Epidemiology and Infection

Other Gastroenteritis

Public health approach to detection of non-O157 Shiga toxin-producing Escherichia coli: summary of two outbreaks and laboratory procedures

J. K. SCHAFFZINa1a2 c1, F. CORONADOa1a2, N. B. DUMASa3, T. P. ROOTa3, T. A. HALSEa3, D. J. SCHOONMAKER-BOPPa3, M. M. LURIEa2, D. NICHOLASa4, B. GERZONICHa4, G. S. JOHNSONa2, B. J. WALLACEa2 and K. A. MUSSERa3

a1 Epidemic Intelligence Service, Scientific Education and Professional Development Program Office (Proposed), Centers for Disease Control and Prevention, Atlanta, GA, USA

a2 Bureau of Communicable Disease Control, Scientific Education and Professional Development Program Office (Proposed), Centers for Disease Control and Prevention, Atlanta, GA, USA

a3 Wadsworth Center, Scientific Education and Professional Development Program Office (Proposed), Centers for Disease Control and Prevention, Atlanta, GA, USA, and

a4 Bureau of Community Environmental Health and Food Protection, New York State Department of Health, Albany, NY, USA

SUMMARY

Routine laboratory testing may not detect non-O157 Shiga toxin-producing Escherichia coli (STEC) reliably. Active clinical, epidemiological, environmental health, and laboratory collaboration probably influence successful detection and study of non-O157 STEC infection. We summarized two outbreak investigations in which such coordinated efforts identified non-O157 STEC disease and led to effective control measures. Outbreak 1 involved illness associated with consuming unpasteurized apple cider from a local orchard. Public health personnel were notified by a local hospital; stool specimens from ill persons contained O111 STEC. Outbreak 2 involved bloody diarrhoea at a correctional facility. Public health personnel were notified by the facility infection control officer; O45 STEC was the implicated agent. These reports highlight the ability of non-O157 STEC to cause outbreaks and demonstrate that a coordinated effort by clinicians, infection-control practitioners, clinical diagnostic laboratorians, and public health personnel can lead to effective identification, investigation, and prevention of non-O157 STEC disease.

(Accepted March 23 2011)

(Online publication May 05 2011)

Correspondence:

c1 Author for correspondence: J. K. Schaffzin, M.D., Ph.D., Cincinnati Children's Hospital Medical Center, Division of General and Community Pediatrics, MLC 2011, 3333 Burnet Ave, Cincinnati, OH 45229-3039, USA. (Email: joshua.schaffzin@cchmc.org)

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