Food safety criteria for Listeria monocytogenes in ready-to-eat (RTE) foods have been applied from 2006 onwards (Commission Regulation (EC) 2073/2005. Still, human invasive listeriosis was reported to increase over the period [2009][2010][2011][2012][2013] in the European Union and European Economic Area (EU/EEA). Time series analysis for the 2008-2015 period in the EU/EEA indicated an increasing trend of the monthly notified incidence rate of confirmed human invasive listeriosis of the over 75 age groups and female age group between 25 and 44 years old (probably related to pregnancies). A conceptual model was used to identify factors in the food chain as potential drivers for L. monocytogenes contamination of RTE foods and listeriosis. Factors were related to the host (i. population size of the elderly and/or susceptible people; ii. underlying condition rate), the food (iii. L. monocytogenes prevalence in RTE food at retail; iv. L. monocytogenes concentration in RTE food at retail; v. storage conditions after retail; vi. consumption), the national surveillance systems (vii. improved surveillance), and/or the bacterium (viii. virulence). Factors considered likely to be responsible for the increasing trend in cases are the increased population size of the elderly and susceptible population except for the 25-44 female age group. For the increased incidence rates and cases, the likely factor is the increased proportion of susceptible persons in the age groups over 45 years old for both genders. Quantitative modelling suggests that more than 90% of invasive listeriosis is caused by ingestion of RTE food containing > 2,000 colony forming units (CFU)/g, and that one-third of cases are due to growth in the consumer phase. Awareness should be increased among stakeholders, especially in relation to susceptible risk groups. Innovative methodologies including whole genome sequencing (WGS) for strain identification and monitoring of trends are recommended. Acknowledgements: The Panel wishes to thank the hearing experts: Andrew Hart and Sophie Roussel for the support provided to this scientific output. The Panel also wishes to thank the consortia of the three outsourcing activities under 'Closing gaps for performing a risk assessment on L. monocytogenes in RTE foods' for their collaboration. In addition, R egis Pouillot is thanked for sharing the dose response model as described in Pouillot et al. (2015). Also the epidemiologists and microbiologists of the nominated public health contact points for listeriosis and Listeria isolates in the European Food-and Waterborne Diseases and Zoonoses network (FWD-Net) are thanked for replying to the questionnaire related to the surveillance of listeriosis.

The qualified presumption of safety (QPS) was developed to provide a safety pre‐assessment within EFSA for microorganisms. Strains belonging to QPS taxonomic units (TUs) still require an assessment based on a specific data package, but QPS status facilitates fast track evaluation. QPS TUs are unambiguously defined biological agents assessed for the body of knowledge, their safety and their end use. Safety concerns are, where possible, to be confirmed at strain or product level, and reflected as ‘qualifications’. Qualifications need to be evaluated at strain level by the respective EFSA units. The lowest QPS TU is the species level for bacteria, yeasts and protists/algae, and the family for viruses. The QPS concept is also applicable to genetically modified microorganisms used for production purposes if the recipient strain qualifies for the QPS status, and if the genetic modification does not indicate a concern. Based on the actual body of knowledge and/or an ambiguous taxonomic position, the following TUs were excluded from the QPS assessment: filamentous fungi, oomycetes, streptomycetes, Enterococcus faecium, Escherichia coli and bacteriophages. The list of QPS‐recommended biological agents was reviewed and updated in the current opinion and therefore now becomes the valid list. For this update, reports on the safety of previously assessed microorganisms, including bacteria, yeasts and viruses (the latter only when used for plant protection purposes) were reviewed, following an Extensive Literature Search strategy. All TUs previously recommended for 2016 QPS list had their status reconfirmed as well as their qualifications. The TUs related to the new notifications received since the 2016 QPS opinion was periodically evaluated for QPS status in the Statements of the BIOHAZ Panel, and the QPS list was also periodically updated. In total, 14 new TUs received a QPS status between 2017 and 2019: three yeasts, eight bacteria and three algae/protists.

