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Abstract
This report of the EFSA and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring activities carried out in 2020 in 27 EU Member States (MS) and nine non-MS. Key statistics on zoonoses and zoonotic agents in humans, food, animals and feed are provided and interpreted historically. Two events impacted 2020 MS data collection and related statistics: the Coronavirus Disease 2019 (COVID-19) pandemic and the withdrawal of the United Kingdom from the EU. In 2020, the first and second most reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The EU trend for confirmed human cases of these two diseases was stable (flat) from 2016 to 2020. Fourteen of the 26 MS reporting data on Salmonella control programmes in poultry met the reduction targets for all poultry categories. Salmonella results for carcases of various species performed by competent authorities were more frequently positive than own-checks conducted by food business operators. This was also the case for Campylobacter quantification results from broiler carcases for the MS group that submitted data from both samplers, whereas overall at EU level, those percentages were comparable. Yersiniosis was the third most reported zoonosis in humans, with 10-fold less cases reported than salmonellosis, followed by Shiga toxin-producing Escherichia coli (STEC) and Listeria monocytogenes infections. Illnesses caused by L. monocytogenes and West Nile virus infections were the most severe zoonotic diseases with the highest case fatality. In 2020, 27 MS reported 3,086 foodborne outbreaks (a 47.0% decrease from 2019) and 20,017 human cases (a 61.3% decrease). Salmonella remained the most frequently reported causative agent for foodborne outbreaks. Salmonella in 'eggs and egg products', norovirus in 'crustaceans, shellfish, molluscs and products containing them' and L. monocytogenes in 'fish and fish products' were the agent/food pairs of most concern. This report also provides updates on tuberculosis due to Mycobacterium bovis or Mycobacterium caprae, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, Coxiella burnetii (Q fever) and tularaemia.
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Seiwald S, Simeon A, Hofer E, Weiss G, Bellmann-Weiler R. Tularemia Goes West: Epidemiology of an Emerging Infection in Austria. Microorganisms 2020; 8:E1597. [PMID: 33081341 PMCID: PMC7602993 DOI: 10.3390/microorganisms8101597] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022] Open
Abstract
The zoonotic disease tularemia is caused by the Gram-negative bacterium Francisella tularensis, with the two major subspecies tularensis and holarctica being responsible for infections in humans and animals. The F. tularensis subspecies holarctica is less virulent and prevalent in Europe and Asia. Over the last few centuries, few epidemic outbreaks and low numbers of infections have been registered in the eastern part of Austria, specifically in the provinces of Lower Austria, Burgenland, and Styria. The reported infections were mostly associated with hunting hares and the skinning of carcasses. Within the last decade, ticks have been identified as important vectors in Tyrol and served as first evidence for the spread of F. tularensis to Western Austria. In 2018, the pathogen was detected in hares in the provinces of Tyrol, Vorarlberg, and Salzburg. We presume that F. tularensis is now established in most regions of Austria, and that the investigation of potential host and vector animals should be spotlighted by public institutions. Tularemia in humans presents with various clinical manifestations. As glandular, ulceroglandular, and typhoidal forms occur in Austria, this infectious disease should be considered as a differential diagnosis of unknown fever.
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Affiliation(s)
- Stefanie Seiwald
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (A.S.); (G.W.)
| | - Anja Simeon
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (A.S.); (G.W.)
| | - Erwin Hofer
- Institute for Veterinary Disease Control, Austrian Agency for Health and Food Safety (AGES), 2340 Mödling, Austria;
| | - Günter Weiss
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (A.S.); (G.W.)
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (A.S.); (G.W.)
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Kittl S, Francey T, Brodard I, Origgi FC, Borel S, Ryser-Degiorgis MP, Schweighauser A, Jores J. First European report of Francisella tularensis subsp. holarctica isolation from a domestic cat. Vet Res 2020; 51:109. [PMID: 32867856 PMCID: PMC7457513 DOI: 10.1186/s13567-020-00834-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/14/2020] [Indexed: 01/16/2023] Open
Abstract
Francisella tularensis subsp. holarctica is a select agent causing life-threatening tularemia. It has been isolated from humans and animals, mainly lagomorphs and rodents, rarely other wild carnivore species. Increasing numbers of human tularemia cases have been reported during the last 5 years in Switzerland. Here we report the first isolation of Francisella tularensis subsp. holarctica from a domestic cat in Europe and compare its genome sequence with other Swiss isolates. The cat isolate shows a close phylogenetic relationship with a contemporary hare isolate from close geographic proximity, indicating a possible epidemiological link.
