Outbreaks stable but illnesses down in 2021 for Norway

The number of foodborne outbreaks in Norway has remained steady but fewer people were sick in 2021 compared to the year before.

A total of 25 foodborne outbreaks were announced this past year, which is on a par with 23 in 2020 but down compared to 46 in 2019 and 52 in 2018.

Overall, 327 people fell sick in the 25 outbreaks in 2021 with a range of three to 30 patients per outbreak. The 23 outbreaks in 2020 affected 495 people.

Data comes from a report that gives an overview of outbreaks and related illnesses reported to the Norwegian Institute of Public Health (FHI) in 2021.

Cause of outbreaks
The most common agents in foodborne outbreaks were Campylobacter and Salmonella with four each and norovirus with three. Eight outbreaks with a total of 115 people sick were because of unknown agents.

Four Campylobacter outbreaks affected 53 people and three norovirus ones sickened 45.

Four Salmonella outbreaks with a total of 44 patients were because of Salmonella Braenderup, Dublin, Enteritidis and Gaminara.

Two E. coli outbreaks had 10 cases with one caused by E. coli O26:H11 and the other by E. coli O157:H7.

Twenty people were part of a hepatitis A outbreak. One Yersinia enterocolitica O:3 event caused 17 illnesses.

Most foodborne outbreaks were reported in restaurants, cafes and other outlets followed by hotels or other accommodations.

Milk and milk products, excluding cheese, caused three outbreaks with 40 cases, followed by fruit and berry products including juice with two outbreaks and 25 cases. The food source was unknown for 16 outbreaks that affected 205 people.

One outbreak each was caused by beef products with 30 patients, chicken meat products with 18 cases, baked goods with three sick and cheese with six ill.

Outbreak details
Norway had five patients in an international Salmonella Braenderup outbreak traced to melons from Honduras. Patients became ill in April 2021. Four of them lived in the same nursing home, while the fifth was in Tr√łndelag. Those infected were 70 to 95 years old. Almost 350 patients were reported from 12 countries in this outbreak. Four were sick in the United States and two in Canada.

The Salmonella enteritidis outbreak in Norway affected 30 people from Jan. 25 to March 19, 2021. Those sick ranged from 2 to 91 years old, the median age was 58 and 60 percent of patients were women. Thirteen people were hospitalized. The outbreak strain was detected in imported beef from Germany and epidemiological data from patient surveys supported the suspicion of this being the source of the outbreak.

Raw milk cheese from France was suspected in a Salmonella Dublin outbreak that sickened six people. Patients had sample dates from January to March 2021. They ranged in age from 43 to 84 and half were women.

A hepatitis A outbreak was linked to imported frozen raspberries. All 20 patients fell ill from April to October. They were between 10 and 80 years old, the median age was 49 and 65 percent were men. Sixteen people were hospitalized. Berries were used in various products such as cakes and raw frozen jam then purchased from different bakeries and cafes.

The source of an E. coli O157 outbreak could not be identified. There were four confirmed and one suspected case from March to July. All but one of them were children under 2 years old. One child developed hemolytic uremic syndrome (HUS).

The vehicle of infection was also not found in the Yersinia enterocolitica outbreak. People became ill in April and May. They ranged from 16 to 54 years old, with a median age of 27. There were 11 women and six men sick. An investigation indicated the source was distributed over large parts of the country and had a short shelf life.

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