 2022. Buttermilk was provided by an Italian supplier where Salmonella was not detected. This firm also sent buttermilk to other plants of Ferrero and Salmonella has not been detected.

There are two Salmonella strains involved, both are multidrug-resistant, and some isolates carry resistance to disinfectants based on quaternary ammonium compounds and hydrogen peroxide, but remain susceptible to azithromycin, ciprofloxacin, meropenem, and third generation cephalosporins.

Chocolate produced in Belgium was distributed to at least 113 countries.

The first patient was reported in the UK on Jan. 7, with a sampling date of Dec. 21, 2021. The UK issued a notice on a European platform on Feb. 17 and another alert on March 25. It notified the WHO about the cluster of monophasic Salmonella Typhimurium on March 27.

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The rate of maximum residue level (MRL) exceedances in 2020 increased compared with 2019 and 2018. It remained high for unprocessed and processed grape leaves, unprocessed cumin seed and processed Brazil nuts that are not covered in random EU testing.

The report is based on data from national official controls by European Union member states, Iceland and Norway and includes figures from the EU‐coordinated control program, which uses a randomized sampling strategy.

National control programs are risk-based, targeting products that likely contain pesticide residues or for which infringements have been identified in past years.

National targeted findings
The number of samples decreased by 9.3 percent compared to 2019 mainly because of the COVID-19 pandemic. Reporting countries analyzed 659 pesticides, with an average of 264 per sample.

For 2020, 94.9 percent of 88,141 samples analyzed fell below the MRL, 5.1 percent exceeded this level, of which 3.6 percent were non‐compliant after taking measurement uncertainty into account. MRLs were exceeded in 3.9 percent of samples in 2019 and 2.3 percent triggered legal sanctions or enforcement actions.

The EU non-approved active substances with the highest MRL exceedance rate were ethylene oxide, chlorates, chlordecone, chlorpyrifos and anthraquinone.

For ethylene oxide, 49 of 230 samples were found to exceed the MRL and 46 were of sesame seeds. This issue was detected in Belgium in late 2020 in sesame seeds from India. No safe levels for this pesticide are established in the EU. Its use is linked to reducing Salmonella.

For chlorpyrifos, 327 samples of 73,874 exceeded the MRL. The substance is not approved for use in the EU since April 2020.

Multiple residues were reported in 24,057 samples. In one strawberry sample of unknown origin up to 35 different pesticides were found. Unprocessed sweet and bell peppers and wine had the highest frequency of multiple quantified residues.

EU random sampling
The EU program covered carrots, cauliflower, kiwi fruit, onions, oranges, pears, potatoes, dried beans, brown rice, rye grain, bovine liver and poultry fat.

For the 12,077 samples analyzed as part of this program, 1.7 percent exceeded the MRL and 0.9 percent were non‐compliant.

MRL exceedance rates rose from 2014 to 2017 and to 2020 in rice, oranges, pears and poultry fat. An increased trend from 2017 to 2020 was also observed in dried beans, kiwi fruit and cauliflower.

Oranges, followed by pears, carrots and rice had the highest number of samples with multiple residues. In one rice sample of unknown origin, 15 different pesticides were quantified.

One non-compliant result was mentioned for fipronil in potatoes. Detection of fipronil residues by Belgian authorities in 2017 led to millions of eggs being recalled in Europe.

From 4,632 samples flagged as organic, 87 were reported with residue levels above their corresponding MRLs, of which 36 samples were non-compliant.

Up to 30 different pesticides were found in honey, mainly thiacloprid. Substances with non-approved uses such as amitraz, chlorfenvinphos and coumaphos were detected.

Samples imported from non-EU countries were found to have a higher MRL exceedance rate and a higher non-compliance level compared to food produced within the EU.

An EFSA dietary risk assessment, as part of its analysis of results, suggests the sampled food commodities are unlikely to pose a concern for consumer health.

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Ferrero has recalled numerous Kinder products, including products labeled for Easter, worldwide.

A total of 156 Monophasic Salmonella Typhimurium cases have been reported in 10 EU countries and the UK, said the European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA). The vast majority of those sick are younger than 10 years old and many have been hospitalized.

Time from manufacture to retail is between 55 and 60 days. The supplier of raw materials for Kinder branded products is batch-dependent but there have been no changes in the past year.

EU officials said the first case in the UK in December cannot be explained by contamination found in the processing plant in the same month. This suggests that if the factory in Belgium was the sole source of infection, contamination in the production line occurred earlier.

