Sweden – Report on food poisoning in Sweden during 2020. 

Livsmedelsverket

The report describes how many people become ill from the food, which are the most common infectious agents and foods that cause the disease cases, where in the food chain the designated foods are contaminated, which countries of origin were indicated for the designated foods, what contributing factors were identified, seasonal variation and changes in recent years. The results from the report provide information to those who have an interest or need for this type of knowledge in their profession and not least to show and give feedback on the valuable work performed by those who investigate, report and otherwise study food poisoning.

Summary Reported Foodborne Illness in Sweden 2020
This Report compiles food poisonings reported to the Swedish Food Agency in 2020. A new online form for submitting reports to the Swedish Food Agency was launched in January 2020, aiming to raise the quality of reported data. In 2020, the Covid-19 pandemic was ongoing also, which affected the number of food poisoning outbreaks during the year.
By food poisoning is meant here an illness caused by eating food containing harmful bacteria, parasites, viruses or toxins. The main purpose of the compilation is to support food poisoning investigations in several ways:
by giving the present position of the most recent food poisonings;
by presenting data that can be used to connect different pathogens to different kinds of foods.by making it possible to follow the development of different combinations;
by making it possible to implement risk management measures as effectively as possible.
The Swedish Food Agency regulation LIVSFS 2005:7 instructs municipal control authorities, in co-operation with health professionals, the County Administrative Board and the Public Health Agency of Sweden, to conduct epidemiological investigations of foodborne outbreaks.
The results must be reported to the Swedish Food Agency without delay. Health Agency and Swedish Food Agency in consultation supplement the control authorities’ reports with reports on local and national outbreaks.
The Report is based on 173 reported events of suspected or confirmed food poisoning with a total of 1,314 cases of illness. In 160 of the reports it was stated that two or more persons were infected from the same source. When compared to the 2019 compilation, we can note that both the number of reports and cases of illness were almost halved in 2020.
This reduction may be due to the restrictions and recommendations introduced in connection to Covid-19 pandemic. For example, there were fewer people using restaurant services, better hand hygiene among people handling food and the cancellation of major public events where food may have been served.
Most reports indicated that the cause was unknown (71%), however for 44% of the reported cases virus was cited as the cause. This is due to 23 outbreaks with 571 cases of illness where the cause was virus. Norovirus continues to cause major outbreaks (22 food poisoning outbreaks with a total of 513 cases), followed by campylobacter which was reported in 4 outbreaks with 158 cases, Vibrio parahaemolyticus, an unusual foodborne pathogen in Sweden, was associated with one outbreak of 50 cases of illness.
The food categories that had the most reported cases of illness were bakery products (210 cases), chicken (155 cases) and foods from the sea (164 cases).Bakery products were a source of infection in outbreaks where norovirus and STEC (Shigatoxin-producing E. coli) were the cause -200 cases and 10 cases, respectively.

Chicken was a source of infection in outbreaks where Campylobacter was the cause -155 cases.
When the source of infection was food from the sea, norovirus in oysters was the cause most cases of illness (124 cases), followed by Vibrio parahaemolyticus in seagrass (50 cases) and histamine in fish (34 cases).
The number of food poisoning reports was highest during the first quarter: between January to March there were 63 reports in, with a total of 634 cases of illness. This is due to both a number of oyster-related outbreaks early in the year and fewer outbreaks occurred during the rest of the year due to restrictions and hygiene recommendations during the covid-19 pandemic. For almost 65% of the disease cases, the source of contamination was food contaminated early in the production chain, e.g. industrial facilities, from which the food was then widely distributed (industry 30 %, primary production 3% and other 31.5%). In order to reduce the number of food poisonings, it is therefore important to have good systems for food safety in primary production and such facilities.
The most commonly mentioned contributing factor was incorrect storage with respect to time and temperature. This factor was listed in 21 reports. For example, this may refer to inappropriate temperature when keeping food heated, or not low enough temperature in cold storage. The second most common factor was “a contaminated ingredient”, as stated in 11 reports.
There is often no information about the country of origin of the implicated food products. This may be due to the fact that this information is optional in the reporting form. It can be also difficult to know in which country viruses or bacteria contaminated a food product.
The reporting authority usually does not have access to information about whether patients have received hospital care. However in 5 reports, it was stated that a total of 7 people received hospital care. No deaths were reported.

Click to access l-2021-nr-23-rapporterade-misstankta-matforgiftningar-2020.pdf

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