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Boone I, Rosner B, Lachmann R, D'Errico ML, Iannetti L, Van der Stede Y, Boelaert F, Ethelberg S, Eckmanns T, Stark K, Haller S, Wilking H. Healthcare-associated foodborne outbreaks in high-income countries: a literature review and surveillance study, 16 OECD countries, 2001 to 2019. Euro Surveill 2021; 26:2001278. [PMID: 34651575 PMCID: PMC8518306 DOI: 10.2807/1560-7917.es.2021.26.41.2001278] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 03/25/2021] [Indexed: 11/20/2022] Open
Abstract
BackgroundHealthcare-associated foodborne outbreaks (HA-FBO) may have severe consequences, especially in vulnerable groups.AimThe aim was to describe the current state of HA-FBO and propose public health recommendations for prevention.MethodsWe searched PubMed, the Outbreak Database (Charité, University Medicine Berlin), and hand-searched reference lists for HA-FBO with outbreak onset between 2001 and 2018 from Organisation for Economic Co-operation and Development (OECD) countries and HA-FBO (2012-2018) from the German surveillance system. Additionally, data from the European Food Safety Authority were analysed.ResultsThe literature search retrieved 57 HA-FBO from 16 OECD countries, primarily in the US (n = 11), Germany (n = 11) and the United Kingdom (n = 9). In addition, 28 HA-FBO were retrieved from the German surveillance system. Based on the number of outbreaks, the top three pathogens associated with the overall 85 HA-FBO were Salmonella (n = 24), norovirus (n = 22) and Listeria monocytogenes (n = 19). Based on the number of deaths, L. monocytogenes was the main pathogen causing HA-FBO. Frequently reported implicated foods were 'mixed foods' (n = 16), 'vegetables and fruits' (n = 15) and 'meat and meat products' (n = 10). Consumption of high-risk food by vulnerable patients, inadequate time-temperature control, insufficient kitchen hygiene and food hygiene and carriers of pathogens among food handlers were reported as reasons for HA-FBO.ConclusionTo prevent HA-FBO, the supply of high-risk food to vulnerable people should be avoided. Well working outbreak surveillance facilitates early detection and requires close interdisciplinary collaboration and exchange of information between hospitals, food safety and public health authorities.
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Affiliation(s)
- Idesbald Boone
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
| | - Bettina Rosner
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
| | - Raskit Lachmann
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
| | - Michele Luca D'Errico
- Istituto Superiore di Sanità, Department of Food Safety, Nutrition and Veterinary Public Health, Rome, Italy
| | - Luigi Iannetti
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, National Reference Laboratory for Listeria monocytogenes, Teramo, Italy
| | | | | | - Steen Ethelberg
- Statens Serum Institut, Infectious Disease Epidemiology and Prevention, Copenhagen, Denmark
| | - Tim Eckmanns
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
| | - Klaus Stark
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
| | - Sebastian Haller
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
| | - Hendrik Wilking
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
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Lund BM. Provision of microbiologically safe food for vulnerable people in hospitals, care homes and in the community. Food Control 2019. [DOI: 10.1016/j.foodcont.2018.09.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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3
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Lund BM. Microbiological Food Safety for Vulnerable People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:10117-32. [PMID: 26308030 PMCID: PMC4555333 DOI: 10.3390/ijerph120810117] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/11/2015] [Accepted: 08/14/2015] [Indexed: 12/29/2022]
Abstract
Foodborne pathogens are more likely to cause infection and to result in serious consequences in vulnerable people than in healthy adults. People with some increase in susceptibility may form nearly 20% of the population in the UK and the USA. Conditions leading to increased susceptibility are listed. The main factors leading to foodborne disease caused by major pathogens are outlined and examples are given of outbreaks resulting from these factors. Measures to prevent foodborne disease include procedures based on Hazard Analysis Critical Control Point principles and prerequisite programmes and, especially for vulnerable people, the use of lower-risk foods in place of higher-risk products.
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Affiliation(s)
- Barbara M Lund
- Institute of Food Research, Norwich Research Park, Norwich, NR4 7UA, UK,.
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Lund BM, O'Brien SJ. Microbiological safety of food in hospitals and other healthcare settings. J Hosp Infect 2009; 73:109-20. [PMID: 19732991 DOI: 10.1016/j.jhin.2009.05.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Accepted: 05/22/2009] [Indexed: 11/16/2022]
Abstract
Cases and outbreaks of foodborne infection in healthcare settings can result in serious illness, wastage of expensive medical treatments, spread of infection to other patients and staff and disruption of services. Providing nutritious meals for vulnerable people in healthcare settings involves a systematic approach to microbiological safety, as provided by hazard analysis and critical control point (HACCP) principles. The types of food served in healthcare settings should be selected to minimise the risk of foodborne infection.
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Abstract
Campylobacter species are among the most commonly identified causative agents of acute bacterial gastroenteritis in humans worldwide. In Austria, campylobacteriosis has been a notifiable disease since 1996 and its incidence has increased continuously over the past years. Improvement of notification has led to an important increase in knowledge of the epidemiology of this disease in Austria. In addition to existing programs monitoring food safety, implementation of a national surveillance program to monitor antimicrobial resistance and the prevalence of campylobacter in food animals allows continuous surveillance of trends in antimicrobial susceptibility patterns in humans, animals and food, as well as a more comprehensive evaluation of the occurrence of campylobacter in the relevant reservoirs of human infection. Such data make it possible to identify the most important areas for intervention and launch of control strategies. As in other countries around the world, antimicrobial resistance of campylobacter from human, animal and food origin, particularly resistance to fluoroquinolones, is of public health concern in Austria. The magnitude of global trade and foreign travel requires EU-wide and worldwide implementation of control strategies to fight campylobacteriosis.
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Affiliation(s)
- Gebhard Feierl
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Austria
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