[Infection risks associated with importation of fresh food in Iceland]

Access to safe food is a privilege for people living in Iceland. Rapid increase in antimicrobial resistance, related to factory farming and antimicrobial use in agriculture, is a major threat to public health. Increasing food trade between countries and continents facilitates global spread of pathogens and resistance. Icelandic agriculture has benefitted from its isolation and small size. After interventions to reduce the prevalence of Campylobacter and Salmonella at poultry farms, the incidence of human campylobacteriolsis is 17-43/100.000, of which about half is domestically acquired and Salmonella infections 10-15/100.000 mainly acquired abroad. Since Enterohaemorrhagic E. coli (EHEC) has not been detected in domestic cattle, the low incidence of infections is not surprising (0-0.6/100.000/year). A recent outbreak due to a multiresistant EHEC strain was traced to imported lettuce. Antimicrobial use in Icelandic agriculture is among the lowest in Europe and domestic infections caused by Salmonella and Campylobacter are rarely caused by resistant strains. Carbapenemase producing Enterobacteriaceae have not been found in Iceland. Low use of antimicrobials in Icelandic agriculture and actions to limit the spread of Campylobacter and Salmonella have been successful. The public should be informed of the importance of the origin of food and that Icelandic food products are among the safest.