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Affiliation(s)
- Sonja Kittl
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
| | - Thierry Francey
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Isabelle Brodard
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Francesco C Origgi
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Stéphanie Borel
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | | | - Ariane Schweighauser
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Joerg Jores
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Abstract
Tularaemia is a zoonotic disease, in Europe caused by Francisella tularensis subsp. holarctica. Many lagomorphs and a variety of small rodents are wildlife species prone to develop clinical disease, while predators and scavengers are relatively resistant and may serve as sentinels. Blood samples from 656 Swedish wild predators and scavengers were serologically investigated using slide agglutination and microagglutination. In the slide agglutination test, 34 seropositive animals were detected, and they were found among all species investigated: brown bear (Ursus arctos), Eurasian lynx (Lynx lynx), raccoon dog (Nyctereutes procyonoides), red fox (Vulpes vulpes), wild boar (Sus scrofa), wolf (Canis lupus) and wolverine (Gulo gulo). Due to haemolysis the microagglutination test was more difficult to read at low titres, and only 12 animals were classified as seropositive. F. tularensis subsp. holarctica was detected by a polymerase chain reaction in lymphatic tissues of the head in one brown bear, one red fox and one wolf. The significance of this finding regarding possible latency of infection is not clear. In conclusion, the results of this study indicate that all predator and scavenger species included in this study may serve as sentinels for tularaemia in Sweden. Their role as reservoirs is unclear.
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Koene M, Rijks J, Maas M, Ruuls R, Engelsma M, van Tulden P, Kik M, IJzer J, Notermans D, de Vries M, Fanoy E, Pijnacker R, Spierenburg M, Bavelaar H, Berkhout H, Sankatsing S, Diepersloot R, Myrtennas K, Granberg M, Forsman M, Roest HJ, Gröne A. Phylogeographic Distribution of Human and Hare Francisella Tularensis Subsp. Holarctica Strains in the Netherlands and Its Pathology in European Brown Hares (Lepus Europaeus). Front Cell Infect Microbiol 2019; 9:11. [PMID: 30805312 PMCID: PMC6378916 DOI: 10.3389/fcimb.2019.00011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/15/2019] [Indexed: 01/05/2023] Open
Abstract
Sequence-based typing of Francisella tularensis has led to insights in the evolutionary developments of tularemia. In Europe, two major basal clades of F. tularensis subsp. holarctica exist, with a distinct geographical distribution. Basal clade B.6 is primarily found in Western Europe, while basal clade B.12 occurs predominantly in the central and eastern parts of Europe. There are indications that tularemia is geographically expanding and that strains from the two clades might differ in pathogenicity, with basal clade B.6 strains being potentially more virulent than basal clade B.12. This study provides information on genotypes detected in the Netherlands during 2011–2017. Data are presented for seven autochthonous human cases and for 29 European brown hares (Lepus europaeus) with laboratory confirmed tularemia. Associated disease patterns are described for 25 European brown hares which underwent post-mortem examination. The basal clades B.6 and B.12 are present both in humans and in European brown hares in the Netherlands, with a patchy geographical distribution. For both genotypes the main pathological findings in hares associated with tularemia were severe (sub)acute necrotizing hepatitis and splenitis as well as necrotizing lesions and hemorrhages in several other organs. Pneumonia was significantly more common in the B.6 than in the B.12 cases. In conclusion, the two major basal clades present in different parts in Europe are both present in the Netherlands. In hares found dead, both genotypes were associated with severe acute disease affecting multiple organs. Hepatitis and splenitis were common pathological findings in hares infected with either genotype, but pneumonia occurred significantly more frequently in hares infected with the B.6 genotype compared to hares infected with the B.12 genotype.
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Affiliation(s)
- Miriam Koene
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Wageningen University and Research, Lelystad, Netherlands
| | - Jolianne Rijks
- Faculty of Veterinary Medicine, Dutch Wildlife Health Centre, Utrecht University, Utrecht, Netherlands
| | - Miriam Maas
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Robin Ruuls
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Wageningen University and Research, Lelystad, Netherlands
| | - Marc Engelsma
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Wageningen University and Research, Lelystad, Netherlands
| | - Peter van Tulden
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Wageningen University and Research, Lelystad, Netherlands
| | - Marja Kik
- Faculty of Veterinary Medicine, Dutch Wildlife Health Centre, Utrecht University, Utrecht, Netherlands
| | - Jooske IJzer
- Faculty of Veterinary Medicine, Dutch Wildlife Health Centre, Utrecht University, Utrecht, Netherlands
| | - Daan Notermans
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Maaike de Vries
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Ewout Fanoy
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.,GGD Rotterdam Rijnmond, Rotterdam, Netherlands
| | - Roan Pijnacker
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Marcel Spierenburg
- Netherlands Food and Consumer Product Safety Authority, Utrecht, Netherlands
| | - Herjan Bavelaar
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, Netherlands
| | - Hanneke Berkhout
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, Netherlands
| | - Sanjay Sankatsing
- Department of Internal Medicine, Diakonessenhuis, Utrecht, Netherlands
| | - Rob Diepersloot
- Department of Medical Microbiology en Immunology, St. Antonius Hospital, Nieuwegein, Netherlands
| | | | | | | | - Hendrik-Jan Roest
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Wageningen University and Research, Lelystad, Netherlands
| | - Andrea Gröne
- Faculty of Veterinary Medicine, Dutch Wildlife Health Centre, Utrecht University, Utrecht, Netherlands
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Pilo P. Phylogenetic Lineages of Francisella tularensis in Animals. Front Cell Infect Microbiol 2018; 8:258. [PMID: 30109216 PMCID: PMC6079424 DOI: 10.3389/fcimb.2018.00258] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 07/11/2018] [Indexed: 12/24/2022] Open
Abstract
Tularemia is a zoonotic disease caused by the facultative intracellular bacterium Francisella tularensis. This microorganism can infect a plethora of animal species and its ecology is particularly complex. Much research was performed to understand its biology but many questions are still open, especially concerning the life cycle of this bacterium in the environment related to physical and biological parameters. Numerous animals are major hosts of F. tularensis but precise reservoir species are not yet well defined. Moreover, the exact range of species susceptible to tularemia is not clear and is complicated by the differences in virulence and ecology observed among the subspecies of F. tularensis. Indeed, different life cycles in nature, including the animal species concerned, were previously described for F. tularensis subsp. tularensis and F. tularensis subsp. holarctica. Recently, molecular techniques showing adequate discrimination between strains were developed, leading to the possibility to investigate links between phylogenetic lineages and infection in animals. New perspectives in research are now possible thanks to the information available and the simplicity of the molecular procedures. Current studies are unfolding the evolution of F. tularensis and these developments will lead to the elucidation of geographical and ecological differences observed by veterinarians, microbiologists and conservation biologists. However, systematic, coordinated collection of data and extensive sampling are important to efficiently assemble the findings of future research.
