Toxoplasmosis is a foodborne zoonosis transmitted by Toxoplasma gondii, a cosmopolitan protozoan that infects humans through exposure to different parasite stages, in particular by ingestion of tissue cysts or tachyzoites contained in meat, primary offal (viscera), and meat-derived products or ingestion of environmental sporulated oocysts in contaminated food or water.
The pig is an important species for infection: raw or undercooked pork consumption not subject to treatment able to inactivate the parasite represents a risk to consumers’ health. Broadening knowledge of transmission ways and prevalence concerning this important pathogen in swine, together with a thorough acquaintance with hazard management are key elements to avoid T. gondii spreading within the swine production chain.
This review aims to illustrate why toxoplasmosis should be regarded as a veterinary public health issue through a careful description of the parasite, routes of infection, and inactivation treatments, highlighting the main prevention lines from pig breeding to pork consumption.
Toxoplasma gongii, a foodborne pathogen in the swine production chain form a European perspective
Hate is a strong word, but when it comes to food poisoning outbreaks that kill little kids and others, it’s not a scare, it’s real.
A scare implies former scream-queen Jamie-Lee Curtis flogging yoghurt that makes people poop.
That’s a food scare.
See how many times the N.Y. Times can use the word scare in its opening paragraphs:
The European Union on Monday notified the food safety authorities in Britain, France, Sweden and Switzerland to be on the lookout for contamination in eggs after a food scare in Belgium, Germany and the Netherlands.
Anna-Kaisa Itkonen, a European Commission spokeswoman, said, “We do not know if the eggs are contaminated or not, but because of these notifications, it’s now up to the national authorities to check.”
The scare over contaminated eggs, which began in Belgium, has led supermarkets there and in Germany and the Netherlands to clear shelves of the product as the crisis entered its third week.
The removal of eggs from shops was prompted by the discovery of the insecticide fipronil in some shipments. The contamination is thought to have been caused by the mixing of the insecticide with a cleaning agent used at chicken farms. The scare began July 19 when the government of Belgium said that fipronil had been found in eggs produced there.
Major supermarket chains in Belgium, including Delhaize and Colruyt, have stopped selling eggs from affected farms. In the Netherlands, one poultry producer declared bankruptcy on Friday as a result of the insecticide scare, according to an industry group.
The Dutch consumer safety authority has published a guide on identifying the tainted eggs through a 10-digit serial number stamped on the shells. The country’s biggest supermarket chain, Albert Heijn, stopped selling many eggs last week, but the company said that eggs were back on sale as normal on Monday. In the Netherlands, an estimated nine million chickens from about 180 farms have been affected.
In Germany, the supermarket chain Aldi withdrew all eggs from sale after the authorities said that about three million eggs imported from the Netherlands had been affected. Since then, fipronil contamination has been found at four farms in the German state of Lower Saxony.
Fipronil is toxic in large quantities and can damage kidneys, liver and lymph glands. The Belgian and Dutch authorities are investigating how the contamination happened.
The Dutch poultry association said that farmers had no idea that cleaners were using the substance. Aalt den Herder, the group’s secretary, said the risk had been overstated.
“It was never an issue of human health, it was an issue of consumer confidence,” he said.
Belgian authorities have now admitted they began investigating pesticide contamination in eggs in early June – several weeks before the public was made aware of a food safety scare affecting several European countries.
Kathy Brison, of the Belgian food safety agency, said on Sunday that a Belgian farm alerted authorities to a possible contamination in June, and they began investigating and alerted Belgian prosecutors.
German authorities are frustrated by the apparent delay in informing European neighbours.
German Agriculture Minister Christian Schmidt plans to speak to his Belgian counterpart about the issue on Monday.
And where would a risk communication failure be without the UK Food Standards Agency, who today reported, “We have no evidence that eggs laid in the UK are contaminated or that Fipronil has been used inappropriately in the UK. 85% of the eggs we consume in the UK are laid here.
“The number of eggs involved represents about 0.0001% of the eggs imported into the UK each year. Our risk assessment, based on all the information available, indicates that as part of a normal healthy diet this low level of potential exposure is unlikely to be a risk to public health and there is no need for consumers to be concerned. Our advice is that there is no need for people to change the way they consume or cook eggs or products containing eggs.”
Sounds good if they’re all getting “laid here.”
Going public: Early disclosure of food risks for the benefit of public health
NEHA, Volume 79.7, Pages 8-14
Benjamin Chapman, Maria Sol Erdozaim, Douglas Powell
Often during an outbreak of foodborne illness, there are health officials who have data indicating that there is a risk prior to notifying the public. During the lag period between the first public health signal and some release of public information, there are decision makers who are weighing evidence with the impacts of going public.
Multiple agencies and analysts have lamented that there is not a common playbook or decision tree for how public health agencies determine what information to release and when. Regularly, health authorities suggest that how and when public information is released is evaluated on a case-by-case basis without sharing the steps and criteria used to make decisions. Information provision on its own is not enough.
