COVID-19 measures still impacting foodborne disease stats in Norway

The impact of the Coronavirus pandemic is still being felt in figures on foodborne infections as the majority of them decreased in Norway this past year.

In 2021, there was a decline for most infectious diseases that spread from food, water and animals and are subject to notification. This is probably due to less travel and infection control measures as a result of the COVID-19 pandemic, according to the Norwegian Institute of Public Health (FHI).

As in previous years, Campylobacter was behind the most reported cases, followed by E. coli and Salmonella. However, FHI said the pandemic made it difficult to interpret trends.

A previous report revealed 25 foodborne outbreaks in 2021 in Norway which is similar to the number in 2020 but down compared to 46 in 2019 and 52 in 2018.

Campylobacter and Salmonella figures
The most illnesses were caused by Campylobacter with 2,055 reported in 2021 versus 2,422 in 2020.

The proportion of cases infected abroad was only 11 percent in 2021 and 2020 compared with 2017 to 2019, before the pandemic, when it was about half of the cases.

Of the 1,196 domestic cases, 526 were hospitalized. Of 223 sickened abroad, they were mostly infected in Spain, including the Canary Islands and Mallorca, Turkey and Poland.

For salmonellosis, the 390 cases in 2021 and 440 in 2020 more than halved compared to before the pandemic. The decline is primarily due to fewer infections abroad, linked to less travel.

The top reported country of infection for those sick abroad was Spain, including the Canary Islands and Mallorca.

Almost half of the 390 cases were hospitalized. Salmonella Enteritidis caused the most illnesses, followed by Typhimurium, Newport and monophasic Salmonella Typhimurium. 

There was an increase in the proportion of hospitalized people for campylobacteriosis and salmonellosis. One possible explanation is that fewer people went to the doctor due to the pandemic, so only those with serious and long-lasting symptoms were diagnosed, said FHI.

E. coli rises but Listeria down
In 2021, 438 cases of E. coli infection were reported, an increase from 331 in 2020. The overall number is still lower than before the pandemic but it is steady for domestic infections. E. coli O103 was behind the most cases, followed by O157, O26 and O146.

Infection led to hospitalization for 145 patients and of three cases that developed hemolytic uremic syndrome (HUS), two were children. These involved E. coli O157, O26 and O113.

In 2021, 20 cases of listeriosis were reported with 14 infected in Norway. All were hospitalized.

There were more cases in the age groups 60-69 years old and 80-89. Seven patients were women and 13 were men. The number of reports dropped compared to 37 in 2020, and there were no outbreaks in 2021.

Reported cases of cryptosporidiosis decreased in 2021 to 355, which is the same level as the years before a peak in 2020 to 483 cases. More than 80 people were hospitalized this past year. In 2020 and 2021, however, the amount of domestic infections increased compared with previous years.

In 2021, 85 cases of yersiniosis were reported with all but two because of Yersinia enterocolitica. They were mainly in February, April and May and 36 were hospitalized. In 2020, 83 cases were recorded.

This past year, there were most cases in the age groups 20-29 years old, 30-39 and 0-9. Forty-five cases were women and 40 were men. In 2020 and 2021, there was a decrease in the number of people ill abroad, while domestic infections increased.

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