Transmission of shiga toxin-producing Escherichia coli O104:H4 at a family party possibly due to contamination by a food handler, Germany 2011

2013 ◽  
Vol 142 (1) ◽  
pp. 99-106 ◽  
Author(s):  
M. DIERCKE ◽  
M. KIRCHNER ◽  
K. CLAUSSEN ◽  
E. MAYR ◽  
I. STROTMANN ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Retrospective Cohort ◽  
Regular Education ◽  
Multivariable Analysis ◽  
Gastrointestinal Symptoms ◽  
Food Handler ◽  
Food Handlers ◽  
Food Items ◽  
Stool Samples

SUMMARYWe investigated a cluster of shiga toxin-producing Escherichia coli (STEC) O104:H4 infections after a family party during a large STEC O104:H4 outbreak in Germany. To identify the vehicle we conducted a retrospective cohort study. Stool samples of party guests, and food and environmental samples from the catering company were tested for STEC. We defined cases as party guests with gastrointestinal symptoms and laboratory-confirmed STEC infection. We found 23 cases among 71 guests. By multivariable analysis consumption of salmon [odds ratio (OR) 15, 95% confidence interval (CI) 2·3–97], herb cream (OR 6·5, 95% CI 1·3–33) and bean salad (OR 6·1, 95% CI 1·4–26) were associated with STEC infection. STEC O104:H4 was detected in samples of bell pepper and salmon. The food handler developed STEC infection. Our results point towards transmission via several food items contaminated by a food handler. We recommend regular education of food handlers emphasizing their role in transmitting infectious diseases.

A foodborne norovirus outbreak at a manufacturing company

2009 ◽  
Vol 138 (4) ◽  
pp. 501-506 ◽  
Author(s):  
T. P. ZOMER ◽  
B. DE JONG ◽  
S. KÜHLMANN-BERENZON ◽  
O. NYRÉN ◽  
B. SVENUNGSSON ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Retrospective Cohort ◽  
Office Workers ◽  
Food Handler ◽  
Stockholm County ◽  
Food Items ◽  
Increased Risk ◽  
Manufacturing Company ◽  
Stool Samples

SUMMARYOver 400 office workers from the same unit of a manufacturing company in Stockholm County, Sweden, fell ill with gastroenteritis. A retrospective cohort study of office workers in the affected unit demonstrated that canteen visitors on one day had an increased risk of illness [risk ratio (RR) 27·1, 95% confidence interval (CI) 15·7–46·8] compared to non-visitors. A second study, investigating canteen visitors' consumption of particular food items, showed that both tomatoes from the salad buffet (RR 5·6, 95% CI 3·2–9·6) and hamburgers (RR 4·9, 95% CI 2·4–9·8) were the most likely vehicles of infection. Norovirus GI.3 (Desert Shield) was identified in stool samples from three office workers and from a food handler who prepared the tomatoes for the salad buffet and hamburger ingredients before vomiting at the workplace on 12 November. The outbreak could have been prevented if the food items prepared by the food handler some hours before vomiting had not been served.

scholarly journals Association of Ct Values from Real-Time PCR with Culture in Microbiological Clearance Samples for Shiga Toxin-Producing Escherichia coli (STEC)

2020 ◽  
Vol 8 (11) ◽  
pp. 1801
Author(s):  
Michael Bording-Jorgensen ◽  
Brendon D. Parsons ◽  
Gillian A.M. Tarr ◽  
Binal Shah-Gandhi ◽  
Colin Lloyd ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Real Time ◽  
Shiga Toxin ◽  
Real Time Pcr ◽  
Gene Detection ◽  
Culture Positivity ◽  
Hands On ◽  
Culture Independent ◽  
Chromogenic Agar ◽  
Stool Samples

Shiga toxin-producing Escherichia coli (STEC) are associated with acute gastroenteritis worldwide, which induces a high economic burden on both healthcare and individuals. Culture-independent diagnostic tests (CIDT) in frontline microbiology laboratories have been implemented in Alberta since 2019. The objectives of this study were to determine the association between gene detection and culture positivity over time using STEC microbiological clearance samples and also to establish the frequency of specimen submission. Both stx genes’ amplification by real-time PCR was performed with DNA extracted from stool samples using the easyMAG system. Stools were inoculated onto chromogenic agar for culture. An association between gene detection and culture positivity was found to be independent of which stx gene was present. CIDT can provide rapid reporting with less hands-on time and technical expertise. However, culture is still important for surveillance and early cluster detection. In addition, stool submissions could be reduced from daily to every 3–5 days until a sample is negative by culture.

