The European Union One Health 2022 Zoonoses Report

**Background:** The European Union (EU) One Health 2022 Zoonoses Report is an annual summary produced by the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC). It compiles and analyzes data on zoonotic infections, foodborne outbreaks, and antimicrobial resistance in humans, animals, and food across the EU, Norway, Switzerland, Iceland, and other reporting countries. The report is mandated by the Zoonoses Directive 2003/99/EC and aims to monitor trends, identify sources, and inform risk management strategies. The 2022 report covers data from 27 EU Member States (MSs) and the United Kingdom (Northern Ireland), with human data extracted from TESSy as of July 2023 and food/animal data from the EFSA zoonoses database as of July 2023.

**Methods:** Data were collected from mandatory and voluntary surveillance systems in MSs. Human case data were reported to ECDC via The European Surveillance System (TESSy), while data on food, animals, feed, and foodborne outbreaks were submitted to EFSA through its Data Collection Framework (DCF). Statistical trend analyses for human cases were performed using regression or nonparametric tests (Cox-Stuart test), with significance set at p < 0.01 (or p < 0.05 for nonparametric tests). For food and animal data, descriptive summaries were provided, and comparisons between competent authority (CA) and food business operator (FBOp) sampling results were made using Fisher's exact test or z-test (p < 0.10 considered significant). For Salmonella in poultry, generalized linear models were used to estimate prevalence trends.

**Key Results:** In 2022, campylobacteriosis was the most frequently reported zoonosis, with 137,107 confirmed cases (notification rate 43.1 per 100,000 population), stable compared to 2021. Salmonellosis was second with 65,208 cases (rate 15.3 per 100,000), also stable. Listeriosis cases increased by 15.9% to 2,738 cases (rate 0.62 per 100,000), the highest since 2007, with 286 deaths (case fatality 18.1%). West Nile virus infections surged by 631.8% to 1,111 locally acquired cases (rate 0.25 per 100,000), with 92 deaths (case fatality 8.3%). Foodborne outbreaks increased by 43.9% compared to 2021, with Salmonella causing the most outbreaks (1,014) and Listeria monocytogenes causing the most deaths (28). In food, Campylobacter was found in 38.3% of official broiler carcass samples, with 19.4% exceeding the 1000 CFU/g limit. Salmonella prevalence in broiler flocks was 3.5%, with 0.25% positive for target serovars. Listeria monocytogenes was detected in 2.3% of fish samples at distribution.

**Clinical Implications:** The report highlights the persistent burden of foodborne zoonoses in the EU, with campylobacteriosis and salmonellosis remaining the most common. The increase in listeriosis cases and deaths, particularly among the elderly, underscores the need for enhanced food safety measures for ready-to-eat products. The dramatic rise in West Nile virus cases, driven by an epidemic in Italy and Greece, emphasizes the importance of vector surveillance and blood safety screening. The data also reveal discrepancies between official and industry sampling results, suggesting potential underreporting by food business operators. Continued One Health surveillance, including whole genome sequencing for pathogen characterization, is critical for early detection and control of outbreaks.