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Euro Surveill ; 23(18)2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29741151

RESUMO

We investigated a large outbreak of Escherichia coli O157 in the United Kingdom (UK) with 165 cases between 31 May and 29 July 2016. No linked cases were reported in other countries. Cases were predominately female (n = 128) and adult (n = 150), 66 attended hospital and nine had features of haemorrhagic uraemic syndrome. A series of epidemiological studies (case-control, case-case, ingredients-based and venue-based studies) and supply chain investigations implicated mixed salad leaves from Supplier A as the likely outbreak vehicle. Whole genome sequencing (WGS) indicated a link with strains from the Mediterranean and informed the outbreak control team to request that Supplier A cease distributing salad leaves imported from Italy. Microbiological tests of samples of salad leaves from Supplier A were negative. We were unable to confirm the source of contamination or the contaminated constituent leaf although our evidence pointed to red batavia received from Italy as the most likely vehicle. Variations in Shiga toxin-producing E.coli surveillance and diagnosis may have prevented detection of cases outside the UK and highlights a need for greater standardisation. WGS was useful in targeting investigations, but greater coverage across Europe is needed to maximise its potential.


Assuntos
Surtos de Doenças , Infecções por Escherichia coli/epidemiologia , Escherichia coli O157/isolamento & purificação , Doenças Transmitidas por Alimentos/epidemiologia , Genoma Bacteriano/genética , Lactuca/microbiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Adulto , Animais , Estudos de Casos e Controles , DNA Bacteriano/genética , Infecções por Escherichia coli/microbiologia , Escherichia coli O157/genética , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/microbiologia , Humanos , Vigilância de Evento Sentinela , Escherichia coli Shiga Toxigênica/genética , Reino Unido/epidemiologia , Sequenciamento Completo do Genoma
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