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Surveillance and outbreak report Open Access
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Abstract

In August 2016, an outbreak of Shiga toxin-producing (STEC) and enteropathogenic (EPEC) with 237 cases occurred in the Helsinki metropolitan area, Finland. Gastroenteritis cases were reported at 11 events served by one catering company. Microbiological and epidemiological investigations suggested rocket salad as the cause of the outbreak. STEC ONT:H11 and EPEC O111:H8 strains isolated from food samples containing rocket were identical to the patient isolates. In this outbreak, the reported symptoms were milder than considered before for STEC infection, and the guidelines for STEC control measures need to be updated based on the severity of the illness. Based on our experience in this outbreak, national surveillance criteria for STEC have been updated to meet the practice in reporting laboratories covering both PCR-positive and culture-confirmed findings. We suggest that EPEC could be added to the national surveillance since diagnostics for EPEC are routinely done in clinical laboratories.

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/content/10.2807/1560-7917.ES.2018.23.35.1700666
2018-08-30
2024-03-28
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.35.1700666
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References

  1. Hernandes RT, Elias WP, Vieira MA, Gomes TA. An overview of atypical enteropathogenic Escherichia coli. FEMS Microbiol Lett. 2009;297(2):137-49.  https://doi.org/10.1111/j.1574-6968.2009.01664.x  PMID: 19527295 
  2. Lienemann T, Salo E, Rimhanen-Finne R, Rönnholm K, Taimisto M, Hirvonen JJ, et al. Shiga toxin-producing Escherichia coli serotype O78:H(-) in family, Finland, 2009. Emerg Infect Dis. 2012;18(4):577-81.  https://doi.org/10.3201/eid1804.111310  PMID: 22469631 
  3. Eichhorn I, Heidemanns K, Semmler T, Kinnemann B, Mellmann A, Harmsen D, et al. Highly virulent non-O157 enterohemorrhagic Escherichia coli (EHEC) serotypes reflect similar phylogenetic lineages, providing new insights into the evolution of EHEC. Appl Environ Microbiol. 2015;81(20):7041-7.  https://doi.org/10.1128/AEM.01921-15  PMID: 26231647 
  4. Bhatt S, Egan M, Jenkins V, Muche S, El-Fenej J. The tip of the iceberg: on the roles of regulatory small RNAs in the virulence of enterohemorrhagic and enteropathogenic Escherichia coli. Front Cell Infect Microbiol. 2016;6(6):105-10.  https://doi.org/10.3389/fcimb.2016.00105  PMID: 27709103 
  5. Tennant SM, Tauschek M, Azzopardi K, Bigham A, Bennett-Wood V, Hartland EL, et al. Characterisation of atypical enteropathogenic E. coli strains of clinical origin. BMC Microbiol. 2009;9(1):117-27.  https://doi.org/10.1186/1471-2180-9-117  PMID: 19490652 
  6. Trabulsi LR, Keller R, Tardelli Gomes TA. Typical and atypical enteropathogenic Escherichia coli. Emerg Infect Dis. 2002;8(5):508-13.  https://doi.org/10.3201/eid0805.010385  PMID: 11996687 
  7. Viljanen MK, Peltola T, Junnila SY, Olkkonen L, Järvinen H, Kuistila M, et al. Outbreak of diarrhoea due to Escherichia coli O111:B4 in schoolchildren and adults: association of Vi antigen-like reactivity. Lancet. 1990;336(8719):831-4.  https://doi.org/10.1016/0140-6736(90)92337-H  PMID: 1976876 
  8. Møller-Stray J, Eriksen HM, Bruheim T, Kapperud G, Lindstedt BA, Skeie Å, et al. Two outbreaks of diarrhoea in nurseries in Norway after farm visits, April to May 2009. Euro Surveill. 2012;17(47):20321.  https://doi.org/10.2807/ese.17.47.20321-en  PMID: 23231858 
  9. Monaghan A, Byrne B, Fanning S, Sweeney T, McDowell D, Bolton DJ. Serotypes and virulence profiles of non-O157 Shiga toxin-producing Escherichia coli isolates from bovine farms. Appl Environ Microbiol. 2011;77(24):8662-8.  https://doi.org/10.1128/AEM.06190-11  PMID: 22003024 
  10. Wu CJ, Hsueh PR, Ko WC. A new health threat in Europe: Shiga toxin-producing Escherichia coli O104:H4 infections. J Microbiol Immunol Infect. 2011;44(5):390-3.  https://doi.org/10.1016/j.jmii.2011.07.001  PMID: 21862425 
  11. Kanayama A, Yahata Y, Arima Y, Takahashi T, Saitoh T, Kanou K, et al. Enterohemorrhagic Escherichia coli outbreaks related to childcare facilities in Japan, 2010-2013. BMC Infect Dis. 2015;15(1):539-47.  https://doi.org/10.1186/s12879-015-1259-3  PMID: 26589805 
  12. McAllister LJ, Bent SJ, Petty NK, Skippington E, Beatson SA, Paton JC, et al. Genomic comparison of two O111:H- enterohemorrhagic Escherichia coli isolates from a historic hemolytic-uremic syndrome outbreak in Australia. Infect Immun. 2016;84(3):775-81.  https://doi.org/10.1128/IAI.01229-15  PMID: 26729762 
  13. European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control. (ECDC). The European Union summary report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in 2014. EFSA Journal. 2015. Available from: https://www.efsa.europa.eu/en/efsajournal/pub/4329
  14. Wang L, Nakamura H, Kage-Nakadai E, Hara-Kudo Y, Nishikawa Y. Comparison by multilocus variable-number tandem repeat analysis and antimicrobial resistance among atypical enteropathogenic Escherichia coli strains isolated from food samples and human and animal faecal specimens. J Appl Microbiol. 2017;122(1):268-78.  https://doi.org/10.1111/jam.13322  PMID: 27718315 
  15. Antikainen J, Kantele A, Pakkanen SH, Lääveri T, Riutta J, Vaara M, et al. A quantitative polymerase chain reaction assay for rapid detection of 9 pathogens directly from stools of travelers with diarrhea. Clin Gastroenterol Hepatol. 2013;11(10):1300-1307.e3.  https://doi.org/10.1016/j.cgh.2013.03.037  PMID: 23639597 
  16. McAuliffe GN, Anderson TP, Stevens M, Adams J, Coleman R, Mahagamasekera P, et al. Systematic application of multiplex PCR enhances the detection of bacteria, parasites, and viruses in stool samples. J Infect. 2013;67(2):122-9.  https://doi.org/10.1016/j.jinf.2013.04.009  PMID: 23603249 
  17. Vinjé J, Vennema H, Maunula L, von Bonsdorff CH, Hoehne M, Schreier E, et al. International collaborative study to compare reverse transcriptase PCR assays for detection and genotyping of noroviruses. J Clin Microbiol. 2003;41(4):1423-33.  https://doi.org/10.1128/JCM.41.4.1423-1433.2003  PMID: 12682125 
  18. Jaakkonen A, Salmenlinna S, Rimhanen-Finne R, Lundström H, Heinikainen S, Hakkinen M, et al. Severe outbreak of sorbitol-fermenting Escherichia coli O157 via unpasteurized milk and farm visits, Finland 2012. Zoonoses Public Health. 2017;64(6):468-75.  https://doi.org/10.1111/zph.12327  PMID: 28045227 
  19. Joensen KG, Scheutz F, Lund O, Hasman H, Kaas RS, Nielsen EM, et al. Real-time whole-genome sequencing for routine typing, surveillance, and outbreak detection of verotoxigenic Escherichia coli. J Clin Microbiol. 2014;52(5):1501-10.  https://doi.org/10.1128/JCM.03617-13  PMID: 24574290 
  20. Joensen KG, Tetzschner AM, Iguchi A, Aarestrup FM, Scheutz F. Rapid and easy in silico serotyping of Escherichia coli isolates by use of whole-genome sequencing data. J Clin Microbiol. 2015;53(8):2410-26.  https://doi.org/10.1128/JCM.00008-15  PMID: 25972421 
  21. Larsen MV, Cosentino S, Rasmussen S, Friis C, Hasman H, Marvig RL, et al. Multilocus sequence typing of total-genome-sequenced bacteria. J Clin Microbiol. 2012;50(4):1355-61.  https://doi.org/10.1128/JCM.06094-11  PMID: 22238442 
  22. International Organisation for Standardisation (ISO). ISO/TS 13136:2012: Microbiology of food and animal feed. Real-time polymerase chain reaction (PCR)-based method for the detection of food-borne pathogens. Horizontal method for the detection of Shiga toxin-producing Escherichia coli (STEC) and the determination of O157, O111, O26, O103 and O145 serogroups. Geneva: ISO; 2012. Available from: https://www.iso.org/standard/53328.html
  23. Media BAM. M195: SHIBAM Components and Instructions. Silver Spring: US Food and Drug Administration. [Accessed: 6.7.2018. Available from: https://www.fda.gov/Food/FoodScienceResearch/LaboratoryMethods/ucm321098.htm
  24. PulseