Epidemiology and Infection

Original Papers

Outbreaks of non-O157 Shiga toxin-producing Escherichia coli infection: USA

R. E. LUNA-GIERKEa1 c1, P. M. GRIFFINa1, L. H. GOULDa1, K. HERMANa1, C. A. BOPPa1, N. STROCKBINEa1 and R. K. MODYa1

a1 Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

SUMMARY

Non-O157 Shiga toxin-producing Escherichia coli (STEC) infections are increasingly detected, but sources are not well established. We summarize outbreaks to 2010 in the USA. Single-aetiology outbreaks were defined as ≥2 epidemiologically linked culture-confirmed non-O157 STEC infections; multiple-aetiology outbreaks also had laboratory evidence of ≥2 infections caused by another enteric pathogen. Twenty-six states reported 46 outbreaks with 1727 illnesses and 144 hospitalizations. Of 38 single-aetiology outbreaks, 66% were caused by STEC O111 (n = 14) or O26 (n = 11), and 84% were transmitted through food (n = 17) or person-to-person spread (n = 15); food vehicles included dairy products, produce, and meats; childcare centres were the most common setting for person-to-person spread. Of single-aetiology outbreaks, a greater percentage of persons infected by Shiga toxin 2-positive strains had haemolytic uraemic syndrome compared with persons infected by Shiga toxin 1-only positive strains (7% vs. 0·8%). Compared with single-aetiology outbreaks, multiple-aetiology outbreaks were more frequently transmitted through water or animal contact.

(Received September 16 2013)

(Revised November 15 2013)

(Accepted November 27 2013)

Key words

  • Diarrhoea;
  • outbreaks;
  • Shiga-like toxin-producing E.coli

Correspondence

c1 Author for correspondence: R. E. Luna-Gierke, MPH, Centers for Disease Control and Prevention, Mailstop C-09, 1600 Clifton Road NE, Atlanta, GA, USA 30333. (Email: RGierke@cdc.gov)

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