There are gaps in information that need to be investigated to understand the root cause, timing and factors behind the contamination, including the possible wider use of contaminated raw material in other processing plants, according to EFSA and ECDC.

Confirmed and probable infections
The first patient was in the UK on Jan. 7, 2022, with a sampling date of Dec. 21, 2021. In mid-February, the UK reported a cluster of 18 cases to an EU system. The latest sampling date is from the UK on March 28, 2022.

The UK has 65 confirmed cases, France has 25, Ireland has 15, Germany has six, Sweden has four, Netherlands has two and one patient each has been reported in Luxembourg and Norway. Belgium has 26 probable cases, Germany has four and Spain has one. In Austria, six people, including five children aged 3 to 6, were infected with the outbreak strain between January and March.

Overall, 88 of 101 interviewed sick people in 10 countries reported consumption of various Ferrero chocolate products, mainly milk chocolate eggs with a small toy inside or small oval shaped, bite-sized chocolate pralines.

Belgian authorities have withdrawn approval for the production site as the company was not able to provide guarantees concerning management of the contamination or safety of its products. A criminal investigation has also been opened, according to media reports.

Ferrero acknowledged there were “internal inefficiencies,” creating delays in getting and sharing information, which impacted the speed and effectiveness of investigations.

Positives in December and January
Monophasic Salmonella Typhimurium matching the outbreak strain was identified at the factory in Arlon in mid-December 2021 by internal analysis. Production was stopped, the affected semi-finished product was destroyed and deep cleaning of lines was carried out. Some finished products made from Dec. 10 to 15 were blocked and later released to market after an internal investigation.

A processing step involving buttermilk was the possible contamination point. The origin of contamination was a filter at the outlet of two raw material tanks, which was removed, cleaned and reconnected after negative testing. Chocolate products were distributed across Europe and globally after negative Salmonella testing.

In January, samples on semi-finished and finished products and surfaces were positive for Salmonella. The last Salmonella-positive was recorded on Jan. 11, 2022, from two buttermilk tanks.

The Arlon plant makes about 7 percent of the total Kinder products manufactured globally on a yearly basis. Distribution includes more than 60 countries ranging from most of Europe, the United States, Argentina, Australia, Canada, New Zealand, Singapore, Hong Kong and Mexico.

About Salmonella infections
Food contaminated with Salmonella bacteria does not usually look, smell, or taste spoiled. Anyone can become sick with a Salmonella infection. Infants, children, seniors, and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC.

Anyone who has eaten any recalled products and developed symptoms of Salmonella infection should seek medical attention. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis.

Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Otherwise, healthy adults are usually sick for four to seven days. In some cases, however, diarrhea may be so severe that patients require hospitalization.

Older adults, children, pregnant women, and people with weakened immune systems, such as cancer patients, are more likely to develop a severe illness and serious, sometimes life-threatening conditions.

Some people get infected without getting sick or showing any symptoms. However, they may still spread the infections to others.

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There are 105 confirmed and 29 probable monophasic Salmonella Typhimurium infections mainly among younger people, according to the European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA).

There is an “unusually high” proportion of children hospitalized, some with severe symptoms such as bloody diarrhea, said the two agencies.

Country details
The United Kingdom is the most affected country with 63 cases. Those sick have sample dates between December 2021 and March 2022, with the majority confirmed in February and March.

Cases are 18 years old or younger, with around 60 percent under the age of 5. There are more females than males sick. At least nine people were hospitalized but no deaths have been reported.

There are 20 confirmed cases in France, 10 in Ireland, four each in Germany and Sweden, two in the Netherlands and one each in Luxembourg and Norway. Belgium is investigating 26 probable cases and Germany has three.

French health authorities were informed by the Institut Pasteur’s National Reference Centre for Salmonella of 21 cases of salmonellosis throughout the country. Eight of them were hospitalized but have since returned home. The median age of patients is 4 years old.

Investigations by Santé Publique France pointed to certain Kinder brand products in 15 patients who were interviewed. These products were manufactured in the same factory in Arlon, Belgium.

In Sweden, the four cases, all of which are children, fell ill from January to March and live in several different regions. The Norwegian patient was sick at the end of February and was infected with the same type of monophasic Salmonella Typhimurium that was detected in the UK.

Based on interviews with patients and initial analytical epidemiological studies across Europe, Ferrero chocolate products have been identified as the likely route of infection.

Expanded recall
ECDC and EFSA are assessing other data from countries and will publish an outbreak assessment in the coming weeks.

Ferrero has expanded a product withdrawal and recall involving Kinder Mini eggs, Kinder Egg Hunt Kit 150-gram, Kinder Surprise 100-gram and Kinder Schokobons with best before dates between April 20 and Aug. 21, 2022.

