A Review of Significant European Foodborne Outbreaks in the Last Decade.

ABSTRACT: Foodborne diseases remain a global public health challenge worldwide. The European surveillance system of multistate foodborne outbreaks integrates elements from public and animal health and the food chain for early detection, assessment, and control. This review includes descriptions of the significant outbreaks that occurred in Europe in the last decade. Their significance and relevance to public health is derived from the changes, improvements, and novelties that pushed toward building a safer food system in the European Union, certainly driven by the One Health approach. In 2011, a point source monoclonal outbreak of infections caused by Escherichia coli serotype O104:H4 in sprouted seeds resulted in hundreds of cases of hemolytic uremic syndrome and several fatalities. In 2015, a prolonged outbreak of Listeria monocytogenes infections caused by contamination of frozen corn in Europe resulted in 47 cases and nine deaths. In 2016, a persistent polyclonal outbreak of Salmonella Enteritidis was linked to the consumption of eggs and was associated with hundreds of cases. The outbreak evaluations highlight the importance of rapid sharing of data (e.g., sequencing and tracing data) and the need for harmonizing bioinformatics outputs and computational approaches to facilitate detection and investigation of foodborne illnesses. These outbreaks led to development of a legal framework for a European collaboration platform for sharing whole genome sequence data and enabled the enforcement of existing hygiene and food safety provisions and the development of new hygiene guidelines and best practices. This review also briefly touches on the new trends in information technologies that are being explored for food traceability and safety. These technologies could enhance the traceability of food throughout the supply chain and redirect the conventional tracing system toward a digitized supply chain.

Evaluation of oral fluids for surveillance of foodborne and zoonotic pathogens in pig farms.

The use of oral fluid (OF) to detect zoonotic pathogens in pigs has been only scarcely assessed. We evaluated OF as a potential specimen for detection by culture of methicillin-resistant Staphylococcus aureus (MRSA) and Yersinia enterocolitica, and the detection of antibodies against Salmonella spp. and hepatitis E virus (HEV) using commercial ELISAs. Samples from 33 pig farms were collected at the beginning and end of the fattening period. Results of the OF samples were compared with the results of serum samples and nasal swabs from individual pigs and pen floor fecal samples, using the Cohen kappa (κ) and the McNemar test. For Salmonella spp. antibodies, OF samples were negative, although the corresponding serum samples were positive. The detection of HEV antibodies in sera and OF had agreement at the first sampling, and poor and significant agreement at the second sampling (κ = 0.185, McNemar p = 0.238; κ = 0.088, McNemar p < 0.001). At both sampling times, the detection of MRSA in nasal swabs and OF showed agreement (κ = 0.466, McNemar p = 0.077; κ = 0.603, McNemar p = 1); agreement was seen for the detection of Y. enterocolitica in fecal and OF samples (κ = 0.012, McNemar p = 0.868; κ = 0.082, McNemar p = 0.061, respectively). According to the McNemar test, the use of pen-based OFs is more feasible for the detection of MRSA and Y. enterocolitica by culture than is detection of antibodies by commercial ELISA.

The EU one-stop-shop collection of publicly available information on COVID-19 in vitro diagnostic medical devices.

The JRC COVID-19 In Vitro Diagnostic Devices and Test Methods Database, aimed to collect in a single place all publicly available information on performance of CE-marked in vitro diagnostic medical devices (IVDs) as well as in house laboratory-developed devices and related test methods for COVID-19, is here presented. The database, manually curated and regularly updated, has been developed as a follow-up to the Communication from the European Commission "Guidelines on in vitro diagnostic tests and their performance" of 15 April 2020 and is freely accessible at https://covid-19-diagnostics.jrc.ec.europa.eu/.

Effects of Probiotics on Cognitive Reactivity, Mood, and Sleep Quality.

