The number of outbreaks in France went up in 2021 but was still below 2018 and 2019 levels.

Figures from Santé publique France show there were 1,309 outbreaks affecting 11,056 people in 2021. A total of 512 people went to hospitals and 16 died.

Reported outbreaks rose from 1,010 in 2020 when figures were strongly impacted by the COVID-19 pandemic, according to officials.

For 327 incidents in 2021, a pathogen could be microbiologically confirmed in food or in at least one sick person per outbreak. A pathogen was suspected without microbiological confirmation for 734 outbreaks.

16 deaths in outbreaks
The most frequently microbiologically confirmed pathogen was Salmonella 147 times. It was mostly Salmonella Enteritidis, followed by monophasic Salmonella Typhimurium but the type was not known in 92 incidents. Confirmed Salmonella outbreaks were responsible for 935 patients and 166 hospitalizations.

Campylobacter caused 52 outbreaks with 178 patients and Bacillus cereus had 46 with 665 patients. Nineteen norovirus outbreaks sickened 493 and 11 histamine outbreaks affected 35 people.

Seven outbreaks were due to E. coli, six to Yersinia enterocolitica, four to Shiga toxin-producing E. coli (STEC), and one each because of Listeria monocytogenes, Clostridium botulinum, and Shigella.

The pathogen was identified in patients for 208 outbreaks, of which 143 were confirmed with Salmonella. Identification of the agent took place in food samples for 89 epidemics with 67 confirmed as Bacillus cereus, Staphylococcus aureus and Clostridium perfringens.

The top suspected pathogens based on epidemiological and clinical information, but not microbiologically /confirm/ied, were the toxins Bacillus cereus, Staphylococcus aureus and Clostridium perfringens. For these three pathogens, 3,787 patients and 169 hospital trips were recorded.

Other suspected outbreaks were caused by Ciguatera, Vibrio parahaemolyticus, STEC, Listeria, various toxins and Enteroinvasive E .coli (EIEC). For almost a fifth of reported outbreaks, no agent could be identified or was suspected.

Sixteen outbreak-related deaths were recorded in 2021 including 12 among residents in seven nursing homes. In two incidents, Listeria was suspected or /confirm/ied. Other deaths were linked to Clostridium perfringens, Bacillus cereus, norovirus and Campylobacter.

Suspect foods and root causes
Every winter, an increase in outbreaks is observed, mainly caused by norovirus and the consumption of contaminated shellfish.

Salmonella is the pathogen most often confirmed or suspected in outbreaks in home-based settings. For incidents linked to eating out, school canteens or company restaurants the blame mostly fell on Bacillus cereus and Staphylococcus aureus.

For many outbreaks, the suspected foods included various ingredients or were ready meals. Shellfish, eggs and egg products, fish, meat, poultry, and dairy products were suspected in some incidents.

Non-conformities of products, materials, storage, or preparation practices were identified for 430 outbreaks. Frequent problems included abuse of the cold chain or preparation errors, defective or unsuitable equipment and non-compliance with hygiene rules or inappropriate handling of food by a family member or staff.

Corrective measures for food outlets included cleaning and disinfection of the establishment as well as staff information and training.