National outbreak of Shiga toxin-producing <i>Escherichia</i> <i>coli</i> O157: H7 linked to mixed salad leaves, United Kingdom, 2016

Gobin, Maya, Hawker, Jeremy, Cleary, Paul, Inns, Thomas ORCID: 0000-0002-1218-958X, Gardiner, Daniel, Mikhail, Amy, McCormick, Jacquelyn, Elson, Richard, Ready, Derren, Dallman, Tim
et al (show 7 more authors) (2018) National outbreak of Shiga toxin-producing <i>Escherichia</i> <i>coli</i> O157: H7 linked to mixed salad leaves, United Kingdom, 2016. EUROSURVEILLANCE, 23 (18). pp. 10-19.

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We investigated a large outbreak of <i>Escherichia coli</i> 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 <i>E.</i><i>coli</i> 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.

Item Type: Article
Uncontrolled Keywords: Animals, Humans, Escherichia coli O157, Escherichia coli Infections, DNA, Bacterial, Sentinel Surveillance, Case-Control Studies, Food Microbiology, Disease Outbreaks, Genome, Bacterial, Adult, Shiga-Toxigenic Escherichia coli, Foodborne Diseases, United Kingdom, Whole Genome Sequencing, Lactuca
Depositing User: Symplectic Admin
Date Deposited: 08 May 2018 06:37
Last Modified: 27 Dec 2023 23:29
DOI: 10.2807/1560-7917.ES.2018.23.18.17-00197
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