The European Food Safety Authority (EFSA) reported a sharp increase in the number of foodborne outbreaks, illnesses and hospitalizations associated with dairy goods consumption.
The data is part of EFSA’s One Health 2023 Zoonoses report, released in December 2024, which includes statistics on foodborne disease outbreaks (FBOs), including the type of foods implicated in these outbreaks and the pathogens that caused them.
According to the report, there were 392 more cases (up 84.1%) and 30 additional hospitalizations (up 57.7%) linked to the ‘milk and milk products’ food group in 2023 than the year prior; though no deaths were recorded in 2023 compared to 7 in 2022.
Contaminated cheese caused 20 outbreaks; other dairy products such as quark or yogurt were linked to 15, and milk products – to 3 outbreaks. Cheese consumption was associated with the highest number of hospitalizations (57), followed by other dairy products (20) and milk (5).
Foodborne diseases linked to dairy were reported by almost half of EU member states (12: Belgium, Finland, France, Germany, Hungary, Italy, Lithuania, Poland, Romania, Slovakia, Spain and Sweden) and two non-members (Serbia and North Macedonia).
Bacteria, such as Salmonella, caused 19 of the outbreaks; with viruses such as norovirus responsible for 9, and parasites - for 1 outbreak.
Why is this happening?
So what’s behind the increase in outbreaks, cases and hospitalizations linked to milk and milk products in 2023?
One particularly large outbreak.
“The sharp increase in the number of human cases in outbreaks associated with the consumption of ‘milk and milk products’ in 2023 compared to 2022 was mainly due to one very large strong-evidence outbreak caused by norovirus reported by Germany,” an EFSA spokesperson told us.
“This German outbreak was associated with the consumption of dairy desserts and involve ed 538 human cases out of a total of 858 cases reported in the EU for all strong-evidence foodborne outbreaks linked to this food group in 2023.”
Strong-evidence outbreaks, cases, hospitalizations and deaths where milk and milk products were implicated, 2023
Outbreaks: 38 (2022 : 30)
Illnesses: 858 (2022 : 466)
Hospitalizations: 82 (2022 : 52)
Deaths: 0 (2022 : 7)
Data: EFSA
The data is therefore not indicative of health and safety discrepancies in the supply chain.
“No specific conclusion regarding food safety practices and foodborne disease prevention can be drawn based on the observed sharp increase in the cases/hospitalizations in 2023,” the EFSA spokesperson confirmed.
“In general, the application of appropriate hygiene practices along the production, processing and handling of all milk and milk products is essential to prevent foodborne diseases associated with the consumption of this food.”
The bigger picture
This isn’t the first time when outbreaks and illnesses linked to milk and milk products have risen across the EU.
EFSA told us that over the last 10 years, sharp increases in the number of reported cases in strong-evidence outbreaks associated with the consumption of milk and milk products had also been observed in:
- 2015 (662 cases) compared to 2014 (324 cases);
- 2017 (1173 cases) compared to 2016 (618 cases), and in
- 2020 (419 cases) compared to 2019 (107 cases).
Similarly to 2023, fluctuations in the number of reported cases were usually due to single or a few large outbreaks.
Dairy foods were also far from the biggest source of foodborne disease outbreaks in 2023.
The vast majority of cases (3,409) were traced to multi-ingredient foods, such as processed food products and prepared dishes; bakery products, and buffet meals. This was similar in scope to years 2022 and 2021.
In 2023, foods of animal origin – i.e. meat, eggs, fish and dairy – were linked to almost two thirds (60%) of all strong-evidence outbreaks; more than half of the hospitalizations (55.3%), and to nearly 4 in 5 deaths (77.8%).
Overall, meat and meat products were the cause of 2,578 illnesses and 133 outbreaks, with eggs (1,223 and 95, respectively) and fish (827 and 83) also among the most frequently implicated foodstuffs.
Foodborne disease prevention checklist
According to the World Health Organization, foodborne illnesses can be prevented by following 5 steps:
- Keep clean.
- Separate raw and cooked.
- Cook thoroughly.
- Keep food at safe temperatures.
- Use safe water and raw materials.
For more details, see Five Keys to Safer Food developed by the WHO.
In terms of pathogens, salmonella caused the largest number of hospitalizations and was present in food categories such as mixed; eggs; pig meat; bakery; broiler meat, and fish. Bacillus cereus toxins was the second leading cause; and norovirus was the third, causing 359 outbreaks in 2023.
EFSA reports that the mean size of outbreaks associated with norovirus infections were among the largest observed that year - and many outbreaks were also large (27 outbreaks included between 50 and 100 cases each) or very large in size (8 outbreaks included over 100 cases each).
In dairy production, pasteurization destroys harmful pathogens, but improper heat treatment practices may lead to the persistence of organisms and contamination of pasteurized milk due to poor handling practices, research suggests.
Cross-contamination is another route to introducing pathogens into dairy products with norovirus; for example, if contaminated frozen berries are mixed into a yogurt.