EFSA is requested to assess the safety of a broad range of biological agents in the context of notification for market authorisation as sources of food and feed additives, food enzymes and plant protection products. The qualified presumption of safety (QPS) assessment was developed to provide a harmonised generic preassessment to support safety risk assessments performed by EFSA's scientific Panels. The safety of unambiguously defined biological agents (at the highest taxonomic unit appropriate for the purpose for which an application is intended), and the completeness of the body of knowledge are assessed. Identified safety concerns for a taxonomic unit are, where possible and reasonable in number, reflected as 'qualifications' in connection with a recommendation for a QPS status. The list of QPS recommended biological agents was reviewed and updated in the current opinion and therefore becomes the valid list. The 2016 update reviews previously assessed microorganisms including bacteria, yeasts and viruses used for plant protection purposes following an Extensive Literature Search strategy. The taxonomic units related to the new notifications received since the 2013 QPS opinion, were periodically evaluated for a QPS status and the results published as Statements of the BIOHAZ Panel. Carnobacterium divergens, Lactobacillus diolivorans, Microbacterium imperiale, Pasteuria nishizawae, Pediococcus parvulus, Bacillus flexus, Bacillus smithii, Xanthomonas campestris and Candida cylindracea were recommended for the QPS list. All taxonomic units previously recommended for the 2013 QPS list had their status reconfirmed as well their qualifications with the exception of Pasteuria nishizawae for which the qualification was removed. The exclusion of filamentous fungi and enterococci from the QPS evaluations was reconsidered but monitoring will be maintained and the status will be re-evaluated in the next QPS Opinion update. Evaluation of bacteriophages should remain as a case-by-case procedure and should not be considered for QPS status. Acknowledgements: The BIOHAZ Panel wishes to thank the EFSA staff member: Mirena Ivanova for the support provided to this scientific output.

The provisional molecular approach, proposed by EFSA in 2013, for the pathogenicity assessment of Shiga toxin-producing Escherichia coli (STEC) has been reviewed. Analysis of the confirmed reported human STEC infections in the EU/EEA (2012-2017) demonstrated that isolates positive for any of the reported Shiga toxin (Stx) subtypes (and encoding stx gene subtypes) may be associated with severe illness (defined as bloody diarrhoea (BD), haemolytic uraemic syndrome (HUS) and/or hospitalisation). Although strains positive for stx2a gene showed the highest rates, strains with all other stx subtypes, or combinations thereof, were also associated with at least one human case with a severe clinical outcome. Serogroup cannot be used as a predictor of clinical outcome and the presence of the intimin gene (eae) is not essential for severe illness. These findings are supported by the published literature, a review of which suggested there was no single or combination of virulence markers associated exclusively with severe illness. Based on available evidence, it was concluded that all STEC strains are pathogenic in humans, capable of causing at least diarrhoea and that all STEC subtypes may be associated with severe illness. Source attribution analysis, based on 'strong evidence' outbreak data in the EU/EEA (2012-2017), suggests that 'bovine meat and products thereof', 'milk and dairy products', 'tap water including well water' and 'vegetables, fruit and products thereof' are the main sources of STEC infections in the EU/EEA, but a ranking between these categories cannot be made as the data are insufficient. Other food commodities are also potentially associated with STEC infections but rank lower. Data gaps are identified, and are primarily caused by the lack of harmonisation in sampling strategies, sampling methods, detection and characterisation methods, data collation and reporting within the EU. (VTEC). All these institutions provided data for this scientific output in the context of two consultations developed via the EU survey tool (Appendices I and J).

Poultry meat is the major source of human campylobacteriosis, the most frequently reported zoonosis in the EU. The prevalence of Campylobacter colonization in European broiler flocks is 71%. Despite considerable efforts, there is still no effective strategy available to prevent or reduce Campylobacter colonization in broilers. This study tested a wide variety of feed additives to reduce Campylobacter shedding in primary poultry production. Twelve additives containing organic or fatty acids, monoglycerides, plant extracts, prebiotics, or probiotics were tested. For each additive, broilers contaminated with Campylobacter jejuni were fed with an additive free diet (control group) or with a supplemented diet (treated group) and Campylobacter loads compared at three sampling times. No treatment was able to prevent broiler colonization by Campylobacter, and there was a high degree of variation in contamination among the birds. At 14 d of age, eight treatments significantly decreased the colonization level compared to the control group by a maximum of 2 log10 CFU/g. At 35 d of age, three of these treatments still had a significant effect with a maximum reduction of 1.88 log10 CFU/g for a probiotic. At 42 d of age, only one short-chain fatty acid was still significantly efficient with a mean reduction over 2 log10 CFU/g. In addition, a probiotic and a prebiotic-like compound significantly decreased the contamination by a maximum of 3 log10 CFU/g, only at the 42-d sampling period. This study gives promising results regarding the use of feed additives to reduce Campylobacter infection in flocks. Nevertheless, a global approach, combining intervention measures at the different steps of the broiler meat production chain could have a greater impact on the reduction of public health risk.