Most Salmonella infections in Denmark contracted abroad

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Article Date: 31 Jul 2013 - 0:00 PDT Current ratings for:
Most Salmonella infections in Denmark contracted abroad

These are some of the findings presented in the annual report on the occurrence of diseases that can be transmitted to humans from animal and food. The report is prepared by the Danish Zoonosis Centre at the National Food Institute, Technical University of Denmark in collaboration with Statens Serum Institut and the Danish Veterinary and Food Administration.

In 2012, 1,198 Danes were registered with a Salmonella infection, which corresponds to 21 cases per 100,000 citizens. It is a little more than the record-low incidence in 2011. Nearly half (45 percent) of all Salmonella infections were contracted while travelling abroad. It is particularly in connection with travels to Egypt, Thailand and Turkey that Danes become infected. Approximately half of the travel-related cases originated from these three countries.

The most common type of Salmonella in Danes was Salmonella typhimurium which caused 415 cases in 2012. Salmonella enteritidis caused 242 cases, which was the lowest number since the action plans for combating Salmonella were introduced in the 1990s. Historically, this Salmonella type has been related to eggs, but today the majority of S. enteritidis cases, 77 percent, are contracted while travelling outside of Denmark.

Danish pork and beef are the main sources

In 2012, 11 foodborne outbreaks due to Salmonella were recorded. Two outbreaks originated from Danish beef, one from Danish pork and one from imported duck. In the remaining seven outbreaks, the food source was unknown. An outbreak is defined by two or more persons falling ill from the same food source.

The annual Salmonella source account estimated Danish pork as the most important source of human salmonellosis cases (8 percent) in 2012, which was similar to 2011. Imported pork accounted for 0.2 percent of the cases in 2012. This was a large reduction compared with the two previous years where just over 5 percent of the cases were due to imported pork. Danish beef was estimated as the second-largest food source of Salmonella cases (7 percent) in 2012. This is a very large increase compared to the last 10 years where 0.5 to 1.5 percent of the cases were due to Danish beef.

"It is very unusual that so many cases are caused by Danish beef. The increase is due to two outbreaks caused by Danish beef and an increase in the number of sporadic cases," says Anne Wingstrand, Senior Researcher at the National Food Institute.

No Salmonella cases from Danish chicken

No cases were attributed to Danish broiler meat in the Salmonella source account in 2012. This is only the second time in the 18 years the Danish Zoonosis Centre at the National Food Institute has prepared the Salmonella source account. The most likely reasons for the low incidence are that Danish law, since 2008, has required fresh broiler meat to be Salmonella-free when put on the market.

"During the past 20 years, Denmark has focused intensely on reducing Salmonella on the farms as well as at the slaughterhouses. We are pleased to see that the efforts have ensured that Danes no longer contract Salmonella from eating Danish broiler meat. The EU also has focus on Salmonella and has set targets for the level of Salmonella in broiler flocks and egg-laying flocks", says Anne Wingstrand, Senior Researcher at the National Food Institute.

Approximately 25 percent of all Salmonella cases in Denmark could not be 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.

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Has the NHS contracted change fatigue from political interference?

Many working in the NHS have contracted change fatigue and weariness from political interference, argues Harrison Carter. Photograph: Getty Images

Frederick Douglass, the American social reformer and orator, said: "If there is no struggle, there is no progress." This is an experience felt by many working in the NHS, the struggle bit at least. Particularly, when they're used as objects for political point scoring or accidental own goals by successive governments. Some of the struggle that the NHS has experienced has been worth it. At the end of the last century and then on into this one, people fought successfully to give patients more choice, freedom and opportunity. However, it is not surprising that many working in the NHS have contracted a bit of change fatigue and weariness from political interference, especially when they don't understand the need for some things to be altered, or why they should act as scapegoats for faltering ideas in the political sphere – as was the case when Anne McIntosh, Conservative MP, blamed female doctors for burdening the NHS.

Labour party members have cried until they're blue in the face that the Health and Social Care Reform Act is a top-down re-organisation of the NHS. The coalition has retorted that its plans for how the health service is managed will offer better patient care at the same time as being cost-effective.

With the government's policy now on the statute book, it will be very difficult for the Labour party to repeal the changes in their entirety. The cost of abolishing all the new organisations sprouting up across the country is too drastic to justify to health professionals and the general public.

A group of such institutions are the clinical commissioning groups that take responsibility for local health care budgets from the defunct primary care trusts. The argument is that GPs are best equipped to determine which services need to be commissioned.

This is where the Labour party can make its move. It believes that the commissioning groups' budget could be managed by local councillors instead. Labour argues that the merger of health, social care and mental health budgets would de-fragment the NHS, ergo, giving people better results. They see it as whole person care.

This philosophy is not too unreasonable. Jeremy Hunt recently declared a return to family doctoring: GPs were to be responsible for their patients' care out of practice hours. For Labour, the GPs on the commissioning groups could be released to deal more directly with patient requests at home.

The population is ageing, and so the need to incorporate all aspects of clinical and non-clinical care is growing. Locally elected councillors, by virtue of a political term, have to answer directly to the public. If they're not up to scratch, then they're given the boot. As representatives of the people, they can spend their time giving the government an earful when things aren't working well. Some commissioning groups have already been having difficulties with local hospital department closures instigated by central government diktat that went over their heads.

People question whether this could be avoided under Labour's proposals.

If Labour is elected in 2015, the successful implementation of the its ideas will be complex and drawn out. Will commissioning groups be content acting as advisory boards instead of making the decisions? Some people would say that they don't think there is anybody better placed to target NHS resources than those who see real patients with real diseases in real adversity every working day. They question whether the humanity might be lost on local councillors who haven't sat in a GP's surgery and listened to patients.

What is obvious is that if the pooling of the £104bn NHS budget with the £15bn social care budget were to take place, elections would truly be centred on healthcare provision. The increased risk of further political meddling with our national treasure, as a result of this, is pertinent. The BMA, the trade union and professional body for doctors, called a vote of no confidence in the health secretary. Mistrust about the management of healthcare in this country is already dangerously high.

Any further political interference in how healthcare is provided would make it an even greater political hot potato that might negatively affect the ability of practitioners to discharge their duties in the future.

Harrison Carter is the director of policy and advocacy at MedsinUK, a charity that takes action against global health inequity. He also works with the primary care and health sciences research institute at Keele University

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