Outbreak of Shiga toxin-producing Escherichia coli O157 linked with consumption of a fast-food product containing imported cucumbers, United Kingdom, August 2020

Abstract

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Identification of domestic reservoirs and common exposures in an emerging lineage of Shiga toxin-producing Escherichia coli O157:H7 in England: a genomic epidemiological analysis

“…Outbreaks of genetically monomorphic isolates were identified in both domestic and non-domestic clades, with most outbreaks associated with non-domestic clades having an absence of patient travel, suggesting an imported mode of transmission, including a recent outbreak caused by STEC O157:H7 lineage IIc in which imported fresh produce was the implicated mode. 21 Although the amounts of sporadic infection were high (>40%) for both domestic and non-domestic clades, domestic infections were significantly more likely to be clustered with another patient, presumably because of sampling from a reservoir of restricted diversity.…”

“…Within England, STEC O157:H7 outbreaks have been caused by a range of transmission modes, originating both from a domestic reservoir 15 or via imported products that were contaminated by a reservoir outside of England. 21 In England, all people with confirmed STEC O157:H7 are asked to complete an Enhanced Surveillance Questionnaire capturing data on clinical presentation, food and environmental exposure, and recent travel and, since 2014, this questionnaire has been supplemented with routine whole-genome sequencing of all confirmed STEC O157:H7 human isolates. These initiatives provided a unique opportunity to synergise rich microbiological and epidemiological longitudinal surveillance data to explore the link between phylogenetically related isolates and likely exposures.…”

“…We found the mixed-effects multinomial model to be useful in modelling this pathogen with many potential routes of transmission. The proximity of cattle farms to irrigation water and fields in which produce is grown are known risk factors for STEC contamination, 20,21 and direct contact with cattle and farms are well established sources of STEC O157:H7 infections. 16 Further studies are needed to better understand the association of domestic lineage IIc clades with fresh produce.…”

“…The lineages associated with these outbreaks vary; 17,18 however, in England, a number of outbreaks linked to fresh produce have been caused by strains that belong to lineage IIc. [19][20][21] Outbreaks associated with fresh produce pose challenges to food safety and public health management, especially with ready-to-eat products that have complex food-distribution chains and short shelf-lives.…”

Integrative Physiological and Transcriptome Analysis Reveals the Mechanism for the Repair of Sub-Lethally Injured Escherichia coli O157:H7 Induced by High Hydrostatic Pressure

“…Escherichia coli O157:H7 has been implicated in many food-borne outbreaks and posed a worldwide threat to public health [ 5 , 6 ]. According to the Centers for Disease Control and Prevention, beef and leafy vegetables were the sources of >25% of all reported E. coli outbreaks and >40% of related illnesses from 2003 to 2012 [ 7 ].…”