A severe outbreak of E. coli 0157 in two psychogeriatric wards

Kohli, HS; Chaudhuri, Ajay; Todd, W. T. A.; Mitchell, A. A. B.; Liddell, K. G.

doi:10.1093/oxfordjournals.pubmed.a042911

Cited by 24 publications

(10 citation statements)

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“…There were no deaths. The most unusual feature of this outbreak is the relatively small number of cases with severe complications in contrast to those observed in published outbreaks involving elderly people where case fatalities ranged from 3 to 36 % [3,[21][22][23][24]. It was not possible to determine how the infection was introduced into the home, although raw beef and lamb were used in the kitchen and inspection did reveal the potential for cross contamination to other foods that would not be cooked [35].…”

Section: Discussionmentioning

confidence: 96%

“…Direct spread has been shown to occur from animals to their keepers and to members of the public at farm visitor centres [12][13][14][15][16]. Person-to-person transmission, particularly relevant in outbreaks associated with day-care nurseries and nursing homes, is well recognized [17][18][19][20][21][22][23], as are water-borne outbreaks, due mainly to faecal contamination of drinking water or recreational bathing water [24][25][26][27][28][29][30]. This report describes an outbreak of E. coli O157 infection in a care home for the elderly in the West Midlands, United Kingdom.…”

Section: Introductionmentioning

confidence: 99%

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An outbreak of Escherichia coli O157 gastroenteritis in a care home for the elderly

et al. 2006

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In the summer of 2001 an outbreak of Escherichia coli O157 gastroenteritis affected staff and residents of a care home for the elderly in the West Midlands, UK. E. coli O157 phage type 2 was isolated from faeces in eight patients and 12 staff members. Thirty-five staff and 40 residents met the case definition for clinical gastrointestinal infection. Serological testing identified a further 14 possible cases of infection amongst asymptomatic staff and residents. The outbreak was atypical, as the disease seemed to be milder than has been observed in past outbreaks in similar settings. The index case, a member of staff, developed bloody diarrhoea and haemolytic-uraemic syndrome (HUS), but only one resident developed bloody diarrhoea and required hospitalization. No deaths occurred, despite the high-risk nature of the affected population. The source of the outbreak could not be identified. The prolonged nature of the outbreak and observed lapses in infection control practices indicated that person-to-person spread was the likely route of transmission. This outbreak illustrates the importance of observing appropriate infection control measures in the institutions providing residential and nursing care to the elderly.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

An outbreak of Escherichia coli O157 gastroenteritis in a care home for the elderly

et al. 2006

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“…The Hartwoodhill Hospital outbreak occurred in October 1990 11. Eight patients and three staff members in this small psychogeriatric hospital in Lanarkshire were infected.…”

Section: Outbreaksmentioning

confidence: 99%

E. coli O157 outbreaks in the United Kingdom: past, present, and future

Pennington¹

2014

IDR

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This review describes Escherichia coli O157 outbreaks in the United Kingdom, beginning from the first, in the 1980s, to those recorded in 2013. We point out that the United Kingdom differs from other countries, particularly the United States, in that it has had a considerable number of outbreaks associated with butchers, but very few caused by contaminated burgers. Two of the butcher-associated outbreaks (in central Scotland in 1996 and South Wales in 2005) were very large and are considered here in detail; the reviewer conducted detailed investigations into both outbreaks. Also considered is the very large outbreak that occurred in visitors to an open farm in Surrey in 2009. Detailed descriptions of some milk-borne outbreaks and incidents connected with camping and childrens’ nurseries have been published, and these are also considered in this review. Large outbreaks in the United Kingdom have sometimes led to policy developments regarding food safety, and these are considered, together with public reactions to them, their health effect, and their value, as examples to follow or eschew in terms of the procedures to be adopted in response to incidents of this kind. Regulatory and legal consequences are also considered. As a wise man said, making predictions is difficult, particularly about the future. This review follows this position but points out that although human infections caused by E. coli O157 are rare in the United Kingdom, their incidence has not changed significantly in the last 17 years. This review points out that although a response to an outbreak is to say “lessons must be learned”, this response has been tempered by forgetfulness. Accordingly, this review restricts its recommendations regarding outbreaks to two: the crucial importance of a rapid response and the importance of experience, and even “gut feeling”, when an inspector is evaluating the safety of a food business.

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“…Outbreaks of hemorrhagic E. coli and C. difficile infections have been recognized in hospitals and nursing homes [182,183]. Some of the strokes, injuries from falls, and even myocardial infarctions occurring in nursing home settings could be caused by the hypovolemia and toxic state induced by these nosocomial diarrheas.…”

Section: Infectious Nosocomial Diarrheamentioning

confidence: 99%

Approach to the Patient with Diarrhea

Powell¹

2008

Principles of Clinical Gastroenterology

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A severe outbreak of E. coli 0157 in two psychogeriatric wards

Cited by 24 publications

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An outbreak of Escherichia coli O157 gastroenteritis in a care home for the elderly

An outbreak of Escherichia coli O157 gastroenteritis in a care home for the elderly

E. coli O157 outbreaks in the United Kingdom: past, present, and future

Approach to the Patient with Diarrhea

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