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

Epidemiol Infect. 2012 Feb;140(2):283-9. doi: 10.1017/S0950268811000719. Epub 2011 May 5.

Abstract

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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Animals
  • Cattle
  • Diarrhea / diagnosis
  • Diarrhea / epidemiology*
  • Diarrhea / microbiology*
  • Disease Outbreaks*
  • Epidemiologic Methods*
  • Escherichia coli Infections / diagnosis
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology*
  • Escherichia coli Infections / transmission
  • Feces / microbiology
  • Food Microbiology
  • Humans
  • Immunoenzyme Techniques
  • Incidence
  • New York
  • Real-Time Polymerase Chain Reaction
  • Shiga Toxin 1 / analysis
  • Shiga Toxin 1 / genetics
  • Shiga Toxin 2 / analysis
  • Shiga Toxin 2 / genetics
  • Shiga-Toxigenic Escherichia coli / genetics
  • Shiga-Toxigenic Escherichia coli / isolation & purification*

Substances

  • Shiga Toxin 1
  • Shiga Toxin 2