Foodborne Outbreak investigation: Al-Ahsa, Saudi Arabia, 2021. A retrospective cohort study (Preprint)

2022 ◽  
Author(s):  
Abdulmohsen Alahmad ◽  
Shady Abdulrahman Kamel
Keyword(s):  
Abdominal Pain ◽  
Incubation Period ◽  
Retrospective Cohort ◽  
Gastrointestinal Symptoms ◽  
Control Measures ◽  
P Value ◽  
Food History ◽  
Food Items ◽  
Number Of Patients ◽  
Laboratory Results

BACKGROUND On 10 September 2021, Al-Ahsa General Health Directorate reported unexpected number of patients had presented with gastrointestinal symptoms. All the patients gave a history of sharing a common meal as they ate from dinner was served at the mother's house the day before. OBJECTIVE We investigated to verify the outbreak, determine its magnitude, identify the source and implement control measures. METHODS A retrospective cohort design was conducted. Cases were defined as any person who ate dinner at the family gathering on the 9th of September 2021 and developed any or a combination of the following symptoms: diarrhea, vomiting, fever, or abdominal pain within 26 hours of food consumption. We collected information on demographics, symptoms, and food history using a semi-structured questionnaire. We reviewed hospital records for symptoms and Vital sings. We reviewed available laboratory results for cases, we conducted active case search to identify more cases. statistical analyses were performed using SPSS 21.0. RESULTS Twenty subjects were defined as cases (74%) and seven as non-cases (26%). among cases, 16 were females (80%), and 4 were males (20%). The ages ranged between 2–70 years. Among cases (59.3%) had vomiting, (59.3%) had a fever, (48.1%) developed diarrhea, (25%) abdominal pain. The incubation period ranged from 10-26 hours (mean 17.8). The relative risks and p- value were calculated for food items to assess the association between consumption of individual food items and subsequent illness. Among 8 food items consumed, red pasta with chicken (Relative Risk RR= 3.14, 95% CI = 3.2-424.6) and pizza (RR= 1.73, 95% CI = 1.74-42.2) were significantly associated with illness. CONCLUSIONS According to the epidemiological investigation, symptoms, incubation period, and laboratory results there might be some differential diagnosis, but we were unable to more definitively identify the source of the outbreak. We recommend more education to the households about food safety

scholarly journals An outbreak of norovirus GI-6 infection following a wedding in North West England

2017 ◽  
Vol 145 (6) ◽  
pp. 1239-1245 ◽  
Author(s):  
K. C. SMITH ◽  
T. INNS ◽  
V. DECRAENE ◽  
A. FOX ◽  
D. J. ALLEN ◽  
...  
Keyword(s):  
Online Survey ◽  
Response Rate ◽  
Multivariable Analysis ◽  
Case Definition ◽  
Food Handler ◽  
North West ◽  
Viral Excretion ◽  
Contaminated Food ◽  
Stool Samples ◽  
Definition Of

SUMMARYIn August 2015 a gastroenteritis outbreak occurred following a wedding. An outbreak investigation was undertaken and a cohort study was conducted using an online survey. Of 140 guests, 134 received the survey and 113 responded (84·3% response rate). Seventy respondents met the case definition of vomiting and/or diarrhoea within 72 h of the wedding (61·9% attack rate). Fifteen exposures were associated with illness; on stratification, all were confounded by the ham hock starter. Multivariable analysis showed a significant association with exposure to ham hock (risk ratio 6·62, 95% confidence interval 2·19–20·03). Eight guests and two catering staff submitted stool samples. All tested positive for norovirus GI-6 infection, including a food handler who had vomiting less than 48 h before the wedding. A single genotype was detected among all samples, suggesting a single source of contamination. The transmission pattern suggested point-source exposure. The most plausible cause of the outbreak was transmission from an infected food handler via contaminated food. This highlights the importance of appropriate exclusions for symptomatic food handlers. Additionally, the food handler's stool sample was submitted 7 days after symptom resolution. The potential for extended viral excretion, and the extremely low infective dose of norovirus, may mean that current exclusion guidelines are not of sufficient duration.

scholarly journals Haemolytic uraemic syndrome and Shiga toxin-producing Escherichia coli infection in children in France

2000 ◽  
Vol 124 (2) ◽  
pp. 215-220 ◽  
Author(s):  
B. DECLUDT ◽  
P. BOUVET ◽  
P. MARIANI-KURKDJIAN ◽  
F. GRIMONT ◽  
P. A. D. GRIMONT ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Prospective Study ◽  
Shiga Toxin ◽  
Haemolytic Uraemic Syndrome ◽  
Serum Samples ◽  
E Coli ◽  
Escherichia Coli Infection ◽  
Stool Samples ◽  
Polymerase Chain