In a statement, the company said no Kinder products released to market have tested positive for Salmonella.

“While the situation remains the same, we are fully aware that Easter is approaching, where we see an increase in sales of these products and therefore, as an additional precautionary measure, we have decided to voluntarily recall the products listed above due to these additional products having been manufactured in the same facility in Belgium, within the same time frame,” according to the company’s statement.

“The company takes food safety extremely seriously and we sincerely apologize for this matter. Our continued commitment to consumer care has driven our decision to extend the voluntary recall.”

Pamela Byrne, chief executive at the Food Safety Authority of Ireland (FSAI), warned consumers not to eat the affected products.

“Ferrero has now extended its list of products that are being recalled. If anyone has any of the affected products at home, we are advising them not to eat them. We know that many of these Kinder products are popular at this time of year with Easter approaching. We urge consumers to check at home if they have any of the products and if they do, to ensure that they are not eaten.”

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The data covers 2019 to 2020, according to a report published by the European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA).

Levels on antimicrobial resistance (AMR) in Salmonella and Campylobacter and indicator bacteria from humans, animals and food are collected annually by the 27 EU member states and analyzed by EFSA and ECDC.

Reporting was impacted by the COVID-19 pandemic affecting laboratory resources, the number of isolates, and the UK no longer being an EU country.

Campylobacter and Salmonella findings
Campylobacter bacteria from humans and poultry continue to show very high resistance to ciprofloxacin, a fluoroquinolone antibiotic that is common for treating some types of bacterial human infections. Increasing trends of resistance against the fluoroquinolone class of antibiotics has been observed in humans and broiler chickens for Campylobacter jejuni.

Erythromycin resistance was either not detected or at very low levels in Campylobacter jejuni from humans but at higher levels in Campylobacter coli isolates from people. Resistance decreased a lot from 2019 to 2020. This could be because of the COVID-19 pandemic and restrictions reducing the number of travel-associated campylobacteriosis infections in 2020, according to the report.

Combined resistance to both ciprofloxacin and erythromycin, which are critically important to treat campylobacteriosis, was rare to low in Campylobacter jejuni from humans and low to moderate in Campylobacter coli.

Multidrug resistance in isolates tested for four antimicrobial classes — fluoroquinolones, macrolides, tetracyclines and aminoglycosides — was very low in Campylobacter jejuni and low in Campylobacter coli.

In Salmonella from human cases, resistance to ampicillin, sulfonamides and tetracyclines was at overall high levels, while resistance to third-generation cephalosporins in 2020 was at very low levels for both cefotaxime and ceftazidime. A moderate level of resistance to the critically important antimicrobial ciprofloxacin was seen but among Salmonella Kentucky isolates there was an extremely high prevalence of resistance.

For Salmonella Enteritidis, increasing trends of resistance to the quinolone/fluoroquinolone class of antibiotics were seen.

Multidrug resistance was high overall among Salmonella reported from human cases in Europe. Eight isolates were resistant to eight of the nine tested substances, only susceptible to meropenem.

Combined resistance to two critically important antibiotics remains low for E. coli, Salmonella and Campylobacter in bacteria from both humans and food-producing animals.

Indicator bacteria
For antimicrobial resistance in indicator E. coli bacteria, large differences in the levels of resistance were found between countries. The 2020 monitoring focused on poultry and such meat, while the focus in 2019 was on pigs and calves less than 1 year old. It also included presumptive ESBL-/AmpC-/carbapenemase-producing E. coli isolates.

In more than half of EU countries, a significant decreasing trend in the prevalence of extended-spectrum Beta-lactamase (ESBL)-producing E. coli was observed in food-producing animals. This is important as particular strains of ESBL-producing E. coli are responsible for serious infections in humans, said the report.

Occurrence of ESBL/AmpC-producing E. coli in food-producing animals and on broiler meat is still high but appears to be going down.

Carbapenem resistance remains extremely rare in E. coli and Salmonella from food-producing animals. Carbapenems are a class of last resort antibiotics. In 2020, five isolates of E. coli with a carbapenemase phenotype were detected during monitoring.

Voluntary monitoring data was also provided on methicillin-resistant Staphylococcus aureus (MRSA) in livestock and food.

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An external scientific report, published by the European Food Safety Authority (EFSA), found evidence gaps exist in relation to the risks to plant, human and animal health and the environment from novel food and feeds within the circular economy model.

