Foodborne illness in Denmark

I have a soft spot for the Danes. Spending five summers hammering nails with a couple of Danish homebuilders in Ontario taught me the value of being well-read and beer at morning coffee, lunch, and afternoon coffee. My friend John Kierkegaard would say, the beer is nice, but the work, it isn’t really so good.

quotes-1600-900-wallpaperWhen I went to Copenhagen for a scientific meeting, sure enough, there was beer at morning coffee.

The Technical University of Denmark reports that almost every other registered salmonella infection in Denmark in 2014 was brought back by Danes travelling overseas. Travel thus remains the largest cause of salmonella infections. An outbreak of salmonella from Danish eggs was also recorded in 2014, which is the first time in five years and illness was again attributed Danish chicken meat.

These are some of the findings presented in the annual report on the occurrence of diseases that can be transmitted from animals and food to humans. The report was prepared by the National Food Institute, Technical University of Denmark, in cooperation with Statens Serum Institut, the national institute of public health, and the Danish Veterinary and Food Administration.

In 2014 a total of 1,122 salmonella infections were reported among Danes, which is equivalent to 19.9 infected cases per 100,000 inhabitants. The figure is in line with the previous year when a historically low number of Danes was infected with salmonella.

In all, 48% became ill with salmonella after travelling overseas in 2014. Most of those who returned home with a travel-related infection had been to Thailand (17.5%), Turkey (15.4%) and Spain (6.4%).

Thus, foreign travel is still the largest cause of salmonella infections among Danes.

tasting-midtfyns-jule-stoutIn the annual source account which the National Food Institute calculates, salmonella infections were attributed Danish chicken meat for the first time since 2011. In total 2% of the infections were estimated to be attributed this source.

“For two decades Danish producers, authorities and researchers have successfully worked hard to make fresh chicken salmonella-free. It is not allowed to sell fresh meat from Danish chickens if the flock is positive for salmonella. There will always be a small risk that positive fresh meat goes under the surveillance radar and makes its way to store refrigerators. This is why it is important to continue to have a close monitoring,” Senior Academic Officer Birgitte Helwigh from the National Food Institute says.

The first salmonella outbreak from Danish eggs for five years has also been registered in 2014. “It has been five years since we last had a foodborne outbreak caused by Danish eggs. The outbreak was associated with an outbreak of acute salmonella illness in the flock, which is extremely rare. The results show how important it is that producers and authorities continue to focus on maintaining the low incidence of salmonella in the egg production,” says Birgitte Helwigh says.

Danish pork was the food source associated with the most infections among persons infected in Denmark. Overall 15% of the reported illness cases were attributed to Danish pork. There were three outbreaks where Danish pork was registered as the source of infection, which contributed 4.6% of the cases.

Approximately one fifth of all salmonella cases in Denmark were not attributed to a specific food source. The reason may be that the cases were caused by foods which were not included in the salmonella source account, e.g. fruit and vegetables, or other sources of infection such as contact with livestock and pets.

With 3,782 cases registered in 2014, campylobacter still causes the most cases of foodborne bacterial illnesses in Denmark. In 2014 a total of 92 listeria infections were registered, which is an increase of 84% compared to the year before. The increase is mainly due to an outbreak in “rullepølse” (a Danish cold cut ready-to-eat speciality) with 41 reported cases.

In 2014, a total of 60 foodborne disease outbreaks were registered compared with 74 outbreaks the year before. An outbreak is when several people become sick from the same food source. As in previous years, norovirus caused the most outbreaks (40%). These outbreaks usually take place in restaurants, where a total of 363 people were infected in 24 of the recorded outbreaks.

Marketing food safety at retail: what USDA can learn from Denmark about eliminating salmonella in poultry

I have a soft spot for the Danes, with their schnapps and pickled herring and home builders and existentialist philosophers (daughter Sorenne, get it?)

Lynne Terry of The Oregonian, who has doggedly followed the Foster Farms Salmonella outbreak, writes that the company issued an apology, aquvitbolstered food safety measures, but people kept getting sick, with nearly 500 illnesses to date.

Foster Farms did not issue a recall, and the USDA did not press for one. Officials said they lack authority to ban salmonella on raw chicken. They said the bacteria were “naturally occurring” in healthy chickens and that all the public had to do was follow good hygiene in the kitchen and cook poultry thoroughly. They also said it would be impossible to get rid of salmonella in poultry.

While reporting on this story, the late William Keene, senior epidemiologist at Oregon Public Health, told me that Denmark had done just that. Talk to a food safety specialist at the Centers for Disease Control and Prevention, Keene said. He’s Danish. He’ll tell you.

In the first installment, Terry quotes  Birgitte Helwigh, senior scientist at the National Food Institute of the Technical University of Denmark, as saying, “In Denmark, we have zero tolerance for salmonella in chicken meat.”

That policy has reaped enormous benefits for consumers, Helwigh said, and saved millions of dollars in medical expenses. Health authorities have not identified any human cases of salmonella poisoning due to Danish chicken meat since 2011 and they estimate there has only been about a dozen illnesses from

Denmark was jolted into battle by a surge of sickness. From the mid-1950s to the mid-1970s, the country averaged about 450 confirmed kierkegaardsalmonella cases a year in a population of 5 million. But in 1977 the number of illnesses started to climb, spiking at nearly 3,500 in 1988.

Scientists pinpointed broiler meat as the culprit. Reporters latched onto the story, consumers became alarmed and the industry grew worried.

“They realized they had a salmonella problem,” said Henrik Wegener, former director of the National Food Institute and now provost of the Technical University. “They also assumed they could do something to solve it.”

No one knows exactly what caused the uptick. Bacteria can mutate and become more virulent. The Danish poultry industry had also changed. Once a scattering of small farms, companies merged and the industry became more centralized, with owners obtaining flocks from the same source.

If those flocks were contaminated, so were the chicks. Bigger chicken houses also increased the chance for contamination. The bacteria, which can live in the intestines of healthy chickens, are spread among birds through feces. If the intestines are nicked during slaughter, the meat becomes contaminated.

Industry turns to testing

In 1989, the Danish poultry industry adopted the first voluntary control measures that were tweaked and tightened over time, eventually becoming mandatory.

The first voluntary step involved testing broiler flocks for salmonella three weeks before slaughter. Testing each bird would have been far too expensive so the Danes collected fecal samples and tested them for bacteria.

If the test was positive, the whole flock was butchered late in the day in an area reserved in the slaughterhouse for contaminated birds.

The testing reduced human illnesses but not enough to satisfy health officials, scientists or industry.

Farmers, especially, were disappointed by the results, Wegener said.

“They spent quite a lot of money on testing and controls but we really didn’t get to the bottom of the problem,” Wegener said.

With processors and farms struggling amid uneven results, in 1993 the largest Danish grocery retail chain stepped in with an ultimatum: Co-op Denmark told suppliers that it would not buy their chicken meat if they did not enact measures to curb salmonella.

The retailer, with nearly 40 percent of the market, told suppliers they had to destroy flocks that had a positive test prior to slaughter. Co-op Denmark also required companies to test a sampling of butchered meat. If any positives popped up, meat from that flock was rejected.

The industry was dismayed by the requirement, said Karin Froidt, Co-op Denmark’s food safety manager.

“They thought it would pass,” Froidt said. “But then we introduced Swedish broiler meat which at the time had a lower incidence of salmonella. They found out we were serious.”

The retailer dangled an incentive, introducing a “salmonella-free” label on raw chicken from companies that complied. That label carried cache with consumers and fetched a higher price.

Salmonella outbreak in Denmark

I have an affinity for the Danes. I spent five summers working with two Danish home builders in Ontario, who introduced me to 45% Danish Schnapps, pate and beet snacks, which Amy and I munched on our balcony yesterday, and when I go to meetings in Copenhagen, they offer beer at the 10:30 a.m. coffee break; and noon; and afternoon coffee (beer).

My friend John the carpenter who fought in WW II (last name Kierkegaard, like the philosopher, Soren, baby Sorenne, get it?) would also have his morning, noon and afternoon beers in Ontario, but would at least admit, “The work, after some beers, it’s not so great when looked at the next day.”

This morning, Denmark is admitting it may have some problems with Salmonella.

The National Food Directorate says that 40 people have contracted Salmonella Enteritidis since May, probably as a result of fried eggs or raw eggs that have not been heated properly.

In several cases, the eggs have been traced back to the Møllebjerggård Ægpakkeri egg packaging plant and a producer that delivers eggs to the plant has been put under observation.

The Directorate has ordered eggs from the producer in question to be withdrawn from the market.