Epidemiology and Infection

Original Papers

Gastroenteritis/Food poisoning

Crab meat: a novel vehicle for E. coli O157 identified in an outbreak in South West England, August 2011

P. MATULKOVAa1a2 c1, M. GOBINa1, J. TAYLORa3, F. OSHINa3, K. O'CONNORa4 and I. OLIVERa1a5

a1 Health Protection Agency South West Regional Epidemiology Unit, UK

a2 European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Sweden

a3 South West (South) Health Protection Unit, UK

a4 Public Protection Service, Plymouth City Council, UK

a5 School of Social and Community Medicine, University of Bristol, UK


In August 2011, we investigated an outbreak of Escherichia coli O157 in Plymouth, England, utilizing a case-control study and food traceback. Nine cases, eight laboratory-confirmed with E. coli O157 phage type 21/28 verocytotoxin 2 and one epidemiologically linked, had onsets from 30 July 2011 to 15 August 2011. We compared cases (n = 8) with controls (n = 28) of similar age and sex (median age 61 vs. 55 years, females 75% vs. 61%). Cases were 58 times more likely to have eaten crab (88% vs. 11%; odds ratio 58, 95% confidence interval 4-2700). Eight cases consumed crab sourced from the same supplier who was not registered with the local authority. This outbreak pointed to crab as a possible vehicle of E. coli O157 infection. We ensured the withdrawal of crab meat sourced from unregistered suppliers from food venues by 25 August 2011. We also emphasized the importance of only using registered suppliers to the food venues. Since then no further associated cases have been reported.

(Received September 19 2012)

(Revised October 31 2012)

(Accepted November 14 2012)

(Online publication December 06 2012)

Key words

  • Case-control study;
  • crab;
  • E. coli O157;
  • outbreak;
  • traceback;
  • vehicle


c1 Author for correspondence: Dr P. Matulkova, 2 Rivergate, Temple Quay, Bristol BS1 6EH, UK. (Email: Petra.Matulkova@nhs.net)