We conducted a study to determine the incidence of haemolytic uraemic syndrome (HUS) in children in France and to assess the role of Shiga-toxin-producing Escherichia coli (STEC) infection in the aetiology of HUS. In collaboration with the Société de Néphrologie Pédiatrique we undertook a retrospective review of all cases of HUS hospitalized from January 1993 to March 1995 and a 1-year prospective study (April 1995–March 1996) of epidemiological and microbiological features of cases of HUS. The polymerase chain reaction (PCR) procedure was used to detect stx, eae, e-hlyA genes directly from case stool samples. Serum samples from cases were examined for antibodies to lipopolysaccharide (LPS) of 26 major STEC serogroups. Two hundred and eighty-six cases were reported. The average incidence per year was 0·7/105 children < 15 years and 1·8/105 children < 5 years. During the prospective study, 122/130 cases were examined for evidence of STEC infection using PCR and/or serological assays and 105 (86%) had evidence of STEC infection. Serum antibodies to E. coli O157 LPS were detected in 79 (67%) cases tested. In conclusion, this study showed that STEC infection is an important cause of HUS in children in France, with a high proportion related to the O157 serogroup.

scholarly journals Enteroaggregative Escherichia coli associated with a foodborne outbreak of gastroenteritis

2008 ◽  
Vol 57 (9) ◽  
pp. 1141-1146 ◽  
Author(s):  
Gaia Scavia ◽  
Monica Staffolani ◽  
Stefano Fisichella ◽  
Gianluca Striano ◽  
Stefano Colletta ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Gastrointestinal Symptoms ◽  
Enteric Pathogens ◽  
Foodborne Outbreak ◽  
E Coli ◽  
Eaec Strain ◽  
Sheep Milk ◽  
Foodborne Outbreaks

This study investigated two foodborne outbreaks of gastroenteritis that occurred 10 days apart among individuals who had meals at the restaurant of a farm holiday resort. Mild gastrointestinal symptoms were reported and none of the patients needed hospitalization. Mean incubation times were 45 and 33 h, and the overall attack rates were 43.5 and 58.3 %, respectively. Stool sample examination was negative for common enteric pathogens in both outbreaks. Specimens from 13 people involved in the second outbreak and 3 restaurant staff were examined for diarrhoeagenic Escherichia coli. An enteroaggregative E. coli (EAEC) strain of serotype O92 : H33 was isolated from six participants and one member of staff. In particular, the EAEC strain was isolated from five of the six cases of diarrhoea examined. The strain showed an aggregative pattern of adherence to HEp-2 cells, did not produce a biofilm and possessed the virulence-related genes aat, aggR, aap and set1A, but not the astA gene. A retrospective cohort study indicated a pecorino cheese made with unpasteurized sheep milk as the possible source (P<0.001). Samples of the cheese had E. coli counts higher than 106 c.f.u. g−1, but the outbreak EAEC strain was not isolated. This report confirms that EAEC infections are probably underdiagnosed because of the limited availability of laboratories capable of identifying this group of pathogenic E. coli.

Isolation and detection of Shiga toxin-producing Escherichia coli in clinical stool samples using conventional and molecular methods

2009 ◽  
Vol 58 (7) ◽  
pp. 905-911 ◽  
Author(s):  
Matthew W. Gilmour ◽  
Linda Chui ◽  
Theodore Chiu ◽  
Dobryan M. Tracz ◽  
Kathryn Hagedorn ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Real Time ◽  
Shiga Toxin ◽  
Real Time Pcr ◽  
Molecular Methods ◽  
Genetic Profile ◽  
Pcr Assay ◽  
Suspension Array ◽  
Stool Samples ◽  
Pcr Targeting

