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1.
Epidemiol Infect ; 149: e108, 2021 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-33866980

RESUMO

Recurrent outbreaks of haemolytic uraemic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli (STEC) serotype O55:H7 occurred in England between 2014 and 2018. We reviewed the epidemiological evidence to identify potential source(s) and transmission routes of the pathogen, and to assess the on-going risk to public health. Over the 5-year period, there were 43 confirmed and three probable cases of STEC O55:H7. The median age of cases was 4 years old (range 6 months to 69 years old) and over half of all cases were female (28/46, 61%). There were 36/46 (78.3%) symptomatic cases, and over half of all cases developed HUS (25/46, 54%), including two fatal cases. No common food or environmental exposures were identified, although the majority of cases lived in rural or semi-rural environments and reported contact with both wild and domestic animals. This investigation informed policy on the clinical and public health management of HUS caused by STEC other than serotype O157:H7 (non-O157 STEC) in England, including comprehensive testing of all household contacts and household pets and more widespread use of polymerase chain reaction assays for the rapid diagnosis of STEC-HUS.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Infecções por Escherichia coli/epidemiologia , Síndrome Hemolítico-Urêmica/epidemiologia , Escherichia coli Shiga Toxigênica/patogenicidade , Adolescente , Adulto , Idoso , Animais , Criança , Pré-Escolar , Inglaterra/epidemiologia , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/transmissão , Feminino , Síndrome Hemolítico-Urêmica/microbiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Filogenia , Fatores de Risco , Sorogrupo , Escherichia coli Shiga Toxigênica/classificação , Escherichia coli Shiga Toxigênica/genética , Adulto Jovem
3.
Epidemiol Infect ; 146(2): 187-196, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29248018

RESUMO

In August 2015, Public Health England detected an outbreak of Shiga toxin-producing Escherichia coli (STEC) serotype O157:H7 caused by contaminated salad leaves in a mixed leaf prepacked salad product from a national retailer. The implicated leaves were cultivated at five different farms and the zoonotic source of the outbreak strain was not determined. In March 2016, additional isolates from new cases were identified that shared a recent common ancestor with the outbreak strain. A case-case study involving the cases identified in 2016 revealed that ovine exposures were associated with illness (n = 16; AOR 8·24; 95% CI 1·55-39·74). By mapping the recent movement of sheep and lambs across the United Kingdom, epidemiological links were established between the cases reporting ovine exposures. Given the close phylogenetic relationship between the outbreak strain and the isolates from cases with ovine exposures, it is plausible that ovine faeces may have contaminated the salad leaves via untreated irrigation water or run-off from fields nearby. Timely and targeted veterinary and environmental sampling should be considered during foodborne outbreaks of STEC, particularly where ready to eat vegetables and salads are implicated.


Assuntos
Surtos de Doenças , Infecções por Escherichia coli/epidemiologia , Escherichia coli O157/genética , Doenças Transmitidas por Alimentos/epidemiologia , Genoma Bacteriano/genética , Lactuca/intoxicação , Adulto , Animais , Infecções por Escherichia coli/microbiologia , Feminino , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/microbiologia , Humanos , Lactuca/microbiologia , Masculino , Análise Multivariada , Razão de Chances , Ovinos/microbiologia , Escherichia coli Shiga Toxigênica/genética , Análise Espaço-Temporal , Reino Unido/epidemiologia
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