Outbreak of Shiga toxin-producing Escherichia coli O157 linked with consumption of a fast-food product containing imported cucumbers, United Kingdom, August 2020.


Journal

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933

Informations de publication

Date de publication:
Oct 2021
Historique:
received: 01 03 2021
revised: 01 04 2021
accepted: 03 04 2021
pubmed: 26 4 2021
medline: 10 11 2021
entrez: 25 4 2021
Statut: ppublish

Résumé

In August 2020, an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 occurred in the United Kingdom. Whole genome sequencing revealed that these cases formed a genetically distinct cluster. Hypotheses generated from case interviews were tested in analytical studies, and results informed environmental sampling and food chain analysis. A case-case study used non-outbreak 'comparison' STEC cases; a case-control study used a market research panel to recruit controls. A total of 36 cases were identified; all cases reported symptom onset between August 3 and August 16, 2020. The majority of cases (83%) resided in the Midlands region of England and in Wales. A high proportion of cases reported eating out, with one fast-food restaurant chain mentioned by 64% (n = 23) of cases. Both the case-case study (adjusted odds ratio (aOR) 31.8, 95% confidence interval (CI) 1.6-624.9) and the case-control study (aOR 9.19, 95% CI 1.0-82.8) revealed statistically significant results, showing that the consumption of a specific fast-food product was independently associated with infection. Consumption of a specific fast-food product was a likely cause of this outbreak. The only ingredient specific to the product was cucumbers. The supply of cucumbers was immediately halted, and no further cases have been identified.

Sections du résumé

BACKGROUND BACKGROUND
In August 2020, an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 occurred in the United Kingdom. Whole genome sequencing revealed that these cases formed a genetically distinct cluster.
METHODS METHODS
Hypotheses generated from case interviews were tested in analytical studies, and results informed environmental sampling and food chain analysis. A case-case study used non-outbreak 'comparison' STEC cases; a case-control study used a market research panel to recruit controls.
RESULTS RESULTS
A total of 36 cases were identified; all cases reported symptom onset between August 3 and August 16, 2020. The majority of cases (83%) resided in the Midlands region of England and in Wales. A high proportion of cases reported eating out, with one fast-food restaurant chain mentioned by 64% (n = 23) of cases. Both the case-case study (adjusted odds ratio (aOR) 31.8, 95% confidence interval (CI) 1.6-624.9) and the case-control study (aOR 9.19, 95% CI 1.0-82.8) revealed statistically significant results, showing that the consumption of a specific fast-food product was independently associated with infection.
CONCLUSIONS CONCLUSIONS
Consumption of a specific fast-food product was a likely cause of this outbreak. The only ingredient specific to the product was cucumbers. The supply of cucumbers was immediately halted, and no further cases have been identified.

Identifiants

pubmed: 33895409
pii: S1201-9712(21)00312-X
doi: 10.1016/j.ijid.2021.04.001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

S62-S68

Informations de copyright

Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Auteurs

Ranya Mulchandani (R)

Field Service, Public Health England, Birmingham, UK; UK Field Epidemiology Training Programme, Public Health England, London, UK. Electronic address: ranya.mulchandani@phe.gov.uk.

Clare Brehmer (C)

Field Service, Public Health England, Birmingham, UK.

Saira Butt (S)

Tuberculosis, Acute Respiratory, Gastrointestinal, Emerging/Zoonotic Infections and Travel Migrant Health Division (TARGET), Public Health England, London, UK; Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK.

Bhavita Vishram (B)

Tuberculosis, Acute Respiratory, Gastrointestinal, Emerging/Zoonotic Infections and Travel Migrant Health Division (TARGET), Public Health England, London, UK.

Melissa Harrison (M)

Field Service, Public Health England, Birmingham, UK.

Elizabeth Marchant (E)

UK Field Epidemiology Training Programme, Public Health England, London, UK; South East Region, Public Health England, Oxford, UK.

Simon Ferris (S)

East Midlands Health Protection Team, Public Health England, Nottingham, UK.

Frieda Jorgensen (F)

Field Service, Public Health England, Birmingham, UK.

Robert Smith (R)

Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK.

Gauri Godbole (G)

Tuberculosis, Acute Respiratory, Gastrointestinal, Emerging/Zoonotic Infections and Travel Migrant Health Division (TARGET), Public Health England, London, UK.

Claire Jenkins (C)

Tuberculosis, Acute Respiratory, Gastrointestinal, Emerging/Zoonotic Infections and Travel Migrant Health Division (TARGET), Public Health England, London, UK; Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK.

Timothy J Dallman (TJ)

Tuberculosis, Acute Respiratory, Gastrointestinal, Emerging/Zoonotic Infections and Travel Migrant Health Division (TARGET), Public Health England, London, UK; Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK.

Neville Q Verlander (NQ)

Statistics Unit, Public Health England, London, UK.

Nick Phin (N)

Tuberculosis, Acute Respiratory, Gastrointestinal, Emerging/Zoonotic Infections and Travel Migrant Health Division (TARGET), Public Health England, London, UK.

Dan Todkill (D)

Field Service, Public Health England, Birmingham, UK; Communicable Disease Control Evidence and Epidemiology, Warwick Medical School, The University of Warwick, Coventry, UK.

Saheer Gharbia (S)

Tuberculosis, Acute Respiratory, Gastrointestinal, Emerging/Zoonotic Infections and Travel Migrant Health Division (TARGET), Public Health England, London, UK.

Jeremy Hawker (J)

Field Service, Public Health England, Birmingham, UK; Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK.

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