An international outbreak of Shiga toxin-producing Escherichia coli O157 infection due to lettuce, September – October 2007

Friesema, Ingrid; Sigmundsdóttir, Guðrún; Zwaluw, Kim van der; Heuvelink, Annet; Schimmer, Barbara; Jager, C M de; Rump, Babette; Bríem, Haraldur; Harðardóttir, Hildur; Atladottir, A; Guðmundsdóttir, Embla Ýr; Pelt, Wilfrid van

doi:10.2807/ese.13.50.19065-en

Cited by 97 publications

(51 citation statements)

References 29 publications

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“…Between 1992 and 2006, 2,274 foodborne outbreaks of infectious intestinal disease were reported in England and Wales, 82 (4%) of which were associated with the consumption of prepared salads (24). It is widely recognized that uncooked salad vegetables can be a cause of foodborne infectious disease (25)(26)(27). Although there are few reports specifically identifying watercress as being associated with cases of bacterial foodborne disease, a previous review of risk factors for STEC O157 cases in England and Wales demonstrated that consumption of watercress was associated with infection (28).…”

Section: Resultsmentioning

confidence: 99%

Public Health Investigation of Two Outbreaks of Shiga Toxin-Producing Escherichia coli O157 Associated with Consumption of Watercress

Jenkins

Dallman

Launders

et al. 2015

Appl Environ Microbiol

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f An increase in the number of cases of Shiga toxin-producing Escherichia coli (STEC) O157 phage type 2 (PT2) in England in September 2013 was epidemiologically linked to watercress consumption. Whole-genome sequencing (WGS) identified a phylogenetically related cluster of 22 cases (outbreak 1). The isolates comprising this cluster were not closely related to any other United Kingdom strain in the Public Health England WGS database, suggesting a possible imported source. A second outbreak of STEC O157 PT2 (outbreak 2) was identified epidemiologically following the detection of outbreak 1. Isolates associated with outbreak 2 were phylogenetically distinct from those in outbreak 1. Epidemiologically unrelated isolates on the same branch as the outbreak 2 cluster included those from human cases in England with domestically acquired infection and United Kingdom domestic cattle. Environmental sampling using PCR resulted in the isolation of STEC O157 PT2 from irrigation water at one implicated watercress farm, and WGS showed this isolate belonged to the same phylogenetic cluster as outbreak 2 isolates. Cattle were in close proximity to the watercress bed and were potentially the source of the second outbreak. Transfer of STEC from the field to the watercress bed may have occurred through wildlife entering the watercress farm or via runoff water. During this complex outbreak investigation, epidemiological studies, comprehensive testing of environmental samples, and the use of novel molecular methods proved invaluable in demonstrating that two simultaneous outbreaks of STEC O157 PT2 were both linked to the consumption of watercress but were associated with different sources of contamination.

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Section: Resultsmentioning

confidence: 99%

Public Health Investigation of Two Outbreaks of Shiga Toxin-Producing Escherichia coli O157 Associated with Consumption of Watercress

Jenkins

Dallman

Launders

et al. 2015

Appl Environ Microbiol

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“…Between September and October of 2007, there was an outbreak of STEC O157 in the Netherlands and Iceland. The most probable cause of the outbreak was contaminated lettuce but samples of the product that were tested were all negative for the pathogen (Friesema et al, 2008).…”

Section: Outbreaks and Incidencementioning

confidence: 99%

Enterohemorrhagic Escherichia coli

Viazis

Diez-Gonzalez

2011

Advances in Agronomy

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“…Outbreaks of VTEC infection in Europe during 2007-2011 and identified as associated with consumption of FoNAO included; shredded lettuce in Denmark (Friesema et al, 2008); and handling loose raw leeks and potatoes in UK (HPA, 2011). From data prior to 2007 in the EU, the following foods were associated with VTEC outbreaks: handling raw vegetables, particularly potatoes in the UK (Morgan et al, 1988); and lettuce in Sweden (Soderstrom et al, 2008).…”

Section: Verocytotoxin-producing Escherichia Coli (Vtec)mentioning

confidence: 99%

Scientific Opinion on the risk posed by pathogens in food of non-animal origin. Part 1 (outbreak data analysis and risk ranking of food/pathogen combinations)

Publication¹

2013

EFSA Journal

179

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European Food Safety Authority (EFSA), Parma, Italy ABSTRACTFood of non-animal origin (FoNAO) is consumed in a variety of forms, and a major component of almost all meals. These food types have the potential to be associated with large outbreaks as seen in 2011 associated with VTEC O104. A comparison of the incidence of human cases linked to consumption of FoNAO and of food of animal origin (FoAO) was carried out to provide an indication of the proportionality between these two groups of foods. It was concluded that outbreak data reported as part of EU Zoonoses Monitoring is currently the only option for EU-wide comparative estimates. Using this data from 2007 to 2011, FoNAO were associated with 10% of the outbreaks, 26% of the cases, 35% of the hospitalisations and 46% of the deaths. If the data from the 2011VTEC O104 outbreak is excluded, FoNAO was associated with 10% of the outbreaks, 18% of cases, but only 8% of the hospitalisations and 5% of the deaths. From 2008 to 2011 there was an increase in the numbers of reported outbreaks, cases, hospitalisations and deaths associated with food of non-animal origin. In order to identify and rank specific food/pathogen combinations most often linked to human cases originating from FoNAO in the EU, a model was developed using seven criteria: strength of associations between food and pathogen based on the foodborne outbreak data from EU Zoonoses Monitoring (2007-11), incidence of illness, burden of disease, dose-response relationship, consumption, prevalence of contamination and pathogen growth potential during shelf life. Shortcomings in the approach using outbreak data were discussed. The top ranking food/pathogen combination was Salmonella spp. and leafy greens eaten raw followed by (in equal rank) Salmonella spp. and bulb and stem vegetables, Salmonella spp. and tomatoes, Salmonella spp. and melons, and pathogenic Escherichia coli and fresh pods, legumes or grain.© European Food Safety Authority, 2013 KEY WORDSFood of non-animal origin, foodborne pathogens, foodborne outbreaks, food/pathogen combination, risk ranking SUMMARYThe European Commission asked EFSA"s BIOHAZ Panel to prepare a scientific Opinion on the public health risk posed by pathogens that may contaminate food of non-animal origin (FoNAO). In particular, this opinion addresses the first two terms of reference for the mandate, namely: (i) to compare the incidence of foodborne human cases linked to FoNAO and foodborne cases linked to food of animal origin (FoAO), and (ii) to identify and rank specific food/pathogen combinations most often linked to foodborne human cases originating from FoNAO in the EU.For the comparison of the incidence of foodborne human cases linked to FoNAO and foodborne cases linked to FoAO, the BIOHAZ Panel concluded that: the analysis of the outbreak data reported as part of EU Zoonoses Monitoring allows attribution of human cases to food of non-animal origin or food of animal origin, and is currently the only option for obtaining a EU-wide comparative estimate of the proportion ...

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An international outbreak of Shiga toxin-producing Escherichia coli O157 infection due to lettuce, September – October 2007

Cited by 97 publications

References 29 publications

Public Health Investigation of Two Outbreaks of Shiga Toxin-Producing Escherichia coli O157 Associated with Consumption of Watercress

Public Health Investigation of Two Outbreaks of Shiga Toxin-Producing Escherichia coli O157 Associated with Consumption of Watercress

Enterohemorrhagic Escherichia coli

Scientific Opinion on the risk posed by pathogens in food of non-animal origin. Part 1 (outbreak data analysis and risk ranking of food/pathogen combinations)

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