Risk communication, to be effective and grounded in behavior theory, should provide control measure options for risk management decisions.
There is no indication in the literature that consumers benefit from paternalistic protection decisions to guard against information overload. A review of the risk communication literature related to outbreaks, as well as case studies of actual incidents, are explored and a blueprint for health authorities to follow is provided.
Raphael Minder of The New York Times reports police in Europe have dismantled a criminal network that was selling horse meat across the Continent that was “not suitable for consumption,” arresting 66 people as part of a four-year investigation prompted by the discovery in Ireland of horse meat in burgers sold as beef.
Europol, the European Union’s law enforcement agency, said on Sunday that all but one of the arrests had been made in Spain. But the Spanish police said in a separate statement that their part of the investigation had accounted for “a small portion of a network stretching across the whole of Europe, under the control of a Dutch citizen.”
The Dutch citizen, who has not been publicly identified and was taken into custody in April in Belgium, was described in a Europol statement as the leader of a criminal gang that had acquired horses on the Iberian Peninsula that were judged to be “in bad shape, too old or simply labeled as ‘not suitable for consumption.’ ”
The animals’ meat was processed and sent to Belgium, one of the European Union’s biggest exporters of horse meat, and the criminal organization modified the animals’ microchips and documentation to facilitate the fraudulent export, the statement said.
In addition to the arrests, the Spanish police said on Sunday that they had seized property and luxury cars, and that they had frozen bank accounts. The police in Britain, France, Italy, Portugal, Romania and Switzerland also carried out interventions, according to Europol, although the statement did not provide details.
Consumption of raw or undercooked pork meat and liver is the most common cause of hepatitis E infection in the EU, said the European Food Safety Authority.
More than 21,000 cases of hepatitis E infections have been reported in humans over the last 10 years, with an overall 10-fold increase in this period.
Rosina Girones, chair of EFSA’s working group on hepatitis E, said: “Even if it is not as widespread as other foodborne diseases, hepatitis E is a growing concern in the EU. In the past, people thought the main source of infection was drinking contaminated water while travelling outside the EU. But now we know the main source of transmission of the disease in Europe is food.”
Domestic pigs are the main carriers of hepatitis E in the EU. Wild boars can also carry the virus, but meat from these animals is less commonly consumed.
Experts from EFSA’s Panel on Biological Hazards recommend that Member States increase awareness of public health risks associated with raw and undercooked pork meat and advise consumers to cook pork meat thoroughly. They also recommend the development of suitable methods for detecting hepatitis E in food.
The European Centre for Disease Prevention and Control (ECDC) has today also published a report on hepatitis E in humans which assesses testing, diagnosis and monitoring methods and reviews available epidemiological data.
Hepatitis E is a liver disease caused by the hepatitis E virus (HEV).
Most people who contract hepatitis E display no or mild symptoms. However, in some cases especially for those with liver damage or patients with a weak immune system, it can lead to liver failure – which can be fatal.
The European Centre for Disease Prevention reports that since March 2016, four EU Member States have reported a total of 40 cases of a new Salmonella serotype with an antigenic formula 11:z41:enz15, which has never been described before. The cases have been reported from Greece (N=22), Germany (N=10), Czech Republic (N=5) and Luxembourg (N=3). Pulsed-Field Gel Electrophoresis (PFGE) and Whole Genome Sequencing (WGS) have confirmed the genetic closeness of the Salmonella isolates, suggesting a common source of infection. The latest case reports are from February 2017.
An epidemiological analytical study performed in Greece in 2016 found an association between infection and a sesame-based product. This hypothesis was confirmed by the identification of the same Salmonella serotype in sesame seeds in October 2016 in Germany. As sesame seeds have a long shelf life and new cases have been reported recently, it is likely that contaminated batches have been circulating in the food chain for several months in a number of Member States.
Although few new cases have been reported in the last three months, the outbreak still appears to be ongoing.
Listeriosis affected about 2,200 people in 2015, causing 270 deaths – the highest number ever reported in the EU. The proportion of cases in the over 64 age group steadily increased from 56% in 2008 to 64% in 2015. Additionally, in this period, the number of reported cases and their proportion has almost doubled in those over 84 years.
“It is concerning that there continues to be an increasing trend of Listeria cases which mostly occur in the elderly population. ECDC is working together with Member States to enhance surveillance for food- and waterborne diseases, starting with Listeria, as earlier detection of relevant clusters and outbreaks can help prevent further cases,” said Mike Catchpole, Chief Scientist at ECDC. “This is a public health threat that can and needs to be addressed”, he added.
Dr. Marta Hugas, Head of Biological Hazards and Contaminants at EFSA, said: “Listeria seldom exceeded the legal safety limits in ready-to-eat foods, the most common foodborne source of human infections. However, it is important that consumers follow manufacturers’ storage instructions and the guidelines given by national authorities on the consumption of foods.”
In 2015, there were 229,213 reported cases of campylobacteriosis. This disease remains the most commonly reported foodborne disease in the EU, showing an upward trend since 2008. Campylobacter is mostly found in chickens and chicken meat.