The isolation of Shiga toxin-producing Escherichia coli (STEC) other than serogroup O157 from clinical stool samples is problematic due to the lack of differential phenotypic characteristics from non-pathogenic E. coli. The development of molecular reagents capable of identifying both toxin and serogroup-specific genetic determinants holds promise for a more comprehensive characterization of stool samples and isolation of STEC strains. In this study, 876 stool samples from paediatric patients with gastroenteritis were screened for STEC using a cytotoxicity assay, commercial immunoassay and a conventional PCR targeting Shiga-toxin determinants. In addition, routine culture methods for isolating O157 STEC were also performed. The screening assays identified 45 stools presumptively containing STEC, and using non-differential culture techniques a total of 20 O157 and 22 non-O157 strains were isolated. These included STEC serotypes O157 : H7, O26 : H11, O121 : H19, O26 : NM, O103 : H2, O111 : NM, O115 : H18, O121 : NM, O145 : NM, O177 : NM and O5 : NM. Notably, multiple STEC serotypes were isolated from two clinical stool samples (yielding O157 : H7 and O26 : H11, or O157 : H7 and O103 : H2 isolates). These data were compared to molecular serogroup profiles determined directly from the stool enrichment cultures using a LUX real-time PCR assay targeting the O157 fimbrial gene lpfA, a microsphere suspension array targeting allelic variants of espZ and a gnd-based molecular O-antigen serogrouping method. The genetic profile of individual stool cultures indicated that the espZ microsphere array and lpfA real-time PCR assay could accurately predict the presence and provide preliminary typing for the STEC strains present in clinical samples. The gnd-based molecular serogrouping method provided additional corroborative evidence of serogroup identities. This toolbox of molecular methods provided robust detection capabilities for STEC in clinical stool samples, including co-infection of multiple serogroups.

scholarly journals IDENTIFIKASI SUBTIPE Enterotoxigenic Escherichia coli DAN Enteroaggregative Escherichia coli DARI SPESIMEN USAP DUBUR PENJAMAH MAKANAN DI DENPASAR MENGGUNAKAN POLYMERASE CHAIN REACTION

2019 ◽  
Vol 8 (1) ◽  
pp. 7
Author(s):  
D A Indah Gitaswari ◽  
Sri Budayanti
Keyword(s):  
Escherichia Coli ◽  
Polymerase Chain Reaction ◽  
Shiga Toxin ◽  
Hepatitis A ◽  
Enterohemorrhagic Escherichia Coli ◽  
Enterotoxigenic Escherichia Coli ◽  
Food Handler ◽  
Chain Reaction ◽  
Diarrheagenic Escherichia Coli ◽  
Polymerase Chain

Penjamah makanan atau food handler memiliki risiko paling tinggi untuk terpapar penyakit yang disebabkan oleh bakteri. Penjamah makanan dapat bertindak sebagai carrier penyakit infeksi seperti demam tifoid, hepatitis A, dan diare. Hal ini disebabkan karena kurangnya kemampuan dari penjamah makanan dalam menjaga kebersihan. Bakteri patogen tersering sebagai penyebab diare adalah Escherichia coli yang diperkirakan sebagai penyebab 1.5 juta kematian per tahun. Bakteri Escherichia coli memiliki beberapa subtipe penyebab diare yang disebut Diarrheagenic Escherichia Coli (DEC) diantaranya adalah Enterotoxigenic Escherichia coli (ETEC), Enteropathogenic Escherichia coli (EPEC), Enteroinvasive Escherichia coli (EIEC), Enteroaggregative Escherichia coli (EAEC), Vero toxin-producing/Shiga toxin-producing Escherichia coli (VTEC/STEC), Enterohemorrhagic Escherichia coli (EHEC). Enterotoxigenic Escherichia coli (ETEC) dan Enteroaggregative Escherichia coli (EAEC) paling sering sebagai penyebab diare. Saat ini prevalensi subtipe Escherichia coli sebagai penyebab diare di Bali masih belum diketahui secara pasti. Untuk melihat prevalensi tersebut, pada penelitian ini akan diteliti tipe ETEC dan EAEC dengan menggunakan metode Polymerase Chain Reaction (PCR) unipleks. Sampel merupakan isolat Escherichia coli dari spesimen usap dubur penjamah makanan di Denpasar tahun 2015. Gen target untuk identifikasi ETEC dan EAEC adalah CVD432 (630 bp), LT (273 bp), dan STh (120 bp). Program PCR yang digunakan pada tahap pre denaturasi 95?C, denaturasi 95?C, suhu annealing 55?C, ekstensi 72?C, dan final ekstensi 72?C. Hasil penelitian didapatkan bahwa prevalensi bakteri Escherichia coli menunjukkan 40% memiliki hasil yang positif terhadap gen ETEC atau EAEC. Dari 40% sampel positif, 31,4% merupakan subtipe EAEC; 5,7% subtipe ETEC; dan 3% memiliki kedua gen yaitu ETEC dan EAEC. Kata kunci: Polymerase Chain Reaction, Enteroaggregative Escherichia coli, Enterotoxigenic Escherichia coli

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