A Foodborne Outbreak of Gastrointestinal Illness Caused by Enterotoxigenic <i>Escherichia coli</i> Serotype O169:H41 in Osaka, Japan

Abstract

Jpn. J. Infect. Dis., 66, 530-533, 2013 SUMMARY: We describe our laboratory investigation of a massive foodborne outbreak of gastrointestinal illness caused by enterotoxigenic Escherichia coli (ETEC) serotype O169:H41 that occurred during a 2-day traditional festival held in September 2012 in Osaka Prefecture, Japan. Of 126 customers who patronized a particular Japanese restaurant during the event, 102 developed symptoms of gastrointestinal disease. We isolated strains of ETEC serotype O169:H41 from 1 food sample and from fecal samples collected from 19 of 34 patients and 2 of 4 food handlers. Pulsed-field gel electrophoresis analysis of these isolates suggested that the foodborne pathogen that caused the diarrheal outbreak was a specific clone of ETEC serotype O169:H41. Based on these findings and our interviews with the restaurant owner and employees, we concluded that a likely cause of the outbreak was an overwhelmed capacity of the restaurant kitchen in terms of preservation of sanitary procedures during the festival and the inability of the restaurant staff to handle the relatively large quantity of food to ensure a lack of contamination with ETEC. Thus, we reconfirm that ETEC strains of serotype O169:H41 remain important causes of domestic foodborne outbreaks in developed countries, including Japan.

Characterization of unstable pEntYN10 from enterotoxigenicEscherichia coli(ETEC) O169:H41

“…The redundancy may also affect its epidemiological features and pathogenicity of ETEC O169: H41. [13][14][15][16][17] Each role of CFs that might contribute to pathogenicity and virulence should be scrutinized one by one using recombinant plasmids to uncover it.…”

“…9,10 E. coli O169:H41 is an ST-producing ETEC isolates which causes foodborne diarrheic disease. 11,12 It was found first as an etiological strain of foodborne case in Japan. Subsequently, its global dissemination has been reported from various countries.…”

“…Subsequently, its global dissemination has been reported from various countries. [13][14][15][16][17] The serotype exhibited variation in ribotypes and outer membrane protein binding patterns, showing its diversity from different outbreaks. 18 One unique characteristic of the strain was its atypical adherence manner to epithelial cell lines such as HEp-2, which resembles that of enteroaggregative E. coli (EAggEC).…”

Prevalence of Diarrheagenic <i>Escherichia coli</i> in Foods and Fecal Specimens Obtained from Cattle, Pigs, Chickens, Asymptomatic Carriers, and Patients in Osaka and Hyogo, Japan

“…Outbreaks due to the ETEC serogroup O169 have been increasing, and ETEC may be an emerging cause of food-borne diseases in Asia, Europe, and the U.S.A. (13)(14)(15)(16)(17).…”

Detection methods for milk pathogenic bacteria by loop-mediated isothermal amplification

“…Enterotoxigenic Escherichia coli (ETEC) is responsible for many largescale foodborne disease outbreaks all over the world (2,3). Annually, ETEC is estimated to cause 200 million diarrheal episodes and approximately 380,000 deaths (4,5).…”