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Affiliation(s)
- Paola Pilo
- Vetsuisse Faculty, Institute of Veterinary Bacteriology, Department of Infectious Diseases and Pathobiology, University of Bern, Bern, Switzerland
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Faber M, Heuner K, Jacob D, Grunow R. Tularemia in Germany-A Re-emerging Zoonosis. Front Cell Infect Microbiol 2018; 8:40. [PMID: 29503812 PMCID: PMC5821074 DOI: 10.3389/fcimb.2018.00040] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 01/31/2018] [Indexed: 11/17/2022] Open
Abstract
Tularemia, also known as “rabbit fever,” is a zoonosis caused by the facultative intracellular, gram-negative bacterium Francisella tularensis. Infection occurs through contact with infected animals (often hares), arthropod vectors (such as ticks or deer flies), inhalation of contaminated dust or through contaminated food and water. In this review, we would like to provide an overview of the current epidemiological situation in Germany using published studies and case reports, an analysis of recent surveillance data and our own experience from the laboratory diagnostics, and investigation of cases. While in Germany tularemia is a rarely reported disease, there is evidence of recent re-emergence. We also describe some peculiarities that were observed in Germany, such as a broad genetic diversity, and a recently discovered new genus of Francisella and protracted or severe clinical courses of infections with the subspecies holarctica. Because tularemia is a zoonosis, we also touch upon the situation in the animal reservoir and one-health aspects of this disease. Apparently, many pieces of the puzzle need to be found and put into place before the complex interaction between wildlife, the environment and humans are fully understood. Funding for investigations into rare diseases is scarce. Therefore, combining efforts in several countries in the framework of international projects may be necessary to advance further our understanding of this serious but also scientifically interesting disease.
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Affiliation(s)
- Mirko Faber
- Gastrointestinal Infections, Zoonoses and Tropical Infections (Division 35), Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Klaus Heuner
- Working Group, Cellular Interactions of Bacterial Pathogens, Centre for Biological Threats and Special Pathogens, Division 2 (ZBS 2), Robert Koch Institute, Berlin, Germany.,Highly Pathogenic Microorganisms, Centre for Biological Threats and Special Pathogens, Division 2 (ZBS 2), Robert Koch Institute, Berlin, Germany
| | - Daniela Jacob
- Highly Pathogenic Microorganisms, Centre for Biological Threats and Special Pathogens, Division 2 (ZBS 2), Robert Koch Institute, Berlin, Germany
| | - Roland Grunow
- Highly Pathogenic Microorganisms, Centre for Biological Threats and Special Pathogens, Division 2 (ZBS 2), Robert Koch Institute, Berlin, Germany
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Francisella tularensis in muscle from diseased hares - a risk factor for humans? Epidemiol Infect 2017; 145:3449-3454. [PMID: 29168443 DOI: 10.1017/s0950268817002540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Tularemia caused by the bacterium Francisella tularensis is a zoonotic disease. Tularemia is a common disease in the hare, and as a game species can be an important source of infection for humans. In this study, hares diagnosed with tularemia were examined with the aim to investigate whether the muscle (meat) had any pathological changes and/or contained F. tularensis. Real-time PCR and/or immunohistochemistry (IHC) detected the bacteria in muscle samples from 40 out of 43 investigated hares. IHC showed that bacteria were few and most commonly located in the peri- and endomysium. Histopathology showed occasional perimysial necroses and mild inflammation in association to the bacteria. Attempts to culture from 14 muscle samples were successful in two cases, both stored in the freezer <1 year. The result of this study shows that since F. tularensis is present in the muscle of infected hares, there is a risk for human infection when consuming undercooked hare meat. The risk is enhanced by the fact that some hares do not have easily detected gross lesions. The study contributes to a better understanding of sources of infection and risk factors for humans to contract tularemia.
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