Hepatitis E increase points to foodborne source

Hepatitis E has been included in a UK report for the first time after increasing evidence that it is a foodborne disease zoonoses.

Confirmed hepatitis E cases have significantly increased in recent years, with 657 cases reported in the UK in 2012, a 39.5% increase since 2011 from foodborne and non-foodborne sources.

10% of pork sausages sampled at point of sale from UK retailers were positive for hepatitis E virus, and similar findings have been reported from other European laboratories, according to a study in the journal Epidemiology & Infection.

Hepatitis E infection does not cause disease in pigs, but an Animal Health and Veterinary Laboratories Agency (AHVLA) investigation in Scottish pigs found serological evidence hepatitis E in 49% of pig samples.

Zoonoses report UK 2012, published by the Department of Environment, Farming and Rural Affairs (DEFRA) is put together by 12 organisations and brings animal and human data from the UK.

The report is led by the Gastrointestinal, Emerging and Zoonotic Infections department, Public Health England (PHE).

A pig abattoir survey from PHE, DEFRA, FSA and AHVLA this year will aim to understand the possible role of infection in pigs on human disease incidence.

Cryptosporidiosis outbreak almost doubles cases

Almost double the number of cryptosporidiosis cases were reported in the UK last year at 6,612 compared to 2011.

The increase was observed across England, Wales and Scotland and was exacerbated by a large outbreak of over 300 cases associated with the consumption of mixed salad leaves.

Zoonoses are defined by the World Health Organisation as “diseases and infections which are transmitted naturally between vertebrate animals and man”.

Campylobacter remains common

Meanwhile, campylobacter continues to be the most commonly reported human gastrointestinal pathogen, but reported human cases increased only slightly during 2012 compared to 2011 (72,592 from 72,266).

In 2012, there were eight campylobacter outbreaks reported, compared with 20 in 2011. Seven were foodborne and although six were associated with the consumption of chicken liver and chicken liver parfait, this was a reduction on the 13 outbreaks reported in 2011.

E.coli, listeria and salmonella

There were 1,217 laboratory confirmed cases of Vero cytotoxin-producing Escherichia coli(VTEC) noted in humans, an 18% decrease compared to 2011.

The number of cases fell in England, Wales and Scotland, but there was a marked increase in Northern Ireland due to a large foodborne outbreak. Of the 188 cases of VTEC O157 reported in Northern Ireland, 140 cases were associated with one outbreak.

In 2012 there were also 60 laboratory confirmed cases of VTEC other than serogroup O157 (non-O157) in humans. The burden of disease due to non-O157 VTEC is likely to be underestimated because the necessary diagnostic tests are not routinely used by most first line laboratories.

Seventeen outbreaks of VTEC in England and Wales affecting a total of 103 cases were reported in 2012. Twelve were non-foodborne, including five with a potential association with animals.

For Listeria, there were 183 cases in the UK in 2012, an increase of 11.6% when compared with 2011.

In 2012, two outbreaks of listeriosis were reported in England. One outbreak involved cross-contamination of pressed beef products (also known as ‘potted beef’ and ‘beef stew’ products) and involved four cases, including two who died.

The second outbreak was traced to cross-contamination of pork pies, and involved 14 cases with one death.

Fourteen foodborne outbreaks of salmonella were reported in the UK in 2012 compared with eighteen in 2011, and of these six each were caused by S. Enteritidis and S. Typhimurium, one Newport and one Agona.

The most common food types associated with outbreaks in 2012 were egg dishes, followed by vegetables and fruits and red meat.