Outbreak of Non‐O157 Shiga Toxin–ProducingEscherichia coliInfection from Consumption of Beef Sausage

Abstract

We describe an outbreak of Shiga toxin-producing Escherichia coli O26:H11 infection in 20 patients (median age, 2 years). The source of the infection was an organic fermented beef sausage. The source was discovered by using credit card information to obtain and compare customer transaction records from the computer systems of supermarkets.

Shiga-Toxigenic Escherichia coli Detection in Stool Samples Screened for Viral Gastroenteritis in Alberta, Canada

“…Most enteric viral infections cause mild to moderate diarrhea (with the exception of rotavirus) (27). Though many severe cases of O157 STEC gastrointestinal infections, especially those of the O157:H7 serotype, yield bloody diarrhea (9,14), most infections do not progress to this stage and therefore can sometimes be thought to have a viral etiology. This is further complicated by non-O157 STEC infections, which are not commonly associated with bloody stool and can often resemble viral gastroenteritis.…”

“…It was possible that the stool samples were submitted late in the illness or that the organisms were not causing a typical diarrheal illness. Of additional concern is the identification of five non-O157 serogroups previously associated with severe illness (O26:HNM, O26:H11, O103:H25, O121:H19, and O145: HNM), including HUS (1,7,9,21,22,26,30). O103:H25 was isolated from patients in both 2007 and 2008; however, the isolate from 2007 was stx 1 positive only, whereas the 2008 isolate was positive for both stx 1 and stx 2 .…”

Shiga Toxin-Producing Escherichia coli in Children: Diagnosis and Clinical Manifestations of O157:H7 and Non-O157:H7 Infection

“…Most studies of O157 and non-O157 STEC have included mixed populations of adults and children (4,5,10,14,16,17,21,23,25). While outbreaks of non-O157 STEC have been reported in children (9) and Klein et al report that 38% of STEC infections were non-O157 in their pediatric cohort (20), the incidence of non-O157 STEC infection in the United States and the clinical sequelae in the pediatric population need to be more clearly defined.…”

Till receipts - a new approach for investigating outbreaks? Evaluation during a large Salmonella Enteritidis phage type 14b outbreak in a north west London takeaway restaurant, September 2009

“…One of the reasons for this could be that access to sales data is not always granted to investigators, and our study benefits from the voluntary provision of complete till receipts by the restaurant owner. Supermarket bonus cards provide data on grocery shopping habits and have been used to generate hypotheses to inform subsequent analytical studies [10,16]. Purchase records from supermarkets have also been used in a virtual cohort approach [17].…”

“…In addition, analyses-of-sales studies have been reported [10,11]. These were hypotheses-generating consumer record analyses [10], and a comparison of the probability of kebab consumption based on information from the kebab shop owner with exposure information from the cases [11].…”