欧洲疾控中心-沙门氏菌病-2023年度流行病学报告（英）-2025_10页_1mb

Salmonellosis Annual Epidemiological Report for 2023 Summary

Core Content

Salmonellosis remains a significant public health concern in the European Union/European Economic Area (EU/EEA), being the second most commonly reported gastrointestinal infection. In 2023, 78,307 laboratory-confirmed cases were reported, with a notification rate of 18.1 cases per 100,000 population, marking an 18.2% increase compared to 2022. This rate is almost back to pre-pandemic levels, with seven countries showing statistically significant increasing trends and only one country (Czechia) showing a significant decrease.

Main Points

Case Rates and Trends

• Total cases: 78,307
• Fatality rate: 88 cases, 0.19% CFR
• Highest rates: Slovakia (73.7), Czechia (69.1), Hungary (46.0)
• Lowest rates: Portugal (5.1), Latvia (5.4), Italy (5.6)
• Seasonal pattern: Cases peak from July to September
• Pandemic impact: A marked drop in cases was observed in 2020 due to pandemic-related restrictions
• Trends (2019–2023): 7 countries showed increasing trends, 1 country showed decreasing trend

Age and Gender

• Gender: No significant difference in notification rates between males and females
• Age: Young children (0–4 years old) had the highest notification rate (91.3 per 100,000), nine times higher than adults (25–64 years old)
• Countries with largest age differences: Bulgaria, Cyprus, Hungary, Poland, and Portugal
• Countries with lowest rates in young children: Finland, Ireland, Sweden, and Norway

Food Sources

• Highest risk foods: Eggs and egg products
• Other food sources: Meat and meat products, mixed foods, milk and milk products, foods of non-animal origin, and fish and fishery products
• Travel-associated cases: 13% of cases with known travel history were travel-associated, with Türkiye, Thailand, Egypt, Spain, and Morocco as the most frequently reported destinations

Antimicrobial Resistance (AMR)

• Multidrug resistance: 19.1% of isolates
• Resistance to critically important antimicrobials:
  • Fluoroquinolones: Increased in 18 of 26 countries, with 21.8% resistance overall
  • Third-generation cephalosporins: Low and stable, with 1.3–1.6% resistance
• Resistance to both fluoroquinolones and cephalosporins: 1.1%
• S. Kentucky: 73.0% multidrug resistance, 17.2% resistance to both fluoroquinolones and cephalosporins
• Azithromycin resistance: Low (<1%)

Key Information

Surveillance Systems

• Notification status: Mandatory in most countries, voluntary in Belgium, France, and the Netherlands
• Population coverage: 85% in Belgium, 64% in the Netherlands, 80% in Spain
• Reporting formats: 29 countries reported case-based data, while Bulgaria reported aggregated data

Outbreaks

• Total outbreaks reported: 44 (in the EU/EEA), 7 (outside the EU/EEA)
• Multi-country outbreaks: 28 out of 44, with 6 covered in joint ECDC-EFSA Rapid Outbreak Assessments
• Common vehicles: Eggs and egg products, chicken kebab, chicken meatballs, small tomatoes, cantaloupe melon
• Serotypes involved: S. Enteritidis (20 outbreaks), S. Typhimurium, S. Virchow, S. Chester, S. Senftenberg, S. Strathcona, S. Saintpaul

WGS Utilization

• WGS data: 29 EU/EEA countries provided data for about 2,800 isolates
• Use of WGS: Enhanced outbreak detection and linkage, especially for multi-country outbreaks
• Limitations: Most infections are not sequenced, limiting outbreak assignment and cluster detection

Conclusion

Salmonellosis continues to be a prevalent food-borne infection in the EU/EEA, with notable variations in case rates across countries. The disease primarily affects young children, with a significantly higher notification rate than adults. Eggs and egg products remain the most common source of outbreaks, but non-animal food sources have also been implicated. Antimicrobial resistance, particularly to fluoroquinolones, has increased in most countries, raising concerns about treatment options. The use of whole-genome sequencing has improved outbreak detection and understanding, although its application is still limited. Public health measures and improved surveillance are essential to mitigate the spread and impact of salmonellosis.