Spain recorded a rise in outbreaks in 2023 compared to past years with 350 because of Salmonella, according to a recent report.

In Spain, outbreaks must be reported to the National Epidemiological Surveillance Network (RENAVE).

In 2023, 833 foodborne and waterborne outbreaks were reported, with 11,510 patients, 415 hospitalizations, and 13 deaths. This included 818 foodborne outbreaks, with 10,125 patients, 414 hospitalizations, and 13 deaths. The agent was unknown in 212 outbreaks with more than 3,100 patients and two deaths.

There was an increase in outbreaks compared to previous years, along with a higher number of patients, hospitalizations, and deaths. In 2022, 612 outbreaks were recorded with 7,302 patients, 234 hospitalizations, and four deaths.

In 2023, the most frequently identified causative agent was Salmonella with 350 outbreaks, which also resulted in the highest number of outbreak-associated patients at 2,747, hospitalizations with 356 and four deaths. The largest Salmonella outbreak affected 159 people.

There were 65 norovirus outbreaks with 1,559 patients, 43 Campylobacter outbreaks with 322 patients, and 35 histamine outbreaks with 275 patients. A large norovirus outbreak sickened 143 people while a big histamine incident had 154 patients.

Setting and food source
The largest waterborne outbreak was caused by norovirus and had 580 patients. The biggest foodborne outbreak was caused by Clostridium spp. with 426 infections.

Two people died in a dozen Bacillus cereus outbreaks with 215 patients. One person died as part of 29 Staphylococcus outbreaks that sickened 318 people. There was no mention of Listeria in the report but one outbreak with 12 cases attributed to “other bacteria” also caused three deaths.

Three Clostridium botulinum outbreaks affected six people and one Trichinella spiralis outbreak had 18 patients. Shiga toxin-producing E. coli (STEC) and non-STEC both caused three small outbreaks each.

Four mushroom poisoning incidents affected 17 people and Ciguatoxin caused two outbreaks with four patients.

Five imported epidemics were reported. The region that had the most outbreaks was Andalusia with 232, followed by Catalonia with 116.

Information on exposure setting was available for 757 outbreaks. The main setting was the restaurant/catering industry with 396 outbreaks, followed by the home at 198 outbreaks.

Information on a food source was available for 574 outbreaks, with the most frequently reported food being eggs and egg products with 174 outbreaks, followed by meat and meat products with 112 outbreaks. A number of Salmonella outbreaks were associated with the consumption of eggs and egg products.