The “Big Six”: Hidden Emerging Foodborne Bacterial Pathogens

Abstract

Non-O157 Shiga toxin-producing Escherichia coli (STEC) are emerging serogroups that often result in diseases ranging from diarrhea to severe hemorrhagic colitis in humans. The most common non-O157 STEC are O26, O45, O103, O111, O121, and O145. These serogroups are known by the name “big six” because they cause severe illness and death in humans and the United States Department of Agriculture declared these serogroups as food contaminants. The lack of fast and efficient diagnostic methods exacerbates the public impact of the disease caused by these serogroups. Numerous outbreaks have been reported globally and most of these outbreaks were caused by ingestion of contaminated food or water as well as direct contact with reservoirs. Livestock harbor a variety of non-O157 STEC serovars that can contaminate meat and dairy products, or water sources when used for irrigation. Hence, effective control and prevention approaches are required to safeguard the public from infections. This review addresses the disease characteristics, reservoirs, the source of infections, the transmission of the disease, and major outbreaks associated with the six serogroups (“big six”) of non-O157 STEC encountered all over the globe.

A Laboratory Perspective on an Epidemiological Pattern of Infectious Gastroenteritis: A Five-year Surveillance between 2016 to 2020 from Established Private Healthcare Centers within Klang Valley in Malaysia

“…The highest occurrence of infectious gastroenteritis in the tropical region is reportedly occur during rainy season, while in temperate regions the highest cases were observed during winter. 30 There is a possibility to have a correlation between the rainy season in September and October with the peak season of positive infectious gastroenteritis cases in Klang Valley, as gathered in the present study. However, the correlation analysis between the rising cases and rainfall could not be confirmed due to the unavailability of meteorology data between the periods, which is worth exploring.…”

“…Thus, there is likelihood for EPEC to spread and contaminate the food supply and food processing chain. 30,31 Furthermore, the prevalence of EPEC has been associated with developing nations, as reviewed by Alharbi and colleagues. 30 Among the reported possible reasons for high EPEC infection in developing nations such as Malaysia are the consumption of insufficient pasteurized milk, direct contact with animal manure and poor handwashing practice in day care or school for children, exposure to the contaminated swimming pools or fecally contaminated rivers or lake.…”

“…30,31 Furthermore, the prevalence of EPEC has been associated with developing nations, as reviewed by Alharbi and colleagues. 30 Among the reported possible reasons for high EPEC infection in developing nations such as Malaysia are the consumption of insufficient pasteurized milk, direct contact with animal manure and poor handwashing practice in day care or school for children, exposure to the contaminated swimming pools or fecally contaminated rivers or lake. 30 Our time series analysis over the five years detected that the peak season for infectious gastroenteritis was between August until October (Figure 2A).…”

“…30 Among the reported possible reasons for high EPEC infection in developing nations such as Malaysia are the consumption of insufficient pasteurized milk, direct contact with animal manure and poor handwashing practice in day care or school for children, exposure to the contaminated swimming pools or fecally contaminated rivers or lake. 30 Our time series analysis over the five years detected that the peak season for infectious gastroenteritis was between August until October (Figure 2A). The rise of confirmed infectious gastroenteritis during the peak season was contributed by the higher detection rate of Salmonella spp.…”

A Response to Article “Anti-Diarrheal Activity of Hydromethanolic Crude Extract and Solvent Fractions of Acacia Seyal (Fabaceae) Roots in Mice” [Letter]

“…However, under the physiological condition, diarrhea is frequently caused by the infections. 5 Therefore, the bacteria infection model could be taken as consideration for being used for the follow-up of this study in the near future. 6 Overall, this study still convey the novel idea of exploring the anti-diarrheal activity possessed by the root extract of Acacia seyal which hopefully could be further explored and studied for addressing the suggestions provided above.…”