The number of cases of salmonellosis, the second most commonly reported foodborne disease in the EU, increased slightly – from 92,007 in 2014 to 94,625 in 2015. The increase observed in the past two years is partly due to improvements in surveillance and better diagnostic methods. However, the long-term trend is still declining and most Member States met their Salmonella reduction targets for poultry populations.
Salmonella is mainly found in meat (poultry) intended to be cooked before consumption.
The overall aim for these EQA schemes was to enhance the European surveillance of food-borne pathogens by evaluating and improving the quality and comparability of molecular typing. The EQAs were organised by Statens Serum Institut (SSI) and included Salmonella enterica subsp. enterica, verocytotoxin-producing Escherichia coli (VTEC) and Listeria monocytogenes. Inter-laboratory comparable pulsed-field gel electrophoresis (PFGE) images were obtained from 10 of 17 of the participating laboratories for Listeria, 15 of 25 for Salmonella, but only nine of 20 for VTEC. Most problems were related to PFGE running conditions and/or incorrect use of image acquisition. Analysis of the gels was done in good accordance with the provided guidelines. Furthermore, we assessed the multilocus variable-number tandem repeat analysis (MLVA) scheme for S. Typhimurium. Of 15 laboratories, nine submitted correct results for all analysed strains, and four had difficulties with one strain only. In conclusion, both PFGE and MLVA are prone to variation in quality, and there is therefore a continuous need for standardisation and validation of laboratory performance for molecular typing methods of food-borne pathogens in the human public health sector.
Evaluation of molecular typing of foodborne pathogens in European reference laboratories from 2012 To 2013
Eurosurveillance, Volume 21, Issue 50, 15 December 2016
S Schjørring, T Niskanen, M Torpdahl, JT Björkman, EM Nielsen
TSEs are a group of diseases that affect the brain and nervous system of humans and animals. With the exception of Classical BSE, there is no scientific evidence that other TSEs can be transmitted to humans.
A low number of BSE cases in cattle were detected in EU Member States, none of which entered the food chain.
Some of the main findings of the report are:
Five cases of BSE in cattle have been reported in the EU, out of about 1.4 million animals tested.
641 cases of scrapie in sheep (out of 319,638 tested) and 1,052 in goats have been reported (out of 135,857 tested) in the EU.
This report provides results on data collected by all EU Member States, Iceland, Norway and Switzerland for 2015 on the occurrence of bovine spongiform encephalopathy
According to the notice on the website, it is apparent that the laboratory analysis was conducted 20 days earlier, on 21 October. So, the obvious question is why was the finding sent 20 days later and why Croatian consumers were not informed about it.
The explanation was given by the Agriculture Ministry, which is responsible for informing citizens about possible withdrawal of food from the market. They said that Croatia, which is a member of the RASFF system, submitted information that one retailer conducted analysis of chicken from Poland (on 21 October) and that the presence of salmonella was found. “Even before obtaining laboratory reports, the meat was past its expiry date and therefore was no longer present in the market. That is the reason why the information in the RASFF system is classified only as a “notice of information”, and not as an “alert”. So, this chicken is no longer on the market in Croatia”, according to the Ministry.
However, while the reply states that the public was not informed because at the time when the report was finished the expiry date had already passed, it seems that the chicken was on the market while waiting for the findings, which realistically means that today someone might have in their freezer contaminated chicken which was bought in October.
It is interesting that the analysis which led to the discovery of salmonella in the chicken took place in the midst of another scandal with salmonella in eggs imported also from Poland. It is therefore worrying that this information was not officially released by the Agriculture Ministry.
It has been just over a month since a boy from Bregana, Mirko Vidović, died after eating eggs that have been infected with salmonella. Although the autopsy process has still not been completed, so the exact cause of death is not known, it is known that the eggs he ate were infested with salmonella. The eggs were withdrawn from the shops. Immediately after the Croatian case was reported to RASFF, it was discovered that several other similar cases were reported in the EU, all connected to a facility in Poland. At the time, as many as 12 other European countries reported salmonella cases as well.
Cases have been reported by Belgium, Denmark, Luxembourg, the Netherlands, Norway, Sweden and the UK. In addition, Croatia reported a cluster of cases, including one death, possibly associated with this outbreak.
Whole genome sequencing, food and environmental investigations, and trace-back investigations established a link between the outbreak and an egg packing centre in Poland. Evidence suggests eggs as the most likely source of infection.
Polish competent authorities and Member States to which suspect eggs were distributed have now halted distribution.
To contain the outbreak and identify possible new cases promptly, the European Centre for Disease Prevention and Control (ECDC) and EFSA recommend that EU Member States step up their monitoring.
Affected countries should continue sharing information on the epidemiological, microbiological and environmental investigations, including issuing relevant notifications using the Rapid Alert System for Food and Feed (RASFF) and the Early Warning and Response System (EWRS), the latter representing the official channel to notify serious cross border threats to health.