Infection Caused by Escherichia coli O157:H7 in Alberta, Canada, and in Scotland: A Five-Year Review, 1987-1991

Abstract

Infections and life-threatening complications due to verotoxin-producing Escherichia coli (VTEC) have been increasingly recognized as a public health problem in recent years. Through enhanced surveillance in Alberta, Canada, and in Scotland, 1,993 cases of VTEC infection and 115 cases of hemolytic-uremic syndrome (HUS) were detected in 1987-1991 in a combined population of more than 7.5 million; there were 24 deaths. The mean annual rates of VTEC infection were 12.1/100,000 and 2.0/100,000 for Alberta and Scotland, respectively. One case of HUS occurred for every 14 (Scotland) to 19 (Alberta) cases of VTEC infection. Rates of VTEC infection were highest among children < 5 years of age, while rates of resultant hospitalization were highest among the elderly. Male-to-female ratios for patients with VTEC infection varied with the age group. The incidence of this infection was highest in the summer: 64.0%-81.7% of cases occurred between May and September. Hamburger was the most common source reported. Unexplained geographic variation in prevalence was evident in both Alberta and Scotland. Most cases were sporadic, although several community and point-source outbreaks were identified in Scotland. HUS exhibited similar epidemiological patterns. Infections with VTEC impose a substantial preventable clinical and public health burden. Routine monitoring of these infections is considered worthwhile in order to elucidate their epidemiology and modes of transmission and ultimately to control them more effectively.

Transmission and control of Escherichia coli O157:H7 — A review

“…Although illnesses due to E. coli O157:H7 have been reported in over 30 countries on six continents, E. coli O157:H7 infections have been reported most frequently in Canada, the United States and the United Kingdom (Doyle 1991;Griffin and Tauxe 1991;Waters et al 1994;Boyce et al 1995;Chapman 1995;Mead and Griffin 1998;Nataro and Kaper 1998;Michino et al 1999). Escherichia coli O157:H7 is also an important pathogen in Japan and Europe, whereas in countries such as Australia, Argentina, Chile and South Africa, non-O157 serotypes of EHEC are more frequently associated with hemorrhagic colitis and HUS (Bettelheim 1998;Nataro and Kaper 1998).…”

Evidence for the benefits of food chain interventions on E. coli O157:H7/NM prevalence in retail ground beef and human disease incidence: A success story

“…22 In Canada, E. coli O157:H7/NM and non-O157 infections became nationally notifiable in 1991 following incidence rates as high as 16.3 cases per 100 000 person-years. 23 The national incidence rate of E. coli O157:H7/NM infections was 2.8 cases per 100 000 person-years in 1997, increasing to about 4 per 100 000 person-years from 1999 to 2001 (excluding the 2000 waterborne outbreak in Walkerton, ON), and decreasing to 1.2 cases per 100 000 person-years in 2014.…”

Distribution of Virulence Genes Related to Adhesions and Toxins in Shiga Toxin-Producing Escherichia coli Strains Isolated from Healthy Cattle and Diarrheal Patients in Japan

“…Since the occurrence of first food poisoning due to EHEC infection in 1982, sporadic cases and outbreaks have been reported in many countries including Japan [3,18,21,40,43]. The Japanese government has initiated a national surveillance for EHEC infections since 1991 when 2 children died due to EHEC O157:H7 infection.…”