A circular economy aims to maintain the value of products, materials and resources for as long as possible. However, there is a need to identify potential emerging issues for the environment and food and feed safety to balance opportunities, benefits and risks. The European Commission adopted a circular economy action plan in March 2020.

A literature review categorized practices at all stages of the food and feed production chain in Europe to give an overview of current and envisaged practices.

Four areas were identified: primary production of food and feed; reducing industrial, manufacturing and processing waste; reducing food and feed waste in wholesale, food retail, catering and households; and reducing food and feed packaging waste.

Associated risks include bacterial and viral contamination of food crops from using wastewater for irrigation, heavy metals and mycotoxins in insects and the allergenic potential of chitosan in bio-based food contact materials.

Insect focus
Another literature search was done to identify emerging risks to plant, animal, human health and the environment from novel foods and feeds in relation to the circular economy. Twenty-six relevant studies investigating such risks were found.

The work was part of an EFSA two year project on food and feed safety vulnerabilities in this area.

Studies covering risk were almost entirely focused on the biological and chemical hazards, risks to health, and environmental impacts of insects as food or feed and what they are reared on. One investigated allergens and possible physical hazards were only discussed in reviews.

Seven articles reported the presence of potential chemical hazards in food or feed. Hazards included heavy metals, dioxins, polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), mineral oil hydrocarbons, veterinary medicines and pesticides.

Post-harvest thermal or freeze-drying treatments may reduce or eliminate some microbiological hazards but authors indicated that not all of them are effective for total inactivation of microorganisms and their toxins.

Novel sources of food and feed, food contact materials (FCM) to extend shelf life and recycling of plastics and paper/card packaging had risks thought to be more difficult to overcome based on a consultation.

Experts recommended that future research in novel food and feed in the circular economy focuses on areas outside insect farming, and that there are investigations into the potential risks associated with EU import of livestock and goods that may be subject to different restrictions or legislation.

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The European Food Safety Authority (EFSA) experts assessed the safety and efficacy of HPP on food, whether it can be used to reduce Listeria monocytogenes in ready-to-eat (RTE) foods, and as an alternative to thermal pasteurization of raw milk.

HPP is a non-thermal food preservation technique to kill microorganisms that cause foodborne diseases or spoil food. It uses pressure for a certain time period. Previous studies have shown minimal effects on taste, texture, appearance, or nutritional values. It is also known as high-hydrostatic pressure processing (HHP) or ultra-high-pressure processing (UHP).

The technique is not specifically regulated at the European Union level but establishments using it on products of animal origin are subject to approval. HPP is applied mainly to pre-packed juices, sauces, dips, fishery products, meat products and ready-to-eat meals at different points in the supply chain.

Reducing Listeria in RTE food
Based on a questionnaire to national authorities and industry, there is a large variability on the level of implementation of HPP in Europe with many sites in some countries but none in others.

The processing method reduces levels of Listeria monocytogenes in RTE cooked meat products. In general, the longer the duration and intensity of the pressure, the greater the reduction. HPP is also effective at tackling other pathogens, such as Salmonella and E. coli.

However, for other types of RTE foods like soft cheese and smoked fish, generic minimum HPP requirements could not be set and specific validation studies would be needed for each food, found the EFSA opinion.

In industry, pressures of between 400 and 600 megapascals are most often applied for microbial inactivation, with common holding times ranging from 1.5 minutes to 6 minutes.

The main factors that influence the efficacy of HPP are water activity and the pH of food, the pressure applied, holding time and temperature, and the target microorganism. Carbohydrates, proteins and lipids have a protective effect on microorganisms, which decreases microbial reduction.

Potential use on milk
There is a growing demand to allow HPP as an alternative to pasteurization as it is expected to keep the properties closer to those of raw milk. However, experts found HPP was not as good at killing microorganisms as pasteurization.

Pathogen reductions in milk with current HPP conditions used by industry are lower than those achieved by thermal pasteurization. However, minimum requirements for pressure and time combinations could be set to achieve lower reductions of hazards based on performance criteria proposed by standards agencies.

Alkaline phosphatase, the milk enzyme widely used to verify thermal pasteurization of cows’ milk, is relatively pressure resistant and use of HPP would be limited to being an over processing indicator.

Experts recommended conducting an analysis on the effect of HPP treatments on compounds in milk to verify their suitability as indicators of efficacy. They also called for more research on HPP inactivation of Listeria monocytogenes and other pathogens for RTE foods like smoked and gravad fish and soft/semi-soft cheese to help construct a predictive model to set the minimum requirements for HPP to ensure safety of these food products.

