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Int J Infect Dis ; 110 Suppl 1: S62-S68, 2021 Oct.
Article in English | MEDLINE | ID: mdl-33895409

ABSTRACT

BACKGROUND: In August 2020, an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 occurred in the United Kingdom. Whole genome sequencing revealed that these cases formed a genetically distinct cluster. METHODS: Hypotheses generated from case interviews were tested in analytical studies, and results informed environmental sampling and food chain analysis. A case-case study used non-outbreak 'comparison' STEC cases; a case-control study used a market research panel to recruit controls. RESULTS: A total of 36 cases were identified; all cases reported symptom onset between August 3 and August 16, 2020. The majority of cases (83%) resided in the Midlands region of England and in Wales. A high proportion of cases reported eating out, with one fast-food restaurant chain mentioned by 64% (n = 23) of cases. Both the case-case study (adjusted odds ratio (aOR) 31.8, 95% confidence interval (CI) 1.6-624.9) and the case-control study (aOR 9.19, 95% CI 1.0-82.8) revealed statistically significant results, showing that the consumption of a specific fast-food product was independently associated with infection. CONCLUSIONS: Consumption of a specific fast-food product was a likely cause of this outbreak. The only ingredient specific to the product was cucumbers. The supply of cucumbers was immediately halted, and no further cases have been identified.


Subject(s)
Cucumis sativus , Escherichia coli Infections , Escherichia coli O157 , Shiga-Toxigenic Escherichia coli , Case-Control Studies , Disease Outbreaks , Escherichia coli Infections/epidemiology , Escherichia coli O157/genetics , Food Microbiology , Humans , Shiga-Toxigenic Escherichia coli/genetics , United Kingdom/epidemiology
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