Vero Cytotoxin–Producing<i>Escherichia coli</i>O157 Gastroenteritis in Farm Visitors, North Wales

Payne, Christopher J.I.; Petrović, Marko D.; Roberts, Richard J.; Paul, Ashish; Linnane, Eithne; Walker, Mark J.; Kirby, David S.; Burgess, Anthony; Smith, Robert; Cheasty, T.; Willshaw, G. A.; Salmon, R. L.

doi:10.3201/eid0905.020237

Cited by 35 publications

(25 citation statements)

References 6 publications

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“…The sources of infection implicated include well water, exposure to mud contaminated with cattle faeces, and direct contact with animals on display. Visiting a farm is now considered an important risk factor for acquiring severe EHEC infections [122,133]. Conversely, EHEC O157 has been frequently isolated from farm workers in the absence of disease suggesting that farm residents may develop immunity, possibly by exposure to the more common and less virulent STEC non-O157 [4,155,185].…”

Section: Environment-related Exposuresmentioning

confidence: 99%

Enterohaemorrhagic Escherichia coli: emerging issues on virulence and modes of transmission

et al. 2005

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-Enterohaemorrhagic Escherichia coli (EHEC) constitute a subset of serotypes (E. coli O157 and some other serogroups) of Shiga toxin (Stx)-producing E. coli (STEC) firmly associated with severe human illnesses like bloody diarrhoea and haemolytic uraemic syndrome. Stx production is essential but not sufficient for EHEC virulence. Most strains are capable of colonising the intestinal mucosa of the host with the "attaching and effacing" mechanism, genetically governed by a large pathogenicity island (PAI) defined as the Locus of Enterocyte Effacement. Other virulence factors carried by mobile genetic elements like PAI and plasmids have been recently described, and their role in the pathogenic process has not been fully elucidated. EHEC are zoonotic pathogens. They rarely cause disease in animals, and ruminants are recognised as their main natural reservoir. Cattle are considered to be the most important source of human infections with EHEC O157, and the ecology of the organism in cattle farming has been extensively studied. The organism has also been reported in sheep, goats, water buffalos, and deer. Pigs and poultry are not considered to be a source of EHEC and the sporadic reports may derive from accidental exposure to ruminant dejections. The epidemiology of EHEC infections has remarkably changed during the past ten years and an increasing number of unusual food vehicles have been associated with human infections. New routes of transmission have emerged, like contact with animals during farm visits and a wide variety of environment-related exposures. As for other zoonotic agents, having animals and raw products that are free from EHEC is not possible in practice. However, their occurrence can be minimised by applying high standards of hygiene in all the steps of the food production chain.

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Section: Environment-related Exposuresmentioning

confidence: 99%

Enterohaemorrhagic Escherichia coli: emerging issues on virulence and modes of transmission

et al. 2005

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“…Laboratory evidence of STEC infection was obtained in three of the 46 cases examined with gastroenteritis, but no obvious epidemiological link among the three cases and between them and the HUS case was found. Two of these children, as well as the child with HUS, belonged to families of dairy farmers and contact with the farming environment is a well known risk factor for acquiring STEC infections [7,[20][21][22]. On the other hand, asymptomatic STEC infections have been frequently described among farm residents, who often develop immunity, probably due to recurrent exposure to less virulent strains [23,24].…”

Section: Discussionmentioning

confidence: 99%

Public health implications of a case of haemolytic–uraemic syndrome associated with a concomitant outbreak of mild gastroenteritis in a small rural community

et al. 2005

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implications of a case of haemolytic-uraemic syndrome associated with a concomitant outbreak of mild gastroenteritis in a small rural community. Epidemiology and infection, 134 (2 SUMMARYThe concomitant occurrence of a case of haemolytic-uraemic syndrome (HUS) and 62 cases of mild gastroenteritis in schools of a small rural community in southern Italy induced the health authorities to suspect a foodborne outbreak of shiga-toxin-producing Escherichia coli (STEC) infection. The schools were closed and the catering service involved was investigated. However, STEC were not isolated from the HUS case or from the 56 cases of gastroenteritis examined, and the HUS case and the outbreak of gastroenteritis were probably just coincidental. A retrospective cohort study failed to show any correlation with consumption of school meals and suggested that the outbreak probably started outside the school setting and then spread within the schools by person-to-person transmission. All the cases examined were negative for common enteric pathogens and the responsible agent for the cases of gastroenteritis was not identified. The concern raised in the small community by the occurrence of a severe case of HUS and the lack of a rapid epidemiological assessment excluding the occurrence of a STEC outbreak, turned an epidemic episode of mild gastroenteritis into a public health emergency with relevant socioeconomic consequences. Prompt intervention in outbreaks following timely and effective risk communication are crucial for taking the most appropriate control measures and avoiding the spread of fear and panic in the community.

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“…E. coli O157 has also been isolated from farm animals, wild birds and household pets [9][10][11]. Direct spread has been shown to occur from animals to their keepers and to members of the public at farm visitor centres [12][13][14][15][16]. Person-to-person transmission, particularly relevant in outbreaks associated with day-care nurseries and nursing homes, is well recognized [17][18][19][20][21][22][23], as are water-borne outbreaks, due mainly to faecal contamination of drinking water or recreational bathing water [24][25][26][27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

An outbreak of Escherichia coli O157 gastroenteritis in a care home for the elderly

et al. 2006

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In the summer of 2001 an outbreak of Escherichia coli O157 gastroenteritis affected staff and residents of a care home for the elderly in the West Midlands, UK. E. coli O157 phage type 2 was isolated from faeces in eight patients and 12 staff members. Thirty-five staff and 40 residents met the case definition for clinical gastrointestinal infection. Serological testing identified a further 14 possible cases of infection amongst asymptomatic staff and residents. The outbreak was atypical, as the disease seemed to be milder than has been observed in past outbreaks in similar settings. The index case, a member of staff, developed bloody diarrhoea and haemolytic-uraemic syndrome (HUS), but only one resident developed bloody diarrhoea and required hospitalization. No deaths occurred, despite the high-risk nature of the affected population. The source of the outbreak could not be identified. The prolonged nature of the outbreak and observed lapses in infection control practices indicated that person-to-person spread was the likely route of transmission. This outbreak illustrates the importance of observing appropriate infection control measures in the institutions providing residential and nursing care to the elderly.

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Vero Cytotoxin–ProducingEscherichia coliO157 Gastroenteritis in Farm Visitors, North Wales

Cited by 35 publications

References 6 publications

Enterohaemorrhagic Escherichia coli: emerging issues on virulence and modes of transmission

Enterohaemorrhagic Escherichia coli: emerging issues on virulence and modes of transmission

Public health implications of a case of haemolytic–uraemic syndrome associated with a concomitant outbreak of mild gastroenteritis in a small rural community

An outbreak of Escherichia coli O157 gastroenteritis in a care home for the elderly

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