RESUMO
Estimating the actual occurrence of foodborne illness is challenging because only a small proportion of foodborne illnesses are confirmed and reported. Many studies have attempted to accurately estimate the overall number of cases of foodborne illness, but none have attempted to estimate the burden of foodborne disease in South Korea. This study used data from the Health Insurance Review and Assessment Service (HIRA), a public health surveillance system in South Korea, to calculate the number of cases and hospitalizations due to 18 specific pathogens and unspecified agents commonly transmitted through contaminated food between 2008 and 2012 in South Korea while accounting for uncertainty in the estimate. The estimated annual occurrences of foodborne illness were 336,138 (90% credible interval [CrI]: 258,379-430,740), with inpatient stays (hospitalizations), outpatient visits (foodborne disease infections), and patients' experiences (without visiting physicians) accounting for 2.3% (n=7809 [90% CrI: 7016-8616]), 14.4% (n=48,267 [90% CrI: 45,883-50,695]) and 83.3% (n=280,062 [90% CrI: 201,795-374,091]), respectively. Escherichia coli, including enterohemorrhagic E. coli, caused most illnesses, followed by nontyphoidal Salmonella spp., Staphylococcus aureus, hepatitis A virus, and norovirus. These results will be useful to food safety policymakers for the prevention and control of foodborne pathogens in South Korea.
Assuntos
Escherichia coli Êntero-Hemorrágica/patogenicidade , Contaminação de Alimentos/prevenção & controle , Doenças Transmitidas por Alimentos/epidemiologia , Efeitos Psicossociais da Doença , Inocuidade dos Alimentos , Vírus da Hepatite A/patogenicidade , Hospitalização , Humanos , Norovirus/patogenicidade , Pacientes Ambulatoriais , República da Coreia/epidemiologia , Salmonella/patogenicidade , Staphylococcus aureus/patogenicidadeRESUMO
The German E. coli crisis in 2011 posed multifaceted challenges to the actors of the German health care system. This paper analyzes the outbreak from a multidisciplinary perspective. It offers best practices and general recommendations for future public health emergencies for hospitals as well as at the federal and local level, addressing medical practitioners as well as health care managers.
Assuntos
Controle de Doenças Transmissíveis/organização & administração , Planejamento em Desastres/organização & administração , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Escherichia coli Êntero-Hemorrágica/patogenicidade , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/prevenção & controle , Síndrome Hemolítico-Urêmica/epidemiologia , Síndrome Hemolítico-Urêmica/prevenção & controle , Vigilância em Saúde Pública/métodos , Comportamento Cooperativo , Eficiência Organizacional , Alemanha , Recursos em Saúde/provisão & distribuição , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Capacitação em Serviço/organização & administração , Comunicação Interdisciplinar , Admissão do Paciente/estatística & dados numéricos , Estudos Retrospectivos , VirulênciaRESUMO
BACKGROUND: Enterohaemorrhagic E. coli (EHEC) can cause severe disease such as bloody diarrhoea and haemolytic uraemic syndrome in humans. Besides production of Shiga toxins, the presence of LEE (eae-gene) and non-LEE (nle) encoded effector genes harboured on O-islands OI-122, OI-71 and OI-57 is associated with EHEC virulence and their frequency in outbreaks. Genes encoded by the EHEC-plasmid are putative virulence markers of EHEC. EHEC-plasmids, LEE and non-LEE effector genes have also been detected in some strains of enteropathogenic E. coli (EPEC). The objective of this study was to analyze the relationship between EHEC and EPEC for virulence genes encoded by genomic O-islands and by the EHEC-plasmids. RESULTS: Nle genes ent/espL2, nleB and nleE (OI-122), nleA, nleF and nleH1-2 (OI-71), nleG5-2 and nleG6-2 (OI-57), espK (CP-933N) and the EHEC-plasmid encoded genes ehxA, espP, etpD and katP were searched in 73 typical and in 235 atypical enteropathogenic E. coli (EPEC) strains. Typical and atypical EPEC each fall into two clusters. Cluster 1 typical (n = 46) and atypical (n = 129) EPEC strains were characterized by the presence of OI-122 encoded genes and grouped together with 64 investigated EHEC strains. Cluster 2 typical (n = 27) and atypical (n = 106) strains grouped together with 52 LEE-negative, Shiga toxin-producing E. coli (STEC) and with 21 apathogenic E. coli strains. Typical EPEC Cluster 1 strains belonged to serotypes frequently involved in severe illness and outbreaks in children (O111:H2, O114:H2, O55:H6, O127:H6 and O142:H6). Atypical EPEC Cluster 1 strains were characterized by serotypes related to EHEC (O26:H11, O55:H7, O145:H28, O103:H2 and O103:H25). CONCLUSION: The OI-122 encoded nleB gene was found to be most closely associated with Cluster 1 strains and may serve as a diagnostic tool for the identification of virulent EHEC and EPEC seropathotypes. OI-71 encoded genes nleA, nleF and nleH1-2 are less associated with Cluster 1 strains. EHEC-plasmid, OI-57 and CP-933 associated genes showed only weak similarities with virulent Cluster 1 EHEC and EPEC strains.