Recent demonstration that probiotics administration has positive effects on mood state in healthy populations suggests its possible role as an adjunctive therapy for depression in clinical populations and as a non-invasive strategy to prevent depressive mood state in healthy individuals. The present study extends current knowledge on the beneficial effects of probiotics on psychological well-being, as measured by changes in mood (e.g., cognitive reactivity to sad mood, depression, and anxiety), personality dimensions, and quality of sleep, which have been considered as related to mood. For this double-blind, placebo-controlled study 38 healthy volunteers assigned to an experimental or control group assumed a daily dose of a probiotic mixture (containing Lactobacillus fermentum LF16, L. rhamnosus LR06, L. plantarum LP01, and Bifidobacterium longum BL04) or placebo, respectively, for 6 weeks. Mood, personality dimensions, and sleep quality were assessed four times (before the beginning of the study, at 3 and 6 weeks, and at 3 weeks of washout). A significant improvement in mood was observed in the experimental group, with a reduction in depressive mood state, anger, and fatigue, and an improvement in sleep quality. No between-groups differences were found. These findings corroborate the positive effect of probiotics on mood state and suggest that probiotics administration may improve psychological well-being by ameliorating aspects of mood and sleep quality.

Consumer Exposure to Antimicrobial Resistant Bacteria From Food at Swiss Retail Level.

Background: Antimicrobial resistance (AMR) in bacteria is an increasing health concern. The spread of AMR bacteria (AMRB) between animals and humans via the food chain and the exchange of AMR genes requires holistic approaches for risk mitigation. The AMRB exposure of humans via food is currently only poorly understood leaving an important gap for intervention design. Method: This study aimed to assess AMRB prevalence in retail food and subsequent exposure of Swiss consumers in a systematic literature review of data published between 1996 and 2016 covering the Swiss agriculture sector and relevant imported food. Results: Data from 313 out of 9,473 collected studies were extracted yielding 122,438 food samples and 38,362 bacteria isolates of which 30,092 samples and 8,799 isolates were AMR positive. A median AMRB prevalence of >50% was observed for meat and seafood harboring Campylobacter, Enterococcus, Salmonella, Escherichia coli, Listeria, and Vibrio spp. and to a lesser prevalence for milk products harboring starter culture bacteria. Gram-negative AMRB featured predominantly AMR against aminoglycosides, cephalosporins, fluoroquinolones, penicillins, sulfonamides, and tetracyclines observed at AMR exposures scores of levels 1 (medium) and 2 (high) for Campylobacter, Salmonella, E. coli in meat as well as Vibrio and E. coli in seafood. Gram-positive AMRB featured AMR against glycoproteins, lincosamides, macrolides and nitrofurans for Staphylococcus and Enterococcus in meat sources, Staphylococcus in seafood as well as Enterococcus and technologically important bacteria (incl. starters) in fermented or processed dairy products. Knowledge gaps were identified for AMR prevalence in dairy, plant, fermented meat and novel food products and for the role of specific indicator bacteria (Staphylococcus, Enterococcus), starter culture bacteria and their mobile genetic elements in AMR gene transfer. Conclusion: Raw meat, milk, seafood, and certain fermented dairy products featured a medium to high potential of AMR exposure for Gram-negative and Gram-positive foodborne pathogens and indicator bacteria. Food at retail, additional food categories including fermented and novel foods as well as technologically important bacteria and AMR genetics are recommended to be better integrated into systematic One Health AMR surveillance and mitigation strategies to close observed knowledge gaps and enable a comprehensive AMR risk assessment for consumers.

Quantitative Outcomes of a One Health approach to Study Global Health Challenges.

Having gained momentum in the last decade, the One Health initiative promotes a holistic approach to address complex global health issues. Before recommending its adoption to stakeholders, however, it is paramount to first compile quantitative evidence of the benefit of such an approach. The aim of this scoping review was to identify and summarize primary research that describes monetary and non-monetary outcomes following adoption of a One Health approach. An extensive literature search yielded a total of 42,167 references, of which 85 were included in the final analysis. The top two biotic health issues addressed in these studies were rabies and malaria; the top abiotic health issue was air pollution. Most studies described collaborations between human and animal (n = 42), or human and environmental disciplines (n = 41); commonly reported interventions included vector control and animal vaccination. Monetary outcomes were commonly expressed as cost-benefit or cost-utility ratios; non-monetary outcomes were described using disease frequency or disease burden measurements. The majority of the studies reported positive or partially positive outcomes. This paper illustrates the variety of health challenges that can be addressed using a One Health approach, and provides tangible quantitative measures that can be used to evaluate future implementations of the One Health approach.

Evaluation of the safety and efficacy of the organic acids lactic and acetic acids to reduce microbiological surface contamination on pork carcasses and pork cuts.

Studies evaluating the safety and efficacy of lactic and acetic acids to reduce microbiological surface contamination on pork carcasses pre-chill and pork meat cuts post-chill were assessed. Lactic acid treatments consisted of 2-5% solutions at temperatures of up to 80°C applied to carcasses by spraying or up to 55°C applied on cuts by spraying or dipping. Acetic acid treatments consisted of 2-4% solutions at temperatures of up to 40°C applied on carcasses by spraying or on cuts by spraying or dipping. The maximum treatment duration was 30 s. The Panel concluded that: [1] the treatments are of no safety concern, provided that the substances comply with the European Union specifications for food additives; [2] spraying of pork carcasses pre-chill with lactic acid was efficacious compared to untreated control, but based on the available data, the Panel could not conclude whether lactic acid was more efficacious than water treatment when spraying of pork carcasses pre-chill or pork meat cuts post-chill. The Panel concluded that dipping of pork meat cuts post-chill in lactic acid was more efficacious than water treatment. However, it could not conclude on the efficacy of acetic acid treatment of pork carcasses pre-chill and/or pork meat cuts post-chill; [3] the potential selection and emergence of bacteria with reduced susceptibility to biocides and/or resistance to therapeutic antimicrobials linked to the use of the substances is unlikely as long as Good Hygienic Practices are implemented; and [4] the release of both organic acids is not of concern for the environment, assuming that wastewaters released by the slaughterhouses are treated, if necessary, to counter the potentially low pH caused by lactic or acetic acid, in compliance with local rules.

Serological and Molecular Investigation of Swine Hepatitis E Virus in Pigs Raised in Southern Italy.

Hepatitis E virus (HEV) infection is a common acute hepatitis transmitted by the fecal-oral route. In developed countries, the virus has a zoonotic potential, and domestic pigs and wild boars are considered main reservoirs. To assess the prevalence of HEV-positive animals in the Calabria region (southern Italy) on a serological and molecular level, a total of 216 autochthonous healthy pigs (Apulo-Calabrese breed) were sampled. Both sera and feces were collected. Pigs were grouped based on age: 117 pigs <6 months and 99 pigs >6 months. By using a commercial enzyme-linked immunosorbent assay system, a total of 173 (80%) of the 216 pigs tested seropositive. In all sampled farms (n = 8), pigs with antibodies (immunoglobulin G) against HEV were detected at a level higher than 60%, with a significant difference among age groups (P < 0.0001). Moreover, 16 fattening pigs were found to be nested reverse transcription PCR positive and thus to shed viral genomes in their feces. These positive findings resulted in a prevalence of 48.4% on the farm level (16 of 35 pigs) and an overall prevalence of 7.4% at the animal level (16 of 216 pigs). Based on the present study, HEV seems to circulate among the autochthonous domestic pig population of southern Italy with a low sharing rate. Further studies exploring the origin of infection are needed to minimize the risk of human exposure and to reduce consequences for public health.

Use of Sonoelastography to Evaluate Texture Modifications of Mozzarella di Bufala Campana Protected Designation of Origin During Storage at Different Temperatures.

Mozzarella cheese from buffalo milk is a fresh, stringy-textured dairy product, exhibiting a porcelain white colour, a smooth, bright, and humid surface, an extremely thin rind and delicate taste. The high humidity typical of this cheese reduces its shelf-life and it is cause of dramatic organoleptic changes during storage. In this study we tested sonoelastography to evaluate texture changes of mozzarella cheese from buffalo milk during storage. Cheeses form local market produced in the same condition were divided in three batches and stored in different conditions: the first (B1) was stored in preserving liquid at room temperature (20°C); the second (B2) was stored without preserving liquid at 4°C; and the third (B3) was stored at 4°C in preserving liquid. In B1 sonoelastography showed a reduction of the hardness and stiffness of rind, while in B2 inelastic tissue increased its thickness. Best results were obtained in B3, where no significant difference was evidenced during storage.