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The UK’s Food Standards Agency (FSA) said after reviewing the evidence, no safety concerns have been identified, which means there will not be a change to regulation in England and Wales. Food Standards Scotland (FSS) also reached the same conclusion.

European action was based on an assessment by the European Food Safety Authority (EFSA) in May 2021 which raised potential concerns over accumulation of titanium dioxide particles in the body and possible genotoxicity. Genotoxicity is the ability for a substance to damage DNA, which may lead to cancer.

In early 2022, the European Commission adopted a ban on the use of titanium dioxide as a food additive after member state backing in late 2021. Because of a six month transition period, it will apply beginning Aug. 7 this year. The additive is widely used to give a white color in foods such as cakes and pastries, confectionery or food supplements.

The EU’s decision will also apply in Northern Ireland because of the Northern Ireland Protocol.

Stella Kyriakides, in charge of EU health and food safety, previously said the safety of food and consumer health was non-negotiable.

“This is why we ensure strict and continuous scrutiny of the highest safety standards for consumers. A cornerstone of this work is to make sure that only safe substances, backed by sound scientific evidence, reach our plates,” she said.

UK verdict
The FSA’s scientific advisory committees reviewed the EFSA opinion and found that the evidence did not support the conclusions made. In the United States, the additive may be used under certain conditions set by the Food and Drug Administration (FDA).

The FSA and FSS are doing a risk assessment on the substance that should be ready for early 2023.

The Committee on the Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) and the Committee on the Mutagenicity of Chemicals in Food, Consumer Products and the Environment (COM) were asked whether they agreed with EFSA.

The COM questioned the quality of the dataset and some of the studies used by the EFSA panel to come to its position. Experts said the evidence did not allow definitive conclusions to be drawn on genotoxicity.

The committee said the wording of EFSA’s conclusion was “not helpful” from a risk communication perspective and the findings may create unnecessary concern for the public.

The COT found there appeared to be a lack of internal consistency and objective weighing of all the evidence and had concerns over the use of data from laboratories not proficient in genotoxicity studies.

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Data for 2020 covers 620,758 samples reported by 27 EU member states, as well as Iceland and Norway. The percentage of samples that exceeded legal maximum levels was 0.19 percent compared to 0.3 percent in 2019. It is the lowest figure for the past 11 years when non-compliance ranged from 0.25 to 0.37 percent.

Samples included bovines, pigs, sheep and goats, equine animals, poultry and aquaculture, as well as milk, eggs, honey, rabbit meat and game.

Most tests were targeted samples but some were suspect samples or collected at import. In 2020, there were 888 or 0.27 percent of non-compliant results out of 331,789 targeted samples. The number of abnormal results was 1,076; meaning some samples contained multiple illegal results.

Presence of unauthorized substances, residues of veterinary medicinal products or chemical contaminants in food may pose a risk to public health.

The number of samples tested was lower in 2020 because of the United Kingdom not reporting data to EFSA as it has left the European Union and issues because of the COVID-19 pandemic, researchers reported.

Deeper analysis of figures
In 2020, the frequency of non‐compliant results was down for antithyroid agents, steroids and resorcylic acid lactones. For prohibited substances like chloramphenicol and nitrofurans, non‐compliance in 2020 was higher than 2019 but lower compared to 2017 and 2018.

For chemical elements including metals, compared to 2017 and 2019, the rate of non‐compliance in 2020 was lower but higher than 2018. Decreases were noted for anthelmintics, organochlorine compounds, organophosphorus compounds, dyes and other substances.

For anticoccidials, non‐steroidal anti‐inflammatory drugs (NSAIDs), other pharmacologically active substances and mycotoxins the frequency of non‐compliance was higher but it was lower for other substances and environmental contaminants.

Non-compliant samples were reported for acetamiprid in honey and fipronil in pigs. These substances are used as plant protection products.

For mycotoxins, non-compliant samples came from pigs, horses and milk because of zearalenone, aflatoxin M1 and ochratoxin A.

Some of malachite green and leuco-malachite green were found. Use of these dyes is forbidden in EU food production but residues can originate from background concentration in fish feed.

For chemical elements, copper, cadmium, total mercury and lead were most frequently identified.

Of the 3,301 honey samples analyzed, 47 were non-compliant as reported by 10 countries. From 18,869 milk samples, 41 non-compliances were recorded by 15 countries. Of 11,251 egg samples, 31 were non-compliant as reported by 10 countries.

Of the 1,283 samples from farmed game, 24 were non-compliant, as reported by four countries. From 2,257 samples analyzed for wild game, 152 were non-compliant from 12 countries.

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