GREECE TRENDS AND SOURCES OF ZOONOSES AND ZOONOTIC AGENTS IN HUMANS, FOODSTUFFS, ANIMALS AND FEEDINGSTUFFS

GREECE 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 203

Greece - 203 Report on trends and sources of zoonoses INFORMATION ON THE REPORTING AND MONITORING SYSTEM Country: Greece Reporting Year: 203 Greece - 203

Greece - 203 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 Greece during the year 203. 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 2 December 2003 on the monitoring of zoonoses and zoonotic agents, amending Decision 90/ 424/ EEC and repealing Council Directive 92/ 7/ EEC, OJ L 325, 7..2003, p. 3 Greece - 203

Greece - 203 Report on trends and sources of zoonoses List of Contents ANIMAL POPULATIONS 2 INFORMATION ON SPECIFIC ZOONOSES AND ZOONOTIC AGENTS 7 2. SALMONELLOSIS 8 2.. General evaluation of the national situation 8 2..2 Salmonellosis in humans 3 2..3 Salmonella in foodstuffs 5 2..4 Salmonella in animals 27 2..5 Salmonella in feedingstuffs 43 2..6 Antimicrobial resistance in Salmonella isolates 47 2.2 CAMPYLOBACTERIOSIS 40 2.2. General evaluation of the national situation 40 2.2.2 Campylobacteriosis in humans 4 2.2.3 Antimicrobial resistance in Campylobacter isolates 42 2.3 LISTERIOSIS 48 2.3. General evaluation of the national situation 48 2.3.2 Listeriosis in humans 50 2.3.3 Listeria in foodstuffs 5 2.3.4 Listeria in animals 57 2.4 E. COLI INFECTIONS 58 2.4. General evaluation of the national situation 58 2.4.2 E. coli infections in humans 59 2.4.3 Escherichia coli, pathogenic in foodstuffs 60 2.4.4 Escherichia coli, pathogenic in animals 63 2.5 TUBERCULOSIS, MYCOBACTERIAL DISEASES 64 2.5. General evaluation of the national situation 64 2.5.2 Tuberculosis, mycobacterial diseases in humans 66 2.5.3 Mycobacterium in animals 68 2.6 BRUCELLOSIS 70 2.6. General evaluation of the national situation 70 2.6.2 Brucellosis in humans 73 2.6.3 Brucella in animals 75 2.7 YERSINIOSIS 83 2.7. General evaluation of the national situation 83 2.7.2 Yersiniosis in humans 84 2.8 TRICHINELLOSIS 85 2.8. General evaluation of the national situation 85 2.8.2 Trichinellosis in humans 87 2.8.3 Trichinella in animals 88 2.9 ECHINOCOCCOSIS 89 2.9. General evaluation of the national situation 89 Greece - 203

Greece - 203 Report on trends and sources of zoonoses 2.9.2 Echinococcosis in humans 9 2.9.3 Echinococcus in animals 92 2.0 TOXOPLASMOSIS 93 2.0. General evaluation of the national situation 93 2.0.2 Toxoplasmosis in humans 94 2. RABIES 95 2.. General evaluation of the national situation 95 2..2 Lyssavirus (rabies) in animals 96 2.2 STAPHYLOCOCCUS INFECTION 203 2.2. General evaluation of the national situation 203 2.3 Q-FEVER 203 2.3. General evaluation of the national situation 203 2.3.2 Coxiella (Q-fever) in animals 205 2.4 WEST NILE VIRUS INFECTIONS 206 2.4. General evaluation of the national situation 206 2.4.2 West Nile Virus in animals 207 3 INFORMATION ON SPECIFIC INDICATORS OF ANTIMICROBIAL 209 3. ESCHERICHIA COLI, NON-PATHOGENIC 20 3.. General evaluation of the national situation 20 3..2 Antimicrobial resistance in Escherichia coli, non-pathogenic 2 3.2 ENTEROCOCCUS, NON-PATHOGENIC 27 3.2. General evaluation of the national situation 27 3.2.2 Antimicrobial resistance in Enterococcus, non-pathogenic isolates 27 4 INFORMATION ON SPECIFIC MICROBIOLOGICAL AGENTS 224 4. CRONOBACTER 225 4.. General evaluation of the national situation 225 4.2 HISTAMINE 225 4.2. General evaluation of the national situation 225 4.3 STAPHYLOCOCCAL ENTEROTOXINS 226 4.3. General evaluation of the national situation 226 5 FOODBORNE OUTBREAKS 227

Greece - 203 Report on trends and sources of zoonoses. 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. Greece - 203

Greece - 203 Report on trends and sources of zoonoses A. Information on susceptible animal population Sources of information SUSCEPTIBLE ANIMAL POPULATION: (please advise the relevant electronic summary tables on EFSA Web based zoonoses monitoring system for 20 Data Collection. ) Source of information: Internal Data Base computerized system of Hellenic Ministry of Agriculture (update 20). These statistics may vary from other national or E.U. sources of animal population records. Greece - 203 2

Greece - 203 Table Susceptible animal populations Cattle (bovine animals) Deer Ducks meat production animals dairy cows and heifers mixed herds - in total farmed - in total mixed flocks/holdings breeding flocks, unspecified - in total Number of herds or flocks * Only if different than current reporting year Number of slaughtered animals Livestock numbers (live animals) 22936 203 49662 203 697 203 67048 203 08 203 22279 203 40223 203 39322 203 724755 203 0 203 734 203 398 203 6293 203 Number of holdings Animal species Category of animals Data Year* Data Year* Data Year* Data Year* 330 203 982632 203 77 203 Greece - 203 Report on trends and sources of zoonoses Gallus gallus (fowl) laying hens broilers 762 203 8276090 203 374 203 6305 203 82837307 203 989 203 - in total 238875 203 Geese mixed flocks/holdings 84 203 832 203 Goats animals under year animals over year 277773 203 935699 203 3

Greece - 203 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 Data Year* Data Year* Data Year* Data Year* Goats - in total 6846 203 6087 203 223472 203 breeding animals 8242 203 Pigs fattening pigs 462979 203 - in total 272 203 98999 203 565674 203 Reindeers farmed - in total 203 68 203 animals under year (lambs) 748005 203 Sheep animals over year 4539660 203 - in total 5049 203 255008 203 5287665 203 Greece - 203 Report on trends and sources of zoonoses meat production flocks 62 203 9600 203 4 203 Turkeys parent breeding flocks 4 203 270350 203 4 203 - in total 5232 203 Wild boars farmed - in total 58 203 2462 203 Fish - Unknown (in lakes-rivers) farmed (fish lagoons) 563 202 26 202 650 202 72 202 4

Greece - 203 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 Data Year* Data Year* Data Year* Data Year* farmed (salt water ) 94669 202 378 202 farmed (several species) 252 202 78 202 Fish farmed - Farm (trout) 900000 202 62 202 farmed - carp 28 7 202 farmed - salmon 2 202 - Farm (bees) 900000 203 23000 203 - Farm (mink, chinchilla) 69 203 276000 203 - Farm (rabbits) 504 203 7050 203 Greece - 203 Report on trends and sources of zoonoses Other animals - Unknown (equines unspecified) 922 203 22900 203 - Unknown (farmed shrimp) 202 - Unknown (sheep and goat mixed herds) 57800 203 868249 203 - Unknown (shellfish) 7630 202 595 202 Footnote: Regarding bees :900000 refers to number of beehives and 23000 refers to number of beekeepers. All numbers listed in the column "livestock numbers" concerning fish and seafood are "produced tons" 5

Greece - 203 Table Susceptible animal populations Greece - 203 Report on trends and sources of zoonoses 6

Greece - 203 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. Greece - 203 7

Greece - 203 Report on trends and sources of zoonoses 2. SALMONELLOSIS 2.. General evaluation of the national situation A. General evaluation History of the disease and/or infection in the country DISEASE/AGENT: Salmonellosis, Salmonella spp. Contaminated materials: Feed materials of animal origin, plant origin and Compound feedingstuffs Surveillance system The legal provisions in place and relevant requirements (Zoonoses Directive 2003 and Zoonoses Regulation 260) had significantly improved the effectiveness of the existing monitoring situation and management practices in the field of Salmonella surveillance. New strategies and schemes for monitoring Salmonella zoonotic agents are in force in accordance with Community Salmonella reduction targets approved. Rapid adaptation and compliance on the new mandatory EU Salmonella control and eradication programmes were observed in all EU member states. Measures in case of positiive findings According to the current EU Directives and Community Legislation. In 200, five (5) Salmonella positive units (from fish meal) were reported from 22 units tested in total under selective and routine monitoring schemes. In 2009, no Salmonella positive units were reported from 232 samples tested in total under selective and routine monitoring schemes. The method ISO 6579 (2002) is used for the detection and isolation of Salmonella serovars. National evaluation of the recent situation, the trends and sources of infection DISEASE/AGENT: Salmonellosis, Salmonella Serovars INFECTED SPECIES: Poultry breeding flocks- Callus gallus Susceptible population Parent breeding stock for egg and meat production line is estimated around 2.372.88 birds of 355 breeding flocks (200 national zoonoses statistics). Surveillance system From the past (Historical data), according to the Annex III of the Dir. 92/7, a Salmonella control program has been carried out since 998. In 2009, the Salmonella national control programme in breeding flocks of Gallus gallus has been implemented and approved (co- financed) by European Commission. The programme was supervised by the Hellenic central veterinary competent authorities and was in line with the uniform EU guidelines and rules approved by the Commission. The results were collected, analyzed and evaluated by the Commission, EFSA and Member States in accordance with the Community pre- Greece - 203 8

Greece - 203 Report on trends and sources of zoonoses defined targets towards the reduction of Salmonella prevalence in Breeding flocks of Gallus gallus ( fowl). Method used: The methods ISO 6579 (2002) and ISO 6579 Amendment : Annex D (2007) were used for the detection and isolation of Salmonella serovars. The Salmonella serotyping was conducted in the National Reference Veterinary Laboratory (NRVLS) for Salmonellosis in animals (located in Chalkida Prefecture of Evia) by using the Agglutination technique: Antigenic formulas of the Salmonella Serovars (9th edition- 2007- WHO Institute Pasteur). Measures in case of positive findings Slaughter of infected flocks, restrictions of placing hatching eggs to the hatchery for as long as the disease exists and all the relevant control measures were taken based on EU Legislation and requirements in force. Epidemiological and statistical report The reported Salmonella Serovars from adult poultry breeders, isolated and identified during the year 200 by the National Reference Laboratory were: S. Enteritidis (n= 5),S. Derby (n= 2 ), S.enterica sub salamae (n=), S. Livingstone(n= ), S. Hadar (n= 2 ), S. Tennessee ( n=2 ), S. Anatum (n= ) and S. Anatum ( n= ). The reported Salmonella Serovars from adult poultry breeders, isolated and identified during the year 2009 by the National Reference Laboratory were: S. Enteritidis (n= 5), S. Typhimurium (n= ), S. Blockley (n= ), S. Livingstone(n= 6), S. Hadar (n= 3), S.Enterica (n= ), S. Umbilo (n= ), S.enterica sub enterica 6,7:d unspecified (n= ). Note: n = number of positive flocks DISEASE/AGENT: Salmonellοsis / Salmonella serovars INFECTED SPECIES: Laying Hens and Broilers of Gallus, gallus (fowl) Surveillance system In 200, Salmonella control and eradication EU- programmes in Laying hens and broilers have been implemented in the country based on suspected and objective samples submitted into the laboratories under the official investigation in 200. Under the framework of the programme industry was carried out as well. Method used The methods ISO 6579 (2002) and ISO 6579 Amendment : Annex D (2007) were used for the detection and isolation of Salmonella serovars in Laying hens and other poultry. The Salmonella serotyping was performed by using the Agglutination technique: Antigenic formulas of the Salmonella Serovars (9th edition- 2007- WHO Institute Pasteur). Fifty two (52) Salmonella positive flocks isolated, serotyped and reported by the National Reference Laboratory for Salmonellosis in Greece (NRLS, Located in Chalkida, Evia prefecture) under the national control programme for Laying hens during the year 200. The most 5 frequent Salmonella reported serovars in Layin hens at production stage is presented below:.s.enteritidis ( n= 6) Greece - 203 9

Greece - 203 Report on trends and sources of zoonoses 2.S. Typhimurium ( n= 4) 3.S.Infantis ( n= 9) 4.S. Branderup ( n= 6) 5.S.Corvallis ( n = 7) The remaining Serovars from positive laying flocks can be analytically retrieved by the Web Reporting System Forty one (4) Salmonella positive flocks isolated, serotyped and reported by the National Reference Laboratory for Salmonellosis in Greece (NRLS, Located in Chalkida, Evia prefecture) under the national control programme for Laying hens during the year 2009. Distribution for the most 6 frequent Salmonella serovars in Layin hens production stage is given below:. S.Enteritidis ( n= 8) 2. S. Typhimurium ( n= 3) 3. S.Corvalis ( n = 4) 4. S.Newport ( n=3) 5. S. Heidelberg (n= 2) 6. S.Branderup ( n = 2) Note: n = number of Salmonella positive flocks Twenty eight (28) Salmonella positive flocks isolated, serotyped and reported by the National Reference Laboratory for Salmonellosis in Greece (NRLS, Located in Chalkida, Evia prefecture) under the national control programme for Broilers during the year 200. Distribution for the most 5 frequent Salmonella serovars in Broilers production perios is given below:.s. Hadar ( n= 5) 2.S. Thompson (n=5) 3. S. Tennesse ( n= 3) 4.S.Infantis ( n= 2) 5.S. Bredeney (n=2) DISEASE/AGENT: Salmonellosis/ Salmonella serovars INFECTED SPECIES: In other poultry ( or other birds ) and other Animals (non poultry) Surveillance system No specific and systematic monitoring control program in place Data are based on clinical samples submitted to the laboratories. Method used The methods ISO 6579 (2002) and ISO 6579 Amendment : Annex D (2007) were used for the detection and isolation of Salmonella serovars in other animals. The Salmonella serotyping was performed by the Agglutination technique: Antigenic formulas of the Salmonella Serovars (9th edition- 2007- WHO Institute Pasteur) In 200, the reported Salmonella serovars derived from 92 tested units (poultry and other animals ) were: S. Typhimurium ( n= 7) and Salmonella spp unspecified (n= 6). Greece - 203 0

Greece - 203 Report on trends and sources of zoonoses Recent actions taken to control the zoonoses EU LEGISLATION FOR CONTROL SALMONELLA PROGRAMMES IN POYLTRY ZOONOSES DIRECTIVE HYGIENE PACKAGE Additional information DISEASE/AGENT: Salmonella/ Salmonella serovars TARGET OF MONITORING: Contaminated Food Surveillance system Routine examination and selective official at retail level, processing plan and slaughterhouse carried out based on National and Community legislation. Method used The ISO 6579 (2002) is used for the detection of Salmonella in food. The Salmonella serotyping was performed by the Agglutination technique: Antigenic formulas of the Salmonella Serovars (9th edition- 2007- WHO Institute Pasteur) Summary National Report ( Reporting Year: 20). and selective Routine monitoring. Broiler meat and products thereof (all categories) Samples tested: 35 Samples positive: 8 Reported serovars : S. Enteritidis (n=), S.Montevideo (n=), S. Hadar (n=4) and S. spp unspecified (n=) 2. Pig meat and products thereof (all categories) Samples tested: 356 Samples positive: 7 Reported serovars : S. Derby ( n=2), S. Umbilo (n=5). 3. Bovine meat and products thereof (all categories) Samples tested: 00 Samples positive: 0 4. Meat from other animals and products thereof (all categories) Samples tested: Samples positive: 0 5. Milk and milk products ( all categories) Samples tested: 48 Samples positive: 0 6. Eggs and egg products( all categories) Samples tested: 0 Samples positive: 0 Greece - 203

Greece - 203 Report on trends and sources of zoonoses 7. Fish and fish products (all categories) Samples tested: 53 Samples positive: 0 8. Other Food ( all categories) Samples tested: 28 Samples positive: 0 200 Overall Salmonella reported Food Prevalence (for all food categories) = 3,7 % ( 75/2367*00) Greece - 203 2

Greece - 203 Report on trends and sources of zoonoses 2..2 Salmonellosis in humans A. Salmonellosis in humans Relevance as zoonotic disease DISEASE/AGENT: Salmonella AFFECTED SPECIES: Humans Surveillance system Mandatory reporting of foodborne infections and intoxications with laboratory confirmation. Hospitalized cases are the main reporting source for further epidemiological investigation. Notification is required within 24 hours after the identification of a case. Epidemiological history and evaluation Results of the 2006 zoonoses monitoring period. A total of 984 human Salmonellosis cases were reported to the competent authorities (incidence per 00.000 persons = 9). The reported cases were classified as autochone (n=749), Imported (n=3) and unknown (n=04) cases respectively. The 2006 annual incidence rate reported significantly lower compared to 2004 for Salmonellosis in humans. History In 2004, 493 ( incidence: 3,70 per 00.000 inhabitants) cases of salmonella were reported including the species : S. enteritidis (309), S.typhimurium (20), S. Adaustua (2), S. Anatum (), S.enteritica- arizonae (29), S. blockley (), S. infantis (), S. paratyphi (2), S.Typhi (6) and the remaining Salmonella spp. ( 2). Historically, the officially reported Salmonella cases in humans the reporting years 998, 999 and 2000 were 98, 22 and 206 respectively. For the year 200, 284 human cases were reported. Human Salmonellosis cases in 2004 caused by S. Enteritidis, S, Typhimurium and other Salmonella serotypes were 493 in total compared to 837 (2003) and 460 (2002) in previous years. According to these data an increase of Salmonella cases has been observed during 2004 in man, but in order to epidemiologically evaluate the real trends of Salmonella incidence, we must have in mind the significant underreporting practice which leads to underestimate figures providing non representative salmonella statistics. Moreover it is important to emphasize that the factor underlined above (underestimation) is considered constant for each reporting year. Results of monitoring Human Salmonella Data are presented in the relevant tables of the EFSA web based electronic system for zoonoses monitoring. Source of human infection Mainly from the consumption of infected, contaminated and croos- contaminated food and poultry meat and products there of. Greece - 203 3

Greece - 203 Report on trends and sources of zoonoses Additional information In 2005, all Salmonella serovars derived from the Antimicrobial Resistance monitoring system are presented in the following summary list with the number of all Salmonella isolates that were serotyped. List of isolates by serotype Salmonella serovarsnumber of isolates Salmonella Enteritidis 732 Salmonella Typhimurium 20 Salmonella Oranienburg 24 Salmonella Blockley 7 Salmonella enterica ss. salamae 5 Salmonella Kottbus 3 Salmonella Bovismorbificans 9 Salmonella Typhi 9 Salmonella Bredeney 7 Salmonella Agona 5 Salmonella Muenchen 5 Salmonella Muenster 5 Salmonella Thompson 5 Salmonella Virchow 4 Salmonella Derby 3 Salmonella Infantis 3 Salmonella Kedougou 3 Salmonella Mbandaka 3 Salmonella Newport 3 Salmonella Paratyphi B 3 Salmonella enterica ss. diarizonae 2 Salmonella Hadar 2 Salmonella Anatum Salmonella Bareilly Salmonella Brandenburg Salmonella Cerro Salmonella enterica ss. houtenae Salmonella Goldcoast Salmonella Kentucky Salmonella Litchfield Salmonella Lomita Salmonella Montevideo Salmonella Paratyphi A Salmonella Poona Salmonella Rissen Salmonella Tennessee All 006 Greece - 203 4

Greece - 203 2..3 Salmonella in foodstuffs Table Salmonella in poultry meat and products thereof Meat from broilers (Gallus gallus) - fresh - Processing plant - Surveillance Meat from broilers (Gallus gallus) - meat preparation - intended to be eaten cooked - Processing plant - Surveillance Meat from broilers (Gallus gallus) - meat products - raw but intended to be eaten cooked - Retail - Surveillance Meat from broilers (Gallus gallus) - minced meat - intended to be eaten cooked - Processing plant - Surveillance Meat from turkey - meat products - cooked, ready-to -eat - Processing plant - Surveillance Source of information state vet lab state vet lab state vet lab state vet lab state vet lab Sampling strategy Objective Objective Objective Objective Objective Sampler Sample type Sample origin Sampling unit Sample weight Units tested Total units positive for Salmonella food sample Single 25 gr 30 5 3 food sample Single 25 20 0 food sample Single 25 5 food sample Single 25 60 0 food sample Single 25g 5 0 S. Enteritidis S. Typhimurium Greece - 203 Report on trends and sources of zoonoses Meat from turkey - meat products - cooked, ready-to -eat - Retail - Surveillance state vet lab Selective food sample Single 25g 0 Meat from broilers (Gallus gallus) - carcase - frozen - Processing plant - Surveillance state vet lab Objective food sample Single 25g 0 2 Meat from broilers (Gallus gallus) - mechanically separated meat (MSM) - Processing plant - Surveillance state vet lab Objective food sample Single 25g 20 0 5

Greece - 203 Table Salmonella in poultry meat and products thereof Meat from broilers (Gallus gallus) - fresh - Processing plant - Surveillance Meat from broilers (Gallus gallus) - meat preparation - intended to be eaten cooked - Processing plant - Surveillance Meat from broilers (Gallus gallus) - meat products - raw but intended to be eaten cooked - Retail - Surveillance Meat from broilers (Gallus gallus) - minced meat - intended to be eaten cooked - Processing plant - Surveillance Meat from turkey - meat products - cooked, ready-to -eat - Processing plant - Surveillance Meat from turkey - meat products - cooked, ready-to -eat - Retail - Surveillance Meat from broilers (Gallus gallus) - carcase - frozen - Processing plant - Surveillance S.,4,[5],2:i: - Salmonella spp., unspecified Other serovars S. Livingstone 2 Greece - 203 Report on trends and sources of zoonoses Meat from broilers (Gallus gallus) - mechanically separated meat (MSM) - Processing plant - Surveillance 6

Greece - 203 Table Salmonella in milk and dairy products Milk, cows' - raw milk for manufacture - intended for manufacture of raw or low heat-treated products - Processing plant - Surveillance Cheeses made from cows' milk - soft and semi-soft - made from pasteurised milk - Processing plant - Surveillance Cheeses made from goats' milk - soft and semi-soft - made from pasteurised milk - Processing plant - Surveillance Cheeses made from sheep's milk - soft and semisoft - made from pasteurised milk - Processing plant - Surveillance Cheeses, made from mixed milk from cows, sheep and/or goats - hard - made from pasteurised milk - Processing plant - Surveillance (Kefalograviera cheese, Graviera cheese, Kefalotiri cheese ) Source of information State Vet lab State Vet Lab State Vet Laqb State Vet Lab State Vet Lab Sampling strategy Objective Objective Objective Objective Objective Sampler Sample type food sample > milk Sample origin Sampling unit Sample weight Units tested Single 25ml 20 Total units positive for Salmonella food sample Single 25g 5 0 food sample Single 25g 5 0 food sample Single 25g 5 0 food sample Single 25g 40 0 S. Enteritidis S. Typhimurium Greece - 203 Report on trends and sources of zoonoses Dairy products (excluding cheeses) - ice-cream - made from pasteurised milk - Processing plant - Surveillance State Vet Lab Objective food sample Single 25g 20 0 Dairy products (excluding cheeses) - yoghurt - Processing plant - Surveillance State Vet Lab Objective food sample Single 25g 40 0 Dairy products (excluding cheeses) - yoghurt - Retail - Surveillance (yogurt dessert ) State Vet Lab Objective food sample Single 25g 5 0 Dairy products, unspecified - Processing plant - Surveillance (Feta) State Vet Lab Objective food sample Single 25g 7

Greece - 203 Table Salmonella in milk and dairy products Dairy products, unspecified - Processing plant - Surveillance (Mizithra chesse, Anthotiro cheese ) Dairy products, unspecified - Processing plant - Surveillance (cheeses substitute ) Dairy products, unspecified - Retail - Surveillance (Feta cheese) Milk, cows' - pasteurised milk - Processing plant - Surveillance Milk, goats' - pasteurised milk - Processing plant - Surveillance Source of information State Vet Lab State Vet Lab State Vet Lab State Vet Lab State Vet Lab S.,4,[5],2:i: - Sampling strategy Objective Objective Objective Objective Objective Salmonella spp., unspecified Sampler Sample type Sample origin Sampling unit Sample weight Units tested Total units positive for Salmonella food sample 25g 40 0 food sample Single 25g 2 0 food sample Single 25g 25 0 food sample Single 25ml 5 0 food sample Single 25ml 5 0 S. Enteritidis S. Typhimurium Greece - 203 Report on trends and sources of zoonoses Milk, cows' - raw milk for manufacture - intended for manufacture of raw or low heat-treated products - Processing plant - Surveillance Cheeses made from cows' milk - soft and semi-soft - made from pasteurised milk - Processing plant - Surveillance Cheeses made from goats' milk - soft and semi-soft - made from pasteurised milk - Processing plant - Surveillance 8

Greece - 203 Table Salmonella in milk and dairy products Cheeses made from sheep's milk - soft and semisoft - made from pasteurised milk - Processing plant - Surveillance Cheeses, made from mixed milk from cows, sheep and/or goats - hard - made from pasteurised milk - Processing plant - Surveillance (Kefalograviera cheese, Graviera cheese, Kefalotiri cheese ) Dairy products (excluding cheeses) - ice-cream - made from pasteurised milk - Processing plant - Surveillance Dairy products (excluding cheeses) - yoghurt - Processing plant - Surveillance Dairy products (excluding cheeses) - yoghurt - Retail - Surveillance (yogurt dessert ) S.,4,[5],2:i: - Salmonella spp., unspecified Greece - 203 Report on trends and sources of zoonoses Dairy products, unspecified - Processing plant - Surveillance (Feta) Dairy products, unspecified - Processing plant - Surveillance (Mizithra chesse, Anthotiro cheese ) Dairy products, unspecified - Processing plant - Surveillance (cheeses substitute ) Dairy products, unspecified - Retail - Surveillance (Feta cheese) 9

Greece - 203 Table Salmonella in milk and dairy products Milk, cows' - pasteurised milk - Processing plant - Surveillance Milk, goats' - pasteurised milk - Processing plant - Surveillance S.,4,[5],2:i: - Salmonella spp., unspecified Greece - 203 Report on trends and sources of zoonoses 20

Greece - 203 Table Salmonella in other food Eggs - table eggs - Retail - Surveillance Egg products - Processing plant - Surveillance Fish - smoked - Processing plant - Surveillance Cheeses, made from mixed milk from cows, sheep and/or goats - hard - made from pasteurised milk - Processing plant - Surveillance (Kafalograviera chesse ) Fish - unspecified - Processing plant - Surveillance Fruits - pre-cut - ready-to-eat - Processing plant - Surveillance (Dried plant products ) Infant formula - dried - intended for infants below 6 months - Hospital or medical care facility - Surveillance Source of information State Vet Lab State Vet Lab State Vet Lab State Vet Lab State Vet Lab State Vet Lab State Vet Lab Sampling strategy Objective Objective Objective Objective Objective Objective Objective Sampler Sample type Sample origin Sampling unit Sample weight Units tested Total units positive for Salmonella food sample Single 25g 0 food sample Single 25g 5 0 food sample Single 25g 40 0 food sample Single 25g 40 0 food sample 25g 0 0 food sample Single 25g 85 food sample Single 25g 6 0 S. Enteritidis S. Typhimurium Greece - 203 Report on trends and sources of zoonoses Live bivalve molluscs - unspecified - Processing plant - Surveillance State Vet Lab Objective food sample Single 25g 278 0 Other processed food products and prepared dishes - sandwiches - Retail - Surveillance State Vet Lab Objective food sample 25g 0 0 2

Greece - 203 Table Salmonella in red meat and products thereof Meat from pig - carcase - Slaughterhouse - Surveillance Meat from pig - fresh - Processing plant - Surveillance Meat from pig - meat preparation - intended to be eaten raw - Processing plant - Surveillance Meat from pig - meat preparation - intended to be eaten cooked - Processing plant - Surveillance Meat from pig - meat products - raw but intended to be eaten cooked - Processing plant - Surveillance Meat from pig - meat products - cooked, ready-toeat - Processing plant - Surveillance Meat from pig - meat products - cooked, ready-toeat - Retail - Surveillance ) Source of information STATE VET LAB State Vet Lab STATE VET LAB STATE VET LAB State Vet Lab State Vet Lab State Vet Lab Sampling strategy Objective Objective Objective Objective Objective Objective Objective Sampler Sample type Sample origin Sampling unit Sample weight Units tested Total units positive for Salmonella food sample Single 0 0 food sample Single 25 5 0 food sample Single 25GRAM 5 0 food sample Batch 0gr 9 0 food sample Single 0g 5 0 food sample Single 25g 77 0 food sample Single 25g 0 0 S. Enteritidis S. Typhimurium Greece - 203 Report on trends and sources of zoonoses Meat from bovine animals - fresh - Processing plant - Surveillance 2) State Vet Lab Objective food sample Single 0 0 Meat from bovine animals - minced meat - intended to be eaten raw - Processing plant - Surveillance State Vet Lab Objective food sample Single 0g 5 0 Meat from bovine animals - minced meat - intended to be eaten cooked - Processing plant - Surveillance State Vet Lab Objective food sample Single 0g 25 0 Meat from bovine animals - minced meat - intended to be eaten cooked - Retail - Surveillance State Vet Lab Objective food sample 0g 0 23

Greece - 203 Table Salmonella in red meat and products thereof Meat from bovine animals - meat preparation - intended to be eaten cooked - Retail - Surveillance Meat from bovine animals - meat products - raw but intended to be eaten cooked - Processing plant - Surveillance Meat from pig - fresh Meat from pig - meat products - cooked, ready-toeat - Retail - Surveillance Other products of animal origin - Processing plant - Surveillance (Frozen meatballs) Source of information State Vet Lab State Vet Lab STATE VET LAB State Vet Lab State Vet Lad S.,4,[5],2:i: - Sampling strategy Objective Selective Objective Objective Objective Salmonella spp., unspecified Sampler Sample type Sample origin Sampling unit Sample weight Units tested Total units positive for Salmonella food sample Single 0g 59 0 food sample Single 0g 5 0 food sample Single 25 GRAM 4 food sample Single 0g 5 0 food sample Single 0g 5 0 S. Enteritidis S. Typhimurium Greece - 203 Report on trends and sources of zoonoses Meat from pig - carcase - Slaughterhouse - Surveillance ) Meat from pig - fresh - Processing plant - Surveillance Meat from pig - meat preparation - intended to be eaten raw - Processing plant - Surveillance Meat from pig - meat preparation - intended to be eaten cooked - Processing plant - Surveillance 24

Greece - 203 Table Salmonella in red meat and products thereof Meat from pig - meat products - raw but intended to be eaten cooked - Processing plant - Surveillance Meat from pig - meat products - cooked, ready-toeat - Processing plant - Surveillance Meat from pig - meat products - cooked, ready-toeat - Retail - Surveillance Meat from bovine animals - fresh - Processing plant - Surveillance Meat from bovine animals - minced meat - intended to be eaten raw - Processing plant - Surveillance Meat from bovine animals - minced meat - intended to be eaten cooked - Processing plant - Surveillance Meat from bovine animals - minced meat - intended to be eaten cooked - Retail - Surveillance 2) S.,4,[5],2:i: - Salmonella spp., unspecified Greece - 203 Report on trends and sources of zoonoses Meat from bovine animals - meat preparation - intended to be eaten cooked - Retail - Surveillance Meat from bovine animals - meat products - raw but intended to be eaten cooked - Processing plant - Surveillance Meat from pig - fresh Meat from pig - meat products - cooked, ready-toeat - Retail - Surveillance 25

Greece - 203 Table Salmonella in red meat and products thereof Other products of animal origin - Processing plant - Surveillance (Frozen meatballs) Comments: ) 2) CARCASS SURFACE carcase surface S.,4,[5],2:i: - Salmonella spp., unspecified Greece - 203 Report on trends and sources of zoonoses 26

Greece - 203 Report on trends and sources of zoonoses 2..4 Salmonella in animals A. Salmonella spp. in Gallus Gallus - breeding flocks Measures in case of the positive findings or single cases Breeding flocks (separate elite, grand parent and parent flocks when necessary) Measures in case of positive findings: Slaughter of infected flocks, restrictions of placing hatching eggs to the hatchery for as long as the disease exists and all the relevant control measures were taken based on EU Legislation and requirements in force. Notification system in place DISEASE/AGENT: Salmonellosis, Salmonella Serovars INFECTED SPECIES: Poultry breeding flocks- Callus gallus Susceptible population Parent breeding stock for egg and meat production line is estimated around 2.25.76 birds / 360 breeding flocks (20 national zoonoses statistics) raised in 90 holdings. Surveillance system From the past (Historical data), according to the Annex III of the Dir. 92/7, a Salmonella control program has been carried out since 998. In 2009, the Salmonella national control programme in breeding flocks of Gallus gallus has been implemented and approved (co- financed) by European Commission. The programme was supervised by the Hellenic central veterinary competent authorities and was in line with the uniform EU guidelines and rules approved by the Commission. The results were collected, analyzed and evaluated by the Commission, EFSA and Member States in accordance with the Community predefined targets towards the reduction of Salmonella prevalence in Breeding flocks of Gallus gallus ( fowl). Method used: The methods ISO 6579 (2002) and ISO 6579 Amendment : Annex D (2007) were used for the detection and isolation of Salmonella serovars. The Salmonella serotyping was conducted in the National Reference Veterinary Laboratory (NRVLS) for Salmonellosis in animals (located in Chalkida Prefecture of Evia) by using the Agglutination technique: Antigenic formulas of the Salmonella Serovars (9th edition- 2007- WHO Institute Pasteur). Results of the investigation Epidemiological and statistical report The reported Salmonella Serovars from adult poultry breeders, isolated and identified during the year 20 by the National Reference Laboratory were: S.Bispebjerg (n=), S.Kentack (n=), S.Havana (n=3), S.Muenster (n=), S.Enterica (n=), S.Infantis (n=2). Note: n = number of positive flocks Greece - 203 27

Greece - 203 Report on trends and sources of zoonoses

Greece - 203 Report on trends and sources of zoonoses B. Salmonella spp. in Gallus Gallus - broiler flocks Monitoring system Sampling strategy Broiler flocks Offficial and own-check following the protocol and frequency laid down in Reg. (EC) N. 200/202. Vaccination policy Broiler flocks In Greece, vaccination against zoonotic salmonella is not applied in broilers. National evaluation of the recent situation, the trends and sources of infection Community target has been achieved and prevelance of all salmonella serotypes is relatively at low level. Greece - 203 29

Greece - 203 Report on trends and sources of zoonoses C. Salmonella spp. in Gallus Gallus - flocks of laying hens Monitoring system Sampling strategy Laying hens flocks and own-check are performed according to the protocol described in Reg. (EC) N. 57/20. Diagnostic/analytical methods used Laying hens: Day-old chicks Analytical methods used for isolation of salmonella spp and serotyping are those laid down in Reg. (EC) N. 57/20. Notification system in place Surveillance system In 2009, Salmonella control EU- programmes in Laying hens and broilers have been implemented in the country based on suspected and objective samples submitted into the laboratories under the official investigation in 2009. Method used The methods ISO 6579 (2002) and ISO 6579 Amendment : Annex D (2007) were used for the detection and isolation of Salmonella serovars in Laying hens and other poultry. The Salmonella serotyping was performed by using the Agglutination technique: Antigenic formulas of the Salmonella Serovars (9th edition- 2007- WHO Institute Pasteur). Results of the investigation Twenty three (23) Salmonella positive flocks isolated, serotyped and reported by the National Reference Laboratory for Salmonellosis in Greece (NRLS, Located in Chalkida, Evia prefecture) under the national control programme for Laying hens during the year 20. Distribution for the Salmonella serovars in Layin hens production stage is given below: S.Muenster (n=), S. Haardt (n=), S. Bovismorbifigans (n=), S.Virchow (n=), S.Enteritidis (n=3), S. Thompson (n=3), S. Infantis (n=), S. Umbilo (n=), S.Havana (n=),.s.hadar (n=), S.Muenchen (n=), S.Carno (n=),.s.mbandaka (n=), S.Enterika untypable (n=), S.Newport (n=), S.Bovismorbificans (n=) S.Glostrup (n=), S.enterica salamae (n=2), S.Stanleyville (n=) Note: n = number of Salmonella positive flocks Thirty two (32) Salmonella positive flocks isolated, serotyped and reported by the National Reference Laboratory for Salmonellosis in Greece (NRLS, Located in Chalkida, Evia prefecture) under the national control programme for Broilers during the year 20. Distribution for the Salmonella serovars in Broilers production perios is given bellow: S.Typhymurium (n=2), S.Havana (n=), S.Montevideo (n=),s.anatum (n=) S.Livingstone (n=4), S.enteritidis (n=0), S.Senftenberg (n=) S.Infantis (n=), S.Thompson (n=2), S.Bredeney (n=), S.Corvalis (n=),s.instanbul (n=),s.muenster (n=),s.tennessee (n=),s.enterica subsp. salamae 4,2:i:- (untypable) (n=2) Note: n = number of positive flocks Greece - 203 30

Greece - 203 Report on trends and sources of zoonoses

Greece - 203 Report on trends and sources of zoonoses D. Salmonella spp. in bovine animals National evaluation of the recent situation, the trends and sources of infection Epidemiological history In the year 2007 the reported salmonella serovars were associated with the results from an EU Pig baseline study. The study was carried out in order to identify the real and observed Salmonella prevalence in pigs in line with Community Legislation and relevant targets to reduce the prevalence over time. The majority of positive Salmonella strains were pig strains. The predominant reported serovars were: S. Typhimurium ( n= 8 ), Salmonella spp unspecified ( n= 7 ), S. Derby (n=9),, S. Enterica.sub.enterica ( n= 7 ), S. Thomson ( n=6 ) and S. Bredeney ( n= 5 ). In a prospective study during 985-990, 84 strains of Salmonella spp have been isolated from animals. The predominant serotype was S.Gallinarum. For 2002 and 2003 S. Typhimurium and S. Agona respectively had been exclusively reported based on the small sample frame tested. In the year 2004 the reported salmonella serovars were S. Typhimurium (Goats, rabbits and turtles ), S. Dublin ( cattle), S. Corvallis (Cattle ), S. Litchfield (Turtles )and Salmmonella spp- non typed (Turtles ). Additional information BOVINE ANIMALS AND OTHER ANIMALS (NON POULTRY) DISEASE/AGENT: Salmonellosis/ Salmonella serovars INFECTED SPECIES: Animals (non poultry) Surveillance system Not specific and systematic monitoring control program in force for the other (non poultry) animals. Data are based on the samples incidentally submitted to the laboratories. Method used The methods ISO 6579 (2002) and ISO 6579 Amendment : Annex D (2007) were used for the detection and isolation of Salmonella serovars in other animals. The Salmonella serotyping was performed by the Agglutination technique: Antigenic formulas of the Salmonella Serovars (9th edition- 2007- WHO Institute Pasteur) In 2009, the reported Salmonella serovars derived from 256 tested units (animals) were: Salmonella spp unspecified (n= 2) and S. Dublin ( n= ). In 2008, the reported Salmonella serovars were: S. Bredeney ( n= 2 ), Salmonella spp unspecified ( n= 2 ), S. Enterica.subsp.enterica ( n= ). Note: n = number of positive flocks Greece - 203 32

Greece - 203 Table Salmonella in breeding flocks of Gallus gallus Gallus gallus (fowl) - breeding flocks, unspecified - adult - Control and eradication programmes Gallus gallus (fowl) - parent breeding flocks for egg production line - day-old chicks - Control and eradication programmes Gallus gallus (fowl) - parent breeding flocks for egg production line - during rearing period - Control and eradication programmes Gallus gallus (fowl) - parent breeding flocks for egg production line - adult - Control and eradication programmes Gallus gallus (fowl) - parent breeding flocks for broiler production line - day-old chicks - Control and eradication programmes No of flocks under control programme Source of information Sampling strategy 330 PVA Census 7 PVA Census 9 PVA Census 20 PVA Census 37 PVA Census Sampler Sample type and industry Industry Industry and industry Industry animal sample animal sample animal sample animal sample animal sample Sample origin Target Verification Sampling unit Units tested Total units positive for Salmonella S. Enteritidis yes Flock 330 8 2 yes Flock 7 0 0 yes Flock 9 0 0 yes Flock 20 2 0 yes Flock 30 0 0 Greece - 203 Report on trends and sources of zoonoses Gallus gallus (fowl) - parent breeding flocks for broiler production line - during rearing period - Control and eradication programmes 45 PVA Census Industry animal sample yes Flock 44 0 0 Gallus gallus (fowl) - parent breeding flocks for broiler production line - adult - Control and eradication programmes 98 PVA Census and industry animal sample yes Flock 97 6 2 33

Greece - 203 Table Salmonella in breeding flocks of Gallus gallus Gallus gallus (fowl) - breeding flocks, unspecified - adult - Control and eradication programmes Gallus gallus (fowl) - parent breeding flocks for egg production line - day-old chicks - Control and eradication programmes Gallus gallus (fowl) - parent breeding flocks for egg production line - during rearing period - Control and eradication programmes Gallus gallus (fowl) - parent breeding flocks for egg production line - adult - Control and eradication programmes Gallus gallus (fowl) - parent breeding flocks for broiler production line - day-old chicks - Control and eradication programmes Gallus gallus (fowl) - parent breeding flocks for broiler production line - during rearing period - Control and eradication programmes S. Hadar S. Infantis S. Typhimurium S. Virchow S.,4,[5],2:i: - Salmonella spp., unspecified S. Bruck S. Livingstone S. Umbilo 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Greece - 203 Report on trends and sources of zoonoses Gallus gallus (fowl) - parent breeding flocks for broiler production line - adult - Control and eradication programmes 0 0 0 0 0 0 2 34

Greece - 203 Table Salmonella in other animals Cattle (bovine animals) - calves (under year) - Farm - Monitoring Cattle (bovine animals) - adult cattle over 2 years - Farm - Monitoring Sheep - Farm - Monitoring Goats - Farm - Monitoring Pigs - fattening pigs - Farm - Monitoring Buffalos - farmed - Farm - Clinical investigations Source of information STATE VET LAB STATE VET LAB STATE VET LAB STATE VET LAB STATE VET LAB STATE VET LAB Salmonella spp., unspecified Sampling strategy Selective Selective Selective Selective Selective Selective S. Montevideo Sampler S. Umbilo Sample type Sample origin Sampling unit Units tested animal sample animal sample animal sample animal sample animal sample animal sample Total units positive for Salmonella Animal 6 0 Animal 3 Animal 7 0 Animal 9 0 Animal 3 0 Animal 0 S. Enteritidis S. S.,4,[5],2:i: Typhimurium - Greece - 203 Report on trends and sources of zoonoses Cattle (bovine animals) - calves (under year) - Farm - Monitoring Cattle (bovine animals) - adult cattle over 2 years - Farm - Monitoring Sheep - Farm - Monitoring Goats - Farm - Monitoring Pigs - fattening pigs - Farm - Monitoring Buffalos - farmed - Farm - Clinical investigations 35

Greece - 203 Table Salmonella in other animals Greece - 203 Report on trends and sources of zoonoses 36

Greece - 203 Table Salmonella in other poultry Gallus gallus (fowl) - laying hens - day-old chicks - Control and eradication programmes Gallus gallus (fowl) - laying hens - during rearing period - Control and eradication programmes Gallus gallus (fowl) - laying hens - adult - Farm - Control and eradication programmes Gallus gallus (fowl) - broilers - before slaughter - Farm - Control and eradication programmes Gallus gallus (fowl) - broilers - before slaughter - Farm - Control and eradication programmes Gallus gallus (fowl) - broilers - before slaughter - Farm - Control and eradication programmes Turkeys - breeding flocks, unspecified - day-old chicks - Farm - Control and eradication programmes No of flocks under control programme Source of information Sampling strategy 8 PVA Census 58 PVA Census 645 PVA Census 6305 PVA Census 6305 PVA Census 6305 PVA Census 0 PVA Census Sampler Sample type Industry Industry and industry Industry and industry and industry animal sample animal sample animal sample animal sample animal sample animal sample animal sample Sample origin Target Verification Sampling unit Units tested Total units positive for Salmonella yes Flock 37 0 yes Flock 76 0 S. Enteritidis yes Flock 432 29 5 yes Flock 00 3 yes Flock 652 0 0 yes Flock 6252 3 yes Flock 0 0 0 Greece - 203 Report on trends and sources of zoonoses Turkeys - breeding flocks, unspecified - during rearing period - Farm - Control and eradication programmes 0 PVA Turkeys - breeding flocks, unspecified - adult - Farm - Control and eradication programmes 4 PVA Census and industry animal sample yes Flock 3 Turkeys - breeding flocks, unspecified - adult - Farm - Control and eradication programmes 4 PVA Census Industry animal sample yes Flock 0 Turkeys - breeding flocks, unspecified - adult - Farm - Control and eradication programmes ) 4 PVA Census animal sample yes Flock 3 0 37

Greece - 203 Table Salmonella in other poultry Turkeys - fattening flocks - before slaughter - Farm - Control and eradication programmes Turkeys - fattening flocks - before slaughter - Farm - Control and eradication programmes Turkeys - fattening flocks - before slaughter - Farm - Control and eradication programmes Gallus gallus (fowl) - laying hens - Farm - Control and eradication programmes (all flocks) Gallus gallus (fowl) - laying hens - day-old chicks - Control and eradication programmes No of flocks under control programme Source of information 62 PVA Census 62 PVA Census 62 PVA Census 760 PVA Census S. S.,4,[5],2:i: Typhimurium - Sampling strategy Salmonella spp., unspecified Sampler Sample type and industry Industry and industry S. Agona animal sample animal sample animal sample animal sample S. Braenderup Sample origin Target Verification Sampling unit Units tested Total units positive for Salmonella yes Flock 52 0 yes Flock 49 0 yes Flock 9 0 S. Enteritidis yes Flock 472 29 5 S. Bredeney S. Cerro S. Corvallis S. Derby S. Glostrup S. Haardt Greece - 203 Report on trends and sources of zoonoses Gallus gallus (fowl) - laying hens - during rearing period - Control and eradication programmes Gallus gallus (fowl) - laying hens - adult - Farm - Control and eradication programmes Gallus gallus (fowl) - broilers - before slaughter - Farm - Control and eradication programmes Gallus gallus (fowl) - broilers - before slaughter - Farm - Control and eradication programmes Gallus gallus (fowl) - broilers - before slaughter - Farm - Control and eradication programmes 0 3 3 2 0 0 0 0 0 0 0 0 0 0 38