The number of foodborne outbreaks reported in Germany halved in 2020, according to a report, but did include a large Salmonella outbreak linked to imported dried coconut.

The Robert Koch Institute (RKI) and Federal Office for Consumer Protection and Food Safety (BVL) said a factor in the decline was the coronavirus pandemic.

In 2020, the two entities received significantly fewer reports of foodborne disease outbreaks than in previous years. In total, 193 outbreaks were reported with 1,143 illnesses, 174 hospitalizations and four deaths compared to 402 outbreaks, 1,970 illnesses, 385 hospitalizations and five deaths in 2019.

As in previous years, the most common causes this past year were Campylobacter and Salmonella. However, Salmonella and Campylobacter infections decreased by 46 percent and 22 percent, respectively, based on calculations by the Robert Koch Institute.

Other pathogens that caused outbreaks were norovirus, Bacillus cereus, Yersinia enterocolitica, Shiga toxin-producing E. coli (STEC), Clostridium perfringens, hepatitis A and E viruses, Listeria monocytogenes, histamines, and Giardia lamblia. The agent was unknown in 10 outbreaks that affected 50 people.

COVID-19 impact
Measures to control the pandemic may be at least partially responsible for the decline in reported foodborne infections and outbreaks, said RKI and BVL. Hygiene such as frequent handwashing can also reduce transmission of foodborne diseases. The closure of restaurants, canteens and cafeterias, as well as cancelled or smaller events with fewer people and without catering facilities, likely reduced the amount of incidents, according to the report.

The agencies added it was possible that infections and outbreaks were also under-recorded, as people with gastrointestinal symptoms may have sought treatment less often for fear of contracting COVID-19 plus the reduced diagnosis and reporting.

Bacillus cereus caused four of 15 outbreaks with high evidence, as defined by the European Food Safety Authority (EFSA), affecting 96 people. Campylobacter and Clostridium perfringens were behind three each with 13 and 64 people sick respectively. Two were due to histamine and Salmonella with 14 and 231 sick including 52 hospitalizations. One was caused by Listeria with 35 sick, 31 hospitalizations and three deaths. It is believed to have been caused by smoked trout fillets from Denmark.

Campylobacter and raw milk was the most frequently reported combination of pathogen and causative food with three outbreaks. Others that occurred twice were Bacillus cereus in rice, and histamine in tuna.

Large outbreak traced to dried coconut
The largest outbreak sickened 161 people and was caused by Salmonella Muenchen. In total, 37 people were hospitalized. It was traced to dried coconut pieces imported from Mozambique.

The second largest, with 70 cases and 15 hospitalizations, was caused by Salmonella Brandenburg. It was linked to a kebab shop in Saxony-Anhalt.

Contributing factors to high evidence outbreaks included inadequate heat treatment; failure to comply with time or temperature storage conditions; inadequate cooling, and cross contamination.

For 178 outbreaks, the evidence of a link between a food and the diseases was judged as low. Campylobacter caused 95 of these outbreaks while Salmonella was behind 41 of them. Overall, at least 690 people fell ill, 90 were hospitalized and one person died.

Four STEC outbreaks sickened 38 people and five Yersinia outbreaks affected 10 people. There were 126 cases in nine norovirus outbreaks, 41 patients in one hepatitis A outbreak and six affected in three hepatitis E outbreaks.

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