The Report referred to in Article 9 of Directive 2003/99/EC

Transcription

1 MALTA The Report referred to in Article 9 of Directive 2003/99/EC TRENDS AND SOURCES OF ZOONOSES AND ZOONOTIC AGENTS IN HUMANS, FOODSTUFFS, ANIMALS AND FEEDINGSTUFFS including information on foodborne outbreaks, antimicrobial resistance in zoonotic agents and some pathogenic microbiological agents. IN 2008

2 Report on trends and sources of zoonoses INFORMATION ON THE REPORTING AND MONITORING SYSTEM Country: Malta Reporting Year: Laboratory name Description Contribution Fiah andfarming Regulation Control division Malta

3 Report on trends and sources of zoonoses PREFACE This report is submitted to the European Commission in accordance with Article 9 of Council Directive 2003/99/ EC*. The information has also been forwarded to the European Food Safety Authority (EFSA). The report contains information on trends and sources of zoonoses and zoonotic agents in Malta during the year The information covers the occurrence of these diseases and agents in humans, animals, foodstuffs and in some cases also in feedingstuffs. In addition the report includes data on antimicrobial resistance in some zoonotic agents and commensal bacteria as well as information on epidemiological investigations of foodborne outbreaks. Complementary data on susceptible animal populations in the country is also given. The information given covers both zoonoses that are important for the public health in the whole European Community as well as zoonoses, which are relevant on the basis of the national epidemiological situation. The report describes the monitoring systems in place and the prevention and control strategies applied in the country. For some zoonoses this monitoring is based on legal requirements laid down by the Community Legislation, while for the other zoonoses national approaches are applied. The report presents the results of the examinations carried out in the reporting year. A national evaluation of the epidemiological situation, with special reference to trends and sources of zoonotic infections, is given. Whenever possible, the relevance of findings in foodstuffs and animals to zoonoses cases in humans is evaluated. The information covered by this report is used in the annual Community Summary Report on zoonoses that is published each year by EFSA. * Directive 2003/ 99/ EC of the European Parliament and of the Council of 12 December 2003 on the monitoring of zoonoses and zoonotic agents, amending Decision 90/ 424/ EEC and repealing Council Directive 92/ 117/ EEC, OJ L 325, , p. 31 Malta

4 Report on trends and sources of zoonoses List of Contents 1 ANIMAL POPULATIONS 1 2 INFORMATION ON SPECIFIC ZOONOSES AND ZOONOTIC AGENTS SALMONELLOSIS General evaluation of the national situation Salmonellosis in humans Salmonella in foodstuffs Salmonella in animals Salmonella serovars and phagetype distribution Antimicrobial resistance in Salmonella isolates CAMPYLOBACTERIOSIS General evaluation of the national situation Campylobacteriosis in humans Campylobacter in foodstuffs Campylobacter in animals Antimicrobial resistance in Campylobacter isolates LISTERIOSIS General evaluation of the national situation Listeriosis in humans Listeria in foodstuffs E. COLI INFECTIONS General evaluation of the national situation E. coli infections in humans Escherichia coli, pathogenic in animals TUBERCULOSIS, MYCOBACTERIAL DISEASES General evaluation of the national situation Tuberculosis, mycobacterial diseases in humans Mycobacterium in animals BRUCELLOSIS General evaluation of the national situation Brucellosis in humans Brucella in animals YERSINIOSIS General evaluation of the national situation Yersiniosis in humans Yersinia in animals TRICHINELLOSIS General evaluation of the national situation Trichinellosis in humans Trichinella in animals ECHINOCOCCOSIS 53 Malta

5 Report on trends and sources of zoonoses General evaluation of the national situation Echinococcosis in humans TOXOPLASMOSIS General evaluation of the national situation Toxoplasmosis in humans RABIES General evaluation of the national situation Rabies in humans Lyssavirus (rabies) in animals Q-FEVER General evaluation of the national situation 59 3 INFORMATION ON SPECIFIC INDICATORS OF ANTIMICROBIAL ENTEROCOCCUS, NON-PATHOGENIC General evaluation of the national situation ESCHERICHIA COLI, NON-PATHOGENIC General evaluation of the national situation Antimicrobial resistance in Escherichia coli, non-pathogenic isolates 61 4 INFORMATION ON SPECIFIC MICROBIOLOGICAL AGENTS HISTAMINE General evaluation of the national situation Histamine in foodstuffs ENTEROBACTER SAKAZAKII General evaluation of the national situation Enterobacter sakazakii in foodstuffs STAPHYLOCOCCAL ENTEROTOXINS General evaluation of the national situation Staphylococcal enterotoxins in foodstuffs 64 5 FOODBORNE OUTBREAKS 65

