An international outbreak of Shiga toxin-producing Escherichia coli O157 infection due to lettuce, September – October 2007

I Friesema; G Sigmundsdottir; K van der Zwaluw; A Heuvelink; B Schimmer; C de Jager; B Rump; H Briem; H Hardardottir; A Atladottir; E Gudmundsdottir; W van Pelt

doi:10.2807/ese.13.50.19065-en

Surveillance and outbreak reports Open Access

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An international outbreak of Shiga toxin-producing Escherichia coli O157 infection due to lettuce, September – October 2007
I Friesema¹ , G Sigmundsdottir^2,3 , K van der Zwaluw¹ , A Heuvelink⁴ , B Schimmer¹ , C de Jager¹ , B Rump⁵ , H Briem² , H Hardardottir³ , A Atladottir² , E Gudmundsdottir⁶ , W van Pelt¹
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Affiliations: ¹ Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands ² Directorate of Health, Centre for Health Protection and Communicable Disease Control, Reykjavik, Iceland ³ Department of Clinical Microbiology, Landspitali University Hospital, Reykjavik, Iceland ⁴ Food and Consumer Product Safety Authority, Zutphen, The Netherlands ⁵ Municipal public health service Hollands Midden, Leiden, the Netherlands ⁶ Food division, Environment and Food Agency, Reykjavik, Iceland

Correspondence:
I Friesema
ingrid.friesema rivm.nl
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Citation style for this article: Friesema I, Sigmundsdottir G, van der Zwaluw K, Heuvelink A, Schimmer B, de Jager C, Rump B, Briem H, Hardardottir H, Atladottir A, Gudmundsdottir E, van Pelt W. An international outbreak of Shiga toxin-producing Escherichia coli O157 infection due to lettuce, September – October 2007. Euro Surveill. 2008;13(50):pii=19065. https://doi.org/10.2807/ese.13.50.19065-en Received: 04 Sept 2008

Abstract

Between 14 September and 20 October 2007, an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157 simultaneously occurred in the Netherlands and Iceland. A total of 50 laboratory-confirmed cases were reported with a STEC O157 infection caused by the same clone. The strain was of type O157:H-, PT8, positive for stx1, stx2, eae and e-hly, and sorbitol negative. The most probable cause of this international outbreak was contaminated lettuce, shredded and pre-packed in a Dutch food processing plant. Samples of the environment, raw produce and end products, taken at several vegetable growers and processing plants all tested negative for STEC O157. However, the only epidemiological link between the cases in the Netherlands and in Iceland was the implicated Dutch processing plant. In Europe, food products are often widely distributed posing the risk of potential spread of food borne pathogens simultaneously to several countries. This international outbreak emphasises the importance of common alert and surveillance systems in earlier detection of international outbreaks and better assessment of their spread.