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Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015
- Noëleen McFarland1,2 , Nick Bundle2,3,4,5 , Claire Jenkins6 , Gauri Godbole7 , Amy Mikhail8 , Tim Dallman6 , Catherine O'Connor9 , Noel McCarthy4,10,11 , Emer O'Connell4,12 , Juli Treacy1 , Girija Dabke1 , James Mapstone13 , Yvette Landy14 , Janet Moore15 , Rachel Partridge16 , Frieda Jorgensen17 , Caroline Willis17 , Piers Mook4,10 , Chas Rawlings4 , Richard Acornley18 , Charlotte Featherstone19 , Sharleen Gayle20 , Joanne Edge20 , Eleanor McNamara21 , Jeremy Hawker4,8,11 , Sooria Balasegaram4
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View Affiliations Hide AffiliationsAffiliations: 1 Health Protection Team (Fareham), Public Health England South East Centre, Fareham, United Kingdom 2 These authors contributed equally to this article and share first authorship 3 UK Field Epidemiology Training Programme, Public Health England, London, United Kingdom 4 Field Epidemiology Services, National Infection Service, Public Health England, London, United Kingdom 5 European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden 6 Gastrointestinal Bacteria Reference Unit, National Infection Service, Public Health England, London, United Kingdom 7 Reference Microbiology Services, National infection Service, Public Health England, London, United Kingdom 8 Gastrointestinal Infection Department, National Infection Service, Public Health England, London, United Kingdom 9 Emerging Infections and Zoonoses, National infection Service, Public Health England, London, United Kingdom 10 University of Warwick, Coventry, United Kingdom 11 National Institute Health Research (NIHR) Health Protection Research Unit in Gastrointestinal Infections, London, United Kingdom 12 UK Public Health Training Scheme, London, United Kingdom 13 Public Health England South of England Region, Bristol, United Kingdom 14 Bournemouth Borough Council, Bournemouth, United Kingdom 15 Weymouth & Portland Borough Council and West Dorset District Council, Weymouth, United Kingdom 16 Public Health Dorset, Dorchester, United Kingdom 17 Food Water and Environmental Microbiology Laboratory, National Infection Service, Public Health England, Salisbury, United Kingdom 18 Environment Agency, Wessex, Blandford, United Kingdom 19 Animal and Plant Health Agency, Thirsk, United Kingdom 20 Food Standards Agency, London, United Kingdom 21 Public Health Laboratory, Health Service Executive, Dublin, Republic of IrelandNoeleen McFarlandnoeleen.mcfarland phe.gov.uk
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Citation style for this article: McFarland Noëleen, Bundle Nick, Jenkins Claire, Godbole Gauri, Mikhail Amy, Dallman Tim, O'Connor Catherine, McCarthy Noel, O'Connell Emer, Treacy Juli, Dabke Girija, Mapstone James, Landy Yvette, Moore Janet, Partridge Rachel, Jorgensen Frieda, Willis Caroline, Mook Piers, Rawlings Chas, Acornley Richard, Featherstone Charlotte, Gayle Sharleen, Edge Joanne, McNamara Eleanor, Hawker Jeremy, Balasegaram Sooria. Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015. Euro Surveill. 2017;22(36):pii=30610. https://doi.org/10.2807/1560-7917.ES.2017.22.36.30610 Received: 04 Nov 2016; Accepted: 14 May 2017
Abstract
The first documented British outbreak of Shiga toxin-producing Escherichia coli (STEC) O55:H7 began in the county of Dorset, England, in July 2014. Since then, there have been a total of 31 cases of which 13 presented with haemolytic uraemic syndrome (HUS). The outbreak strain had Shiga toxin (Stx) subtype 2a associated with an elevated risk of HUS. This strain had not previously been isolated from humans or animals in England. The only epidemiological link was living in or having close links to two areas in Dorset. Extensive investigations included testing of animals and household pets. Control measures included extended screening, iterative interviewing and exclusion of cases and high risk contacts. Whole genome sequencing (WGS) confirmed that all the cases were infected with similar strains. A specific source could not be identified. The combination of epidemiological investigation and WGS indicated, however, that this outbreak was possibly caused by recurrent introductions from a local endemic zoonotic source, that a highly similar endemic reservoir appears to exist in the Republic of Ireland but has not been identified elsewhere, and that a subset of cases was associated with human-to-human transmission in a nursery.
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