6 Report on trends and sources of zoonoses 1. ANIMAL POPULATIONS The relevance of the findings on zoonoses and zoonotic agents has to be related to the size and nature of the animal population in the country. Malta

7 Table Susceptible animal populations Number of herds or flocks Number of slaughtered animals Livestock numbers (live animals) Number of holdings Animal species Category of animals Year Year Year Year Cattle (bovine animals) calves (under 1 year) dairy cows and heifers in total meat production animals mixed herds Deer farmed - in total Ducks breeding flocks, unspecified - in total 1) 2) elite breeding flocks 0 grandparent breeding flocks 0 in total 0 meat production flocks 0 mixed flocks/holdings parent breeding flocks 3) Gallus gallus (fowl) breeding flocks for egg production line - in total 0

8 Table Susceptible animal populations Number of herds or flocks Number of slaughtered animals Livestock numbers (live animals) Number of holdings Animal species Category of animals Year Year Year Year Gallus gallus (fowl) breeding flocks for meat production line - in total breeding flocks, unspecified - in total broilers elite breeding flocks for egg production line elite breeding flocks for meat production line elite breeding flocks, unspecified - in total grandparent breeding flocks for egg production line grandparent breeding flocks for meat production line grandparent breeding flocks, unspecified - in total in total laying hens mixed flocks/holdings 4) parent breeding flocks for egg production line 0 3

9 Table Susceptible animal populations Number of herds or flocks Number of slaughtered animals Livestock numbers (live animals) Number of holdings Animal species Category of animals Year Year Year Year Gallus gallus (fowl) Geese parent breeding flocks for meat production line parent breeding flocks, unspecified - in total breeding flocks, unspecified - in total elite breeding flocks grandparent breeding flocks in total meat production flocks mixed flocks/holdings 0 parent breeding flocks 0 Goats animals over 1 year animals under 1 year in total 5) meat production animals 6) 0 milk goats

10 Table Susceptible animal populations Number of herds or flocks Number of slaughtered animals Livestock numbers (live animals) Number of holdings Animal species Category of animals Year Year Year Year Goats mixed herds Pigs breeding animals breeding animals - unspecified - sows and gilts fattening pigs in total mixed herds Reindeers farmed - in total 7) Sheep animals over 1 year animals under 1 year (lambs) in total meat production animals 8) 9) milk ewes mixed herds Turkeys breeding flocks, unspecified - in total 10) 5

11 Table Susceptible animal populations Number of herds or flocks Number of slaughtered animals Livestock numbers (live animals) Number of holdings Animal species Category of animals Year Year Year Year Turkeys elite breeding flocks grandparent breeding flocks in total meat production flocks mixed flocks/holdings parent breeding flocks Wild boars farmed - in total 11) 12) 13) 14) 15) Comments: 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) Bovine Farms in Malta consist of dairy breeds, the males of whichare fattened for slaughter. there are no farmed deer in Malta There are no Duck operations in Malta 4 of the broiler farms are mixed holdings. These holdings are mixed farms having both goats and sheep. Although these farms are predominantly dairy and cheese produceing units they from time to time sell animals for slaughter. These holdings are mixed holdings with a small number of animals slaughtered for meat. There are no farmed or wild Reindeers in Malta These holdings are mixed farms having both goats and sheep. Although these farms are predominantly dairy and cheese produceing units they from time to time sell animals for slaughter. hese holdings are mixed holdings with a small number of animals slaughtered for meat

12 Table Susceptible animal populations 13) 14) 15) 0 0 There are no wild or farmed boar in Malta 7

13 Report on trends and sources of zoonoses 2. INFORMATION ON SPECIFIC ZOONOSES AND ZOONOTIC AGENTS Zoonoses are diseases or infections, which are naturally transmissible directly or indirectly between animals and humans. Foodstuffs serve often as vehicles of zoonotic infections. Zoonotic agents cover viruses, bacteria, fungi, parasites or other biological entities that are likely to cause zoonoses. Malta

14 2.1 SALMONELLOSIS General evaluation of the national situation Salmonellosis in humans Table Salmonella in humans - Species/serotype distribution S. Clackamas S. Croft S. Derby S. Enteritidis S. Give Salmonella Cases Cases Inc. Autochth Autochth Imported on cases on Inc. cases Imported Inc. Unknown status S. Goldcoast S. Indiana S. Infantis S. Kedougou S. Kentucky S. Livingstone S. Typhimurium S. Species S. enterica subsp. enterica

15 Table Salmonella in humans - Age distribution S. Clackamas S. Croft S. Derby S. Enteritidis S. Give Age Distribution <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years 65 years and older Age unknown Total: All M F All M F All M F All M F All M F S. Goldcoast S. Indiana S. Infantis S. Kedougou S. Kentucky All M F All M F All M F All M F All M F <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years years and older

16 Table Salmonella in humans - Seasonal distribution Month S. Clackama s S. Croft S. Derby S. Enteritidi s S. Give S. Goldcoas S. IndianaS. Infantis t S. Kedougo u S. Kentucky S. Livingsto ne S. Typhimuri um Salmonell a spp. S. enterica subsp. enterica January February March April May June July August September October Cases Cases Cases Cases Cases Cases Cases Cases Cases Cases Cases Cases Cases Cases November December Total:

17 2.1.3 Salmonella in foodstuffs Table Salmonella in poultry meat and products thereof Meat from broilers (Gallus gallus) - fresh - at slaughterhouse - Survey - EU baseline survey (acc. to C.D 516/2007) Meat from turkey - fresh - at slaughterhouse - Monitoring - official sampling (whole carcass) Meat from broilers (Gallus gallus) - fresh - at slaughterhouse - Survey - EU baseline survey (acc. to C.D 516/2007) 1) 2) 1) Source of information S. Kottbus Sampling unit slaughter 25g slaughter 25g 1 0 S. Typhimuriu m Sample weight Salmonella spp., unspecified Units tested Total units positive for Salmonella spp. S. Bredeney S. Enteritidis S. Hadar S. Haifa S. Infantis S. Kentucky Meat from turkey - fresh - at slaughterhouse - Monitoring - official sampling (whole carcass) 2) Comments: 1) 2) There are only 4 slaughterhouses in Malta, samples were taken through simple randomisation proportionaltely according to their annual production. In 2008 only one slaughter batch of 300 birds was slaughtered in december. The other dya-olds imported were sold to indiviuals to be fattened for own consumption. Footnote: 10 isolates were not typed since the cultures could not be regenerated. 14

18 2.1.4 Salmonella in animals Table Salmonella in breeding flocks of Gallus gallus Footnote: No breeding flocks present in the region of Malta 15

19 Table Salmonella in other poultry Footnote: No salmonella controle programmes were carried out in poultry in

20 2.1.5 Salmonella serovars and phagetype distribution The methods of collecting, isolating and testing of the Salmonella isolates are described in the chapters above respectively for each animal species, foodstuffs and humans. The serotype and phagetype distributions can be used to investigate the sources of the Salmonella infections in humans. Findings of same serovars and phagetypes in human cases and in foodstuffs or animals may indicate that the food category or animal species in question serves as a source of human infections. However as information is not available from all potential sources of infections, conclusions have to be drawn with caution. Table Salmonella Enteritidis phagetypes in humans Footnote: Phage typing is not performed in Malta 17

21 Table Salmonella Typhimurium phagetypes in humans Footnote: Phage typing is not performed in Malta. 18

22 2.1.6 Antimicrobial resistance in Salmonella isolates Table Antimicrobial susceptibility testing of Salmonella in humans, Salmonella Typhimurium S. Typhimurium Aminoglycosides Fluoroquinolones Penicillins Trimethoprim Isolates out of a monitoring program (yes/no) Number of isolates available in the laboratory Antimicrobials: Gentamicin Ciprofloxacin Ampicillin Trimethoprim humans no 44 N n

23 Table Breakpoints for antibiotic resistance testing Test Method Used Standards used for testing Disc diffusion NCCLS Agar dilution Broth dilution E-test Aminoglycosides Fluoroquinolones Penicillins Trimethoprim Gentamicin Ciprofloxacin Ampicillin Trimethoprim Standard for breakpoint Breakpoint concentration (microg/ml) Range tested<br/>concentration (microg/ml) Disk content Breakpoint Zone diameter (mm) Susceptible <= Intermediate Resistant > lowest highest microg Susceptible >= Intermediate Resistant <= 20

24 2.2 CAMPYLOBACTERIOSIS General evaluation of the national situation Campylobacteriosis in humans Table Campylobacter in humans - Species/serotype distribution C. coli C. jejuni C. upsaliensis C. fetus Campylobacter Campylobacter spp., unspecified Cases Cases Inc. Autochth Autochth Imported on cases on Inc. cases Imported Inc. Unknown status

25 Table Campylobacter in humans - Age distribution <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years 65 years and older Age unknown Total: Age Distribution C. coli C. jejuni C. fetus C. upsaliensis Campylobacter spp., unspecified All M F All M F All M F All M F All M F

26 Table Campylobacter in humans - Seasonal distribution January February March April May June July August September Month C. coli C. jejuni C. upsaliens is C. fetus Campylob acter spp., unspecifi ed Cases Cases Cases Cases Cases October November December not known Total:

27 2.2.3 Campylobacter in foodstuffs Table Campylobacter in poultry meat Meat from broilers (Gallus gallus) - fresh - at slaughterhouse - Survey - EU baseline survey (1 carcass after chilling per sampling batch tested) Meat from turkey - fresh - at slaughterhouse - Monitoring - official sampling (1 carcass after chilling per slaughter batch tested) Comments: 1) 1) Source of information Sampling unit Sample weight Units tested Total units positive for thermophilic Campylobac ter spp. slaughter 25g slaughter 25g C. coli C. jejuni C. lari C. upsaliensis only one slaughterbatch of 300 birds was slaughtered throughout the year. other birds fattened were in very small numbers for own consumption Thermophili c Campylobac ter spp., unspecified 24

28 2.2.4 Campylobacter in animals Table Campylobacter in animals Gallus gallus (fowl) - broilers - at slaughterhouse - animal sample - caecum - Survey - EU baseline survey (10 caeca per slaughter batch samlpled) Turkeys - at slaughterhouse - animal sample - caecum - Monitoring - official sampling - objective sampling (10 caeca collected from the slaughter batch) Comments: 1) In 2008, only one slaughter batch of300 birds was slaughtered. 1) Source of information Sampling unit Units tested Total units positive for thermophilic Campylobac ter spp. slaughter slaughter C. coli C. jejuni C. lari C. upsaliensis Thermophili c Campylobac ter spp., unspecified 25

29 2.2.5 Antimicrobial resistance in Campylobacter isolates Table Antimicrobial susceptibility testing of C. coli - qualitative data C. coli Aminoglycosides Fluoroquinolones Macrolides Tetracyclines Isolates out of a monitoring program (yes/no) Number of isolates available in the laboratory Antimicrobials: Gentamicin Streptomycin Ciprofloxacin Erythromycin Tetracyclin Gallus gallus (fowl) - at slaughterhou se - Survey - EU baseline survey yes 83 N n

30 Table Antimicrobial susceptibility testing of C. coli in Gallus gallus (fowl) - at slaughterhouse - Survey - EU baseline survey - quantitative data [Dilution method] C. coli Gallus gallus (fowl) - at slaughterhouse - Survey - EU baseline survey Aminoglycosides Fluoroquinolones Macrolides Penicillins Quinolones Tetracyclines Isolates out of a monitoring program (yes/no) Number of isolates available in the laboratory Antimicrobials: Gentamicin Streptomycin Ciprofloxacin Erythromycin Ampicillin Nalidixic acid Tetracyclin yes break points N n <= >2048 lowest highest

31 Table Antimicrobial susceptibility testing of C. jejuni in Gallus gallus (fowl) - at slaughterhouse - Survey - EU baseline survey - quantitative data [Dilution method] C. jejuni Gallus gallus (fowl) - at slaughterhouse - Survey - EU baseline survey Aminoglycosides Fluoroquinolones Macrolides Penicillins Quinolones Tetracyclines Isolates out of a monitoring program (yes/no) Number of isolates available in the laboratory Antimicrobials: Gentamicin Streptomycin Ciprofloxacin Erythromycin Ampicillin Nalidixic acid Tetracyclin yes break points N n <= >2048 lowest highest

32 Table Antimicrobial susceptibility testing of C. jejuni - qualitative data C. jejuni Aminoglycosides Fluoroquinolones Macrolides Tetracyclines Isolates out of a monitoring program (yes/no) Number of isolates available in the laboratory Antimicrobials: Gentamicin Streptomycin Ciprofloxacin Erythromycin Tetracyclin Gallus gallus (fowl) - at slaughterhou se - Survey - EU baseline survey yes 40 N n

33 Table Antimicrobial susceptibility testing of Campylobacter in humans Campylobacter spp., unspecified Macrolides Isolates out of a monitoring program (yes/no) Number of isolates available in the laboratory Antimicrobials: Erythromycin humans no 22 N n

34 Table Breakpoints used for antimicrobial susceptibility testing Test Method Used Standards used for testing Disc diffusion VetMIC Agar dilution Broth dilution E-test Aminoglycosides Fluoroquinolones Macrolides Quinolones Gentamicin Streptomycin Ciprofloxacin Erythromycin Nalidixic acid Standard for breakpoint Breakpoint concentration (microg/ml) Range tested<br/>concentration (microg/ml) Disk content Breakpoint Zone diameter (mm) Susceptible <= Intermediate Resistant > lowest highest microg Susceptible >= Intermediate Resistant <= Tetracyclines Tetracyclin

35 Table Breakpoints used for antimicrobial susceptibility testing Test Method Used Standards used for testing Disc diffusion VetMIC Agar dilution Broth dilution E-test Aminoglycosides Fluoroquinolones Macrolides Quinolones Gentamicin Streptomycin Ciprofloxacin Erythromycin Nalidixic acid Standard for breakpoint Breakpoint concentration (microg/ml) Range tested<br/>concentration (microg/ml) Disk content Breakpoint Zone diameter (mm) Susceptible <= Intermediate Resistant > lowest highest microg Susceptible >= Intermediate Resistant <= Tetracyclines Tetracyclin

36 Table Breakpoints used for antimicrobial susceptibility testing Test Method Used Standards used for testing Disc diffusion NCCLS Agar dilution Broth dilution E-test Macrolides Erythromycin Standard for breakpoint Breakpoint concentration (microg/ml) Range tested<br/>concentration (microg/ml) Disk content Breakpoint Zone diameter (mm) Susceptible <= Intermediate Resistant > lowest highest microg Susceptible >= Intermediate Resistant <= 33

37 2.3 LISTERIOSIS General evaluation of the national situation Listeriosis in humans Table Listeria in humans - Species/serotype distribution Listeria spp. Congenital cases Deaths Listeria Cases Cases Inc

38 Table Listeria in humans - Age distribution L. monocytogenes Listeria spp. Age Distribution <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years 65 years and older Age unknown Total: All M F All M F 35

39 2.3.3 Listeria in foodstuffs Table Listeria monocytogenes in milk and dairy products Cheeses made from goats' milk - soft and semisoft - made from pasteurised milk - at retail - Monitoring - official sampling - objective sampling Source of information Sampling unit Sample weight Units tested Total units positive for L.monocyto genes Laboratory batch Units tested with detection method Listeria monocytoge nes presence in x g Units tested with enumeration method > detection limit but <= 100 cfu/g L. monocytoge nes > 100 cfu/g 36

40 2.4 E. COLI INFECTIONS General evaluation of the national situation E. coli infections in humans Table Escherichia coli, pathogenic in humans - Age distribution Escherichia coli, pathogenic HUS - clinical cases - lab. confirmed cases - caused by O157 (VT+) - caused by other VTEC Cases Cases Inc. Autochth Autochth Imported on cases on Inc. cases Imported Inc. - clinical cases - laboratory confirmed - caused by 0157 (VT+) - caused by other VTEC

41 Table Escherichia coli, pathogenic in humans - Species/serotype distribution Verotoxigenic E. coli (VTEC) VTEC O157:H7 VTEC non-o157 Age Distribution <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years 65 years and older Age unknown Total: All M F All M F All M F

42 2.4.3 Escherichia coli, pathogenic in animals 2.5 TUBERCULOSIS, MYCOBACTERIAL DISEASES General evaluation of the national situation Tuberculosis, mycobacterial diseases in humans Table Mycobacterium in humans - Species/serotype distribution M. bovis Mycobacterium M. tuberculosis Cases Cases Inc. Autochth Autochth Imported on cases on Inc. cases Imported Inc

43 Table Mycobacterium in humans - Age distribution M. bovis M. tuberculosis Age Distribution <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years 65 years and older Age unknown Total: All M F All M F Footnote: It should be noted that human cases of TB include pulmonary and non-pulmonary cases, while 73% of the cases were in migrants of African origin. 40

44 2.5.3 Mycobacterium in animals Table Tuberculosis in other animals Goats - - blood - Control and eradication programmes - official sampling (587) Comments: 1) All caprine animals over 6 months present on dairy farms are tested 1) Source of information Sampling unit Units tested Total units positive for Mycobacteri um spp. flock 23 0 M. bovis M. tuberculosis Mycobacteri um spp., unspecified 41

45 Table Bovine tuberculosis in countries and regions that do not receive Community co-financing for eradication programmes Malta Total Total - 1 Region Footnote: Total number Indicators of existing bovine Herds Animals Officially free herds Number of herds % Number of herds Infected herds % Routine tuberculin testing Interval between routine tuberculin tests Number of animals tested Number of tuberculin tests carried out before the introduction into the herds (Annex A(I)(2)(c) third indent (1) of Directive 64/432/EEC) Number of animals with suspicious lesions of tuberculosis examined and submitted to histopathologic al and bacteriological examinations Number of animals detected positive in bacteriological examination Animals are tested every 6 months.tb testing is carried out on only those farms that are milk producers that total to 150 herds. The rest of the herds consist of mainly ovine caprine herds whic also have a few bovine animals that are kept for fattening. These units have mainly males for meat production. 42

46 Table Tuberculosis in farmed deer Footnote: No farmed deer present in Malta 43

47 2.6 BRUCELLOSIS General evaluation of the national situation Brucellosis in humans Table Brucella in humans - Species/serotype distribution B. abortus B. melitensis B. suis Brucella Occupational cases Cases Cases Inc. Autochth Autochth Imported on cases on Inc. cases Imported Inc. 44

48 Table Brucella in humans - Age distribution B. abortus B. melitensis Brucella spp. Age Distribution <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years 65 years and older Age unknown Total: All M F All M F All M F

49 2.6.3 Brucella in animals Table Bovine brucellosis in countries and regions that do not receive Community co-financing for eradication programme Region Malta Total Total - 1 Total number of existing bovine Herds Animals Officially free herds Number of herds % Infected herds Number of herds % Number of bovine herds tested Serological tests Number of animals tested Surveillance Number of infected herds Examination of bulk milk Information about Epidemiological investigation Number of bovine herds tested Number of animals or pools tested Number of infected herds Number of notified abortions whatever cause Number of isolations of Brucella infection Number of abortions due to Brucella abortus Investigations of suspect cases Number of animals tested with serologic al blood tests Number of suspende d herds Number of positive animals Sero logically BST Number Number of animals of animals examined positive microbio microbio logically logically

50 Table Ovine or Caprine Brucellosis in countries and regions that do not receive Community co-financing for eradication programme Total number of existing Officially free herds Infected herds Surveillance Investigations of suspect cases Malta Total Total - 1 Region Footnote: Herds Data relative to ovicaprine herds Animals Number of herds % Number of herds % Number of herds tested Number of animals tested Number of infected herds Number of animals tested with serological blood tests Number of animals positive serologically Number of animals examined microbio logically Number of animals positive microbio logically Number of suspended herds 47

51 2.7 YERSINIOSIS General evaluation of the national situation Yersiniosis in humans Table Yersinia in humans - Species/serotype distribution Y. enterocolitica O:3 O:9 Yersinia Cases Cases Inc. Autochth Autochth Imported on cases on Inc. cases Imported Inc. 48

52 Table Yersinia in humans - Age distribution Y. enterocolitica Yersinia spp. Age Distribution <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years 65 years and older Age unknown Total: All M F All M F 49

53 Table Yersinia in humans - Seasonal distribution January February March April May June July August September October Month Y. Yersinia enterocoli spp. tica Cases Cases November December not known Total:

54 2.7.3 Yersinia in animals 2.8 TRICHINELLOSIS General evaluation of the national situation Trichinellosis in humans Table Trichinella in humans - Species/serotype distribution Trichinella spp. Trichinella Cases Cases Inc. Autochth Autochth Imported on cases on Inc. cases Imported Inc. 51

55 Table Trichinella in humans - Age distribution Trichinella spp. Age Distribution <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years 65 years and older Age unknown Total: All M F

56 2.8.3 Trichinella in animals 2.9 ECHINOCOCCOSIS General evaluation of the national situation Echinococcosis in humans Table Echinococcus in humans - Species/serotype distribution Echinococcus E. granulosus E. multilocularis Echinococcus spp. Cases Cases Inc. Autochth Autochth Imported on cases on Inc. cases Imported Inc. 53

57 Table Echinococcus in humans - Age distribution E. granulosus E. multilocularis Echinococcus spp. Age Distribution <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years 65 years and older Age unknown Total: All M F All M F All M F

58 2.10 TOXOPLASMOSIS General evaluation of the national situation Toxoplasmosis in humans Table Toxoplasma in humans - Species/serotype distribution Toxoplasma Toxoplasma spp. Congenital cases Cases Cases Inc

59 Table Toxoplasma in humans - Age distribution Toxoplasma spp. Age Distribution <1 year 1 to 4 years 5 to 14 years 15 to 24 years 25 to 44 years 45 to 64 years 65 years and older Age unknown Total: All M F

60 Report on trends and sources of zoonoses 2.11 RABIES General evaluation of the national situation A. Rabies general evaluation History of the disease and/or infection in the country Last rerported rabies case at the beginning of the 20th century! Malta

61 Report on trends and sources of zoonoses Rabies in humans A. Rabies in humans Reporting system in place for the human cases Rabies is still a notifiable disease in Malta. ECDC definition holds Malta

62 Report on trends and sources of zoonoses Lyssavirus (rabies) in animals 2.12 Q-FEVER General evaluation of the national situation A. Coxiella burnetii (Q-fever) general evaluation History of the disease and/or infection in the country No reported cases in recent years. Malta

63 Report on trends and sources of zoonoses 3. INFORMATION ON SPECIFIC INDICATORS OF ANTIMICROBIAL RESISTANCE Malta

64 3.1 ENTEROCOCCUS, NON-PATHOGENIC General evaluation of the national situation 3.2 ESCHERICHIA COLI, NON-PATHOGENIC General evaluation of the national situation Antimicrobial resistance in Escherichia coli, non-pathogenic Table Antimicrobial susceptibility testing of E. coli in humans E. coli Isolates out of a monitoring program (yes/no) Number of isolates available in the laboratory Antimicrobials: humans no 14 N n Aminoglycosides Gentamicin 11 0 Fluoroquinolones Ciprofloxacin 11 0 Penicillins Ampicillin 11 1 Trimethoprim Trimethoprim + sulfonamides Trimethoprim Trimethoprim + sulfonamides

65 Report on trends and sources of zoonoses 4. INFORMATION ON SPECIFIC MICROBIOLOGICAL AGENTS Malta

66 4.1 HISTAMINE General evaluation of the national situation Histamine in foodstuffs 4.2 ENTEROBACTER SAKAZAKII General evaluation of the national situation Enterobacter sakazakii in foodstuffs Table Enterobacter sakazakii in food Source of information Sampling unit Sample weight Total units positive for Units tested E. sakazakii Enterobacter sakazakii Infant formula - dried - at retail - imported - Surveillance laboratory batch 25g

67 4.3 STAPHYLOCOCCAL ENTEROTOXINS General evaluation of the national situation Staphylococcal enterotoxins in foodstuffs 64

68 Report on trends and sources of zoonoses 5. FOODBORNE Foodborne outbreaks are incidences of two or more human cases of the same disease or infection where the cases are linked or are probably linked to the same food source. Situation, in which the observed human cases exceed the expected number of cases and where a same food source is suspected, is also indicative of a foodborne outbreak. Malta

69 Report on trends and sources of zoonoses Foodborne Outbreaks: summarized data Total number of outbreaks Outbreaks Human cases Hospitalized Deaths Number of verified outbreaks Bacillus Campylobacter Clostridium Escherichia coli, pathogenic Foodborne viruses Listeria Other agents Parasites Salmonella Staphylococcus Unknown Yersinia Malta