Salmonella monitoring data, food-borne outbreaks and antimicrobial resistance data for 2014 in the European Union

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Salmonella monitoring data, food-borne outbreaks and antimicrobial resistance data for 2014 in the European Union Valentina Rizzi BIOMO team, BIOCONTAM Unit, EFSA 21 st EURL-Salmonella workshop 9 June 2016, Saint Malo, France

OUTLINE EUSR production Zoonoses Data Models and Picklists Production Criteria EU Summary tables EUSRs zoonoses-fbo and AMR, 2014 New format Main findings

EU ANNUAL ZOONOSES MONITORING: DATA FLOW

EU ANNUAL ZOONOSES MONITORING: REPORTING TOOLS The EFSA web application and the Data Collection Framework (DCF) and reporting manuals provide the format of the reporting (standardised tables, categorisations of food and animals, definitions) From 2016

OUTLINE EUSR production Zoonoses Data Models and Picklists Production Criteria EU Summary tables EUSRs zoonoses-fbo and AMR, 2014 New format Main findings

EUSRS NEW FORMAT More concise 170 pp. EUSR tables without marked observations: only referenced in Appendix and hyperlinked (~ EFSA data roadmap)

EUSRS NEW FORMAT EU Salmonella monitoring data

Zoonoses EU Salmonella monitoring data HUMAN ZOONOSES CASES IN EU, 2014 Campylobacteriosis (N = 236,851) Salmonellosis (N = 88,715) Yersiniosis (N = 6,625) Yersiniosis (N = 6,625 VTEC infections (N = 5,955) VTEC infections (N = 5,955) Listeriosis (N = 2,161) Listeriosis Echinococcosis (N = 2,161) (N = 801) Echinococcosis (N = 801) Q fever (N = 777) Q fever (N = 777) Tularaemia (N = 480) Tularaemia (N = 480 Brucellosis Trichinellosis (N = 347) (N = 319) Brucellosis (N = 347) TB caused by M. bovis (N = 145) Trichinellosis TB caused by M. bovis West Nile fever (N = 319) (N = 145) (N = 77) West Nile fever (N = 77) Rabies (N = 3) 0.00 1.00 2.00 3.00 Notification rate per 100,000 population Rabies (N = 3) 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0 55.0 60.0 65.0 70.0 75.0 Notification rate per 100,000 population

REPORTED HOSPITALISATION AND CASE-FATALITY RATES DUE TO ZOONOSES IN CONFIRMED HUMAN CASES IN THE EU, 2014 Disease Number of confirmed 1 human cases Status available (%) Hospitalisation Number of reporting MSs 2 Reported hospitalised cases Proportion hospitalised (%) Outcome available (%) Number of reporting MSs 2 Reported deaths Case-fatality (%) Campylobacteriosis 236,851 25.4 16 18,303 30.4 73.6 15 25 0.01 Salmonellosis 88,715 32.2 14 9,830 34.4 49.6 15 65 0.15 Yersiosis 6,625 15.2 12 442 44.0 58.3 14 5 0.13 VTEC infections 5,955 39.9 15 930 39.2 58.6 18 7 0.20 Listeriosis 2,161 38.0 16 812 98.9 64.8 20 210 15.0 Echinococcosis 801 24.0 14 122 63.5 24.6 12 1 0.51 Q fever 777 NA NA NA NA 51.2 11 1 0.26 Brucellosis 347 62.0 9 142 66.1 41.5 10 0 0 Tularaemia 480 47.1 8 92 40.7 49.0 9 0 0 Trichinellosis 319 74.6 5 150 63.0 74.9 6 2 0.84 West Nile fever 1 77 66.2 6 48 94.1 66.2 6 7 13.7 Rabies 3 NA NA NA NA 66.6 3 2 100 Deaths 1. Exception: West Nile fever w here total number of cases w ere included. 2. Not all countries observed cases for all diseases NA not applicable as the information is not collected for this disease.

SALMONELLOSIS IN HUMANS Salmonellosis on the decline There was a statistically significant decreasing trend of salmonellosis in the 7- year period of 2008-2014.

SALMONELLA IN FOOD, IN THE EU, 2014 Food samples not complying with the EU Salmonella criteria, 2011-2014 Minced meat and meat preparations intended to be eaten raw (3 MS, N=168) Minced meat and meat preparations from poultry intended to be eaten cooked (11 MS, N=1,418) Minced meat and meat preparations from other species than poultry intended to be eaten cooked (14 MS, N= 3,901) Mechanically separated meat (1 MS, N=13) Meat products intended to be eaten raw (6 MS, N=1,234) Meat products from poultry meat intended to be eaten cooked (6 MS, N=346) Gelatine and collagen (3 MS, N=7784) % non-compliant single samples 0 1 2 3 4 5 6 7 8 9 Cheeses, butter and cream made from raw or low heat-treated milk (7 MS, N=830) Milk powder and whey powder (3 MS, N=107) Ice-cream (13 MS, N=8,261) 2011 2012 2013 2014 Single samples Egg products (7 MS, N=625) Ready-to-eat foods containing raw egg (3 MS, N=145) Cooked crustaceans and molluscan shellfish (4 MS, N=344) Live bivalve molluscs and live echinoderms, tunicates and gastropods (3 MS, N=95) Ready-to-eat sprouted seeds (2 MS, N=87) Ready-to-eat pre-cut fruit and vegetables (9 MS, N=1,517) Ready-to-eat unpasteurised fruit and vegetable juices (5 MS, N=333) Dried infant formulae, and dried dietary foods for medical purposes (9 MS, N=859) Fresh poultry meat (15 MS, N=2,591)

SALMONELLA IN FOOD, IN THE EU, 2014 In fresh poultry meat, subject to a Salmonella criterion for S. Enteritidis and S. Typhimurium, the reported non-compliance decreased to 0.1% in single samples and remained at 0.2% in batches. No major change as regards the contamination of foodstuffs with Salmonella spp. compared with previous years. Salmonella was most frequently detected in poultry meat, and less often in pig or bovine meat. The highest proportions of Salmonella-positive single samples were reported for fresh turkey meat (3.5%) followed by fresh broiler meat (2.2%), pig meat (0.6%) and bovine meat (0.1%). Salmonella was rarely found in table eggs, at levels of 0.3% (single samples) or 1.0% (batch samples). However, eggs and egg products were the most important source of food-borne Salmonella outbreaks. Salmonella was also detected in other foods, including ready-to-eat (RTE) foods, at low to very low levels.

SALMONELLA IN ANIMALS, IN THE EU, 2014 Breeding flocks: 21 MS met the Salmonella reduction target and the EU prevalence for the five target serovars was 0.6%. Flocks of laying hens: 23 MS met their relative Salmonella reduction targets and the EU prevalence for the two target serovars (S. Enteritidis and S. Typhimurium) was further reduced from 1.0% in 2013 to 0.9% in 2014. Broiler flocks: 21 MS met the reduction target and the EU prevalence for the two target serovars was 0.2%, the same as in 2013. Turkey breeding flocks: all 15 MS which reported data on met the target, with an overall prevalence of 0.2% for the two target serovars (0.3% in 2013). Fattening turkey flocks: 21 MS met the target for before slaughter. At the EU level, 0.2% of the fattening turkey flocks were infected with the two target serovars, the same as in 2013.

EU flock prevalence EU Salmonella monitoring data PREVALENCE OF TARGET SALMONELLA SEROVARS IN POULTRY AND TURKEYS, IN THE EU Prevalence of S. Enteritidis, S. Typhimurium, S. Infantis, S. Virchow and/or S. Hadar-positive breeding flocks of Gallus gallus during production in the EU, 2007-2014; of S. Enteritidis and/or S. Typhimurium-positive laying hen flocks, broiler flocks, flocks of breeding and fattening turkeys, during the production period in the EU, 2008-2014 4 3.5 3 2.5 2 Breeding hen flocks Laying hen flocks Broiler flocks Flocks of breeding turkeys Flocks of fattening turkeys 1.5 1 0.5 0 2007 2008 2009 2010 2011 2012 2013 2014 Year

SALMONELLA SEROVARS IN HUMANS Distribution of reported confirmed cases of human salmonellosis in the EU/EEA, 2012 2014, by the 20 most frequent serovars in 2014 Serovar 2012 2013 2014 Cases MSs % Cases MSs % Cases MSs % Enteritidis 33,850 27 41.2 29,090 27 39.5 33,965 27 44.3 Typhimurium 18,216 27 22.2 14,852 27 20.2 14,284 27 18.6 Monophasic Typhimurium 1.4.[5].12:i:- 5,932 12 7.2 6,313 14 8.6 5,851 14 7.6 Infantis 2,007 26 2.4 2,226 25 3.0 1,846 26 2.4 Newport 770 21 0.9 714 21 1.0 770 20 1.0 Stanley 1,115 20 1.4 813 21 1.1 757 23 1.0 Derby 732 21 0.9 818 21 1.1 755 23 1.0 Kentucky 647 23 0.8 651 23 0.9 606 21 0.8 Virchow 544 20 0.7 571 22 0.8 509 22 0.7 Bovismorbificans 421 20 0.5 412 20 0.6 442 22 0.6 Agona 470 18 0.6 581 24 0.8 380 23 0.5 Saintpaul 372 18 0.5 401 18 0.5 379 19 0.5 Muenchen 253 20 0.3 448 17 0.6 371 17 0.5 Napoli 376 16 0.5 434 14 0.6 333 14 0.4 Brandenburg 303 17 0.4 290 17 0.4 297 20 0.4 Chester 106 12 0.1 111 13 0.2 294 18 0.4 Hadar 307 20 0.4 267 19 0.4 287 16 0.4 Java 316 11 0.4 238 10 0.3 280 9 0.4 Braenderup 254 17 0.3 245 19 0.3 276 17 0.4 Oranienburg 315 16 0.4 274 15 0.4 261 17 0.3 Other 14,877-18.1 13,883-18.9 13,724-17.9 Total 82,183 27 100.0 73,632 27 100.0 76,667 27 100.0 Source: 25 MS and tw o non-ms-austria, Belgium, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norw ay, Portugal, Romania, Slovakia, Slovenia, Spain, Sw eden and United Kingdom.

SANKEY DIAGRAM OF REPORTED SALMONELLA SEROVAR ISOLATES, IN ANIMAL SPECIES, FOOD OF ANIMAL ORIGIN AND ANIMAL FEEDINGSTUFFS, BY MATRIX, EU, 2014

SALMONELLA SEROVAR DESCRIPTIVE ANALYSES, DATA BETWEEN 2010 AND 2014 Data were collated into 13 matrices: chickens (Gallus gallus), broiler flocks, broiler meat, turkeys, turkey meat, pigs, pig meat, cattle, bovine meat and compound feed for chickens, turkeys, pigs and cattle. Salmonella spp. were isolated from all matrices except compound feed for turkeys. In each category, only the ten most common serovars from 2014 are listed, and all other isolates are referred to under other serovars. This means that data on low prevalence MS is not covered. In this context it should be noted that some MS do not fully serotype all isolates, which means that some isolates from the top ten serovars may be included under other serovars in those MS. MS are obliged to report the five regulated serovars (S. Enteritidis, S. Typhimurium, S. Hadar, S. Virchow and S. Infantis) for breeding chickens, while for other poultry production sectors, only S. Enteritidis and S. Typhimurium are regulated serovars. Therefore, some MS only report S. Enteritidis and S. Typhimurium for categories other than breeding chickens, including broiler chickens, laying hens and broiler meat. This results in a possible bias towards the regulated serovars (S. Enteritidis and S. Typhimurium) for some MS. It also implies that the true occurrence of serovars other than the regulated ones is uncertain.

SALMONELLA TRENDS FROM GALLUS GALLUS BETWEEN 2010 AND 2014 The most commonly reported serovar in Gallus gallus was S. Infantis, accounting for 2,057 or 38.3% of isolates, followed by S. Mbandaka (651 isolates; 12.1%) and S. Enteritidis (641 isolates; 11.9%). S. Livingstone and S. Typhimurium were reported from 360 (6.7%) and 209 isolates (4.8%), respectively. While the number of S. Enteritidis and S. Typhimurium reports has steadily declined over the past five years, the number of reported S. Infantis isolates has increased and is now more than double that reported in 2010.

DISTRIBUTION OF S. INFANTIS REPORTED FROM GALLUS GALLUS, IN THE EU 2014 S. Infantis (~ proportion of all isolates from Gallus gallus). As described previously, the proportion of S. Infantis isolates is highest in some MS in Central and Eastern Europe, with Slovenia and Romania reporting the highest relative percentages. Note: Number of units with serotyped Salmonella isolates; Austria (160), Belgium (233), Bulgaria (8), Cyprus (63), Czech Republic (231), Denmark (33), France (81), Germany (67), Greece (72), Hungary (63), Latvia (9), Poland (127), Iceland (14), Italy (1,582), Norway (4), Romania (1,735), Slovenia (155), Spain (109) and United Kingdom (563).

DISTRIBUTION OF S. KENTUCKY REPORTED FROM GALLUS GALLUS, IN THE EU, 2014 S. Kentucky (~ proportion of all isolates from Gallus gallus). Although relative percentages are significantly lower compared to S. Infantis, clustering can be seen in Southern, Central and Eastern European MS. Note: Number of units with serotyped Salmonella isolates; Austria (160), Belgium (233), Cyprus (63), Czech Republic (231), Italy (1,582), Romania (1,735) and Spain (109).

SALMONELLA TRENDS IN BROILER MEAT BETWEEN 2010 AND 2014 Reporting of these non-regulated serovars seems to be inconsistent over the years, with some countries reporting in one year but not in others. This may be due to changes in serotyping priorities, changes in reporting serovars other than the regulated ones or the fact that only the 10 most common serovars are reported by name each year by EFSA. In some cases, individual MS may run intensive monitoring programmes in one year, leading to a higher number of isolates, but may not do so in the following year.

DISTRIBUTION OF S. INFANTIS REPORTED FROM BROILER MEAT, IN THE EU, 2014 S. Infantis (~ proportion of all isolates from broiler meat): clustering in Central and Eastern European MS can be seen, with Austria, Hungary, Bulgaria and Romania all reporting around 90% of broiler meat isolates as S. Infantis. Note: Number of units with serotyped Salmonella isolates; Austria (41), Belgium (53), Bulgaria (55), Czech Republic (312), Denmark (5), Estonia (2), Germany (20), Hungary (207), Iceland (1), Netherlands (39), Romania (96), Slovakia (124), Spain (125) and Switzerland (4).

FOODBORNE OUTBREAKS IN EU, 2014 In 2014, a total of 5,251 food-borne outbreaks reported in EU 45,665 human cases, 6,438 hospitalisations and 27 deaths reported Unknown Viruses Salmonella Bacterial toxins Campylobacter Other causative agents Escherichia coli, pathogenic (including VTEC) Other bacterial agents Parasites 2008 2009 2010 2011 2012 2013 2014 Yersinia Number of outbreaks As in previous years, eggs and egg products was the most common food vehicle associated with strong-evidence outbreaks (18.2%), followed by mixed food (12.8%), crustaceans, shellfish, molluscs and products thereof (8.1%) and vegetables and juices (7.1%).

SALMONELLA OUTBREAKS IN EU, 2014 1,048 outbreaks reported (from 23 MSs) 20 % of the total number of reported outbreaks in EU 44.4% decrease since 2008 Overall, the outbreaks involved 9,226 cases, 1,944 hospitalisations and 14 deaths. 225 outbreaks with strong evidence Fatal cases were reported in 8 outbreaks: 5 with strong-evidence two caused by S. Enteritidis PT14b (4) one due to S. Enteritidis PT8 (2) one due to S. Muenchen (4) one due to Salmonella not typeable (1) 3 with weak evidence one due to S. Enteritidis (1) two due to Salmonella spp., unspecified (2) 24

SALMONELLA OUTBREAKS, EU, 2014 As in previous years, eggs and egg products were the most frequently identified food vehicles. Bakery products accounted for 12.9% outbreaks (5.1% in 2013) and pig meat and products thereof for 9.3% of the outbreaks (as in 2013). In addition, in 2014, one waterborne strong-evidence outbreak caused by Salmonella was reported. Distribution of food vehicles in strong-evidence outbreaks Meat and meat products, 3.1% Sweets and chocolate, 3.1% Cheese, 3.1% Broiler meat (Gallus gallus) and products thereof, 3.6% Mixed food Other foodstuffs Buffet meals, 2.7% 6.2% 6.7% Bovine meat and products thereof, 2.2% 44.0% Vegetables and juices and other products thereof, 1.3% Milk, 0.9% Crustaceans, shellfish, molluscs and products thereof, 0.9% Eggs and egg products Pig meat and products thereof 9.3% 12.9% N=225 Bakery products 25

SALMONELLOSIS Decline of salmonellosis in humans attributed to success of the Salmonella control programmes in poultry implemented in all EU Member States most EU Member States met the target set for the reduction of Salmonella in poultry flocks for 2014 in fresh poultry meat, compliance with EU Salmonella criteria increased Member States investments in control measures is yielding noticeable results INTEGRATED APPROACH

2014 EUSR AMR SALMONELLA spp. in a nutshell! Specific focus on poultry populations in 2014 Frequent resistance to Fluoroquinolones observed Low resistance to other Critically Important Antimicrobials Low occurrence of ESBL/AmpC producers No carbapenemase producers detected Transferable resistance to colistin recently reported Continually evolving threat from emerging AMR Need to review the data collected, interpret the findings and assess trends

MARKED VARIATIONS between Salmonella serovars S. Infantis and S. Kentucky o contribute significantly to the overall numbers of multi-resistant Salmonella o both display high-level resistance to Ciprofloxacin between reporting countries Higher resistance in Eastern and Southern Europe

FREQUENCY DISTRIBUTION S vs. R (1-9 ABs) Salmonella spp. laying hens Salmonella spp. broilers Salmonella spp. broilers meat Salmonella spp. turkeys Salmonella spp. turkeys meat

EMERGING RESISTANCE MECHANISMS Salmonella spp. N=2,293 N=872 Low occurrence of ESBL/AmpC producers! No Carbapenemaseproducers!

RESISTANCE TO COLISTIN IN SALMONELLA According to WGS analyses performed at the EURL-AR, Colistin resistance gene mcr-1 present in some isolates of different serotypes analysed

THANKS FOR YOUR ATTENTION! EFSA is committed to: Excellence, Independency, Responsiveness and Transparency Acknowledgements: ECDC BIOCONTAM Unit DATA Unit Member States External contractors EURL AMR www.efsa.europa.eu Contacts in EFSA Valentina.Rizzi@efsa.europa.eu zoonoses@efsa.europa.eu