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Europe sees big drop in E. coli infections in 2020

There was a big drop in the number of Shiga toxin-producing E. coli (STEC) infections in Europe in 2020, according to recently published data.

In 2020, 4,824 confirmed STEC infections were reported. This is down from 8,339 in 2019. STEC infection is acquired primarily through consumption of contaminated food or water and contact with animals or their feces.

Data on STEC infections were reported by 29 countries. Notification is voluntary in Belgium, France, Luxembourg and Spain or based on another type of system in Italy.

Germany with 1,409 and Ireland with 734 had the most infections, accounting for 44 percent of all cases. The highest country-specific notification rates were recorded in Ireland, Malta, Denmark and Norway.

HUS case data and type of E. coli
The age group 0 to 4 years represented 1,326 of the 4,819 patients for whom age information was available.

A total of 39 percent of the 1,957 STEC patients with information were hospitalized, and 14 people died. Most of the deaths occurred in people over 65 years of age, and a third of them suffered from hemolytic uremic syndrome (HUS), which is a type of kidney failure.

Of 324 HUS cases, most were in the 0-4 or 5-14 age group, with a case fatality rate of 2 percent.

The majority of HUS cases caused by O26 were reported from France, Italy, and Ireland; the first two base their surveillance of STEC infections on the detection of HUS cases.

The five most common serogroups were O26, O157, O103, O145, and O146. There has been an increasing trend in STEC O26 over the past five years, while STEC O157 infections have decreased over the same period, the European Center for Disease Prevention and Control (ECDC) said.

There were 34 outbreaks involving 208 people in nine countries. Two outbreaks were caused by tap or well water and one by meat products, dairy products other than cheese, and cheese made from cow’s milk. STEC O157 was behind three outbreaks, two were linked to STEC O145 and one was caused by STEC O26.

In the five-year period from 2015 to 2019, there was an increase in the overall trend of reported STEC cases. However, in 2020 infections decreased markedly due to the COVID-19 pandemic and figures for the United Kingdom are no longer included.

Brucella infections hit record low
Brucella infections also decreased from 314 in 2019 to 134 in 2020.

Brucellosis occurs when people come into contact with infected animals or consume contaminated animal products, such as unpasteurized milk and milk products or undercooked meat.

Brucellosis data were reported by 28 countries. In Denmark, it is not reportable or under surveillance. Notification is compulsory in other EU countries, but in Belgium it is based on another type of system.

Greece, France, Germany and Italy had the most confirmed cases. Greece had the highest rate, followed by Portugal and Sweden. In Sweden, all reported cases were travel-related.

Nearly two-thirds of the 129 reported cases of brucellosis were hospitalized and two were fatal.

The COVID-19 pandemic significantly affected the number of reported infections in 2020, with cases falling to their lowest level since the start of EU-level surveillance in 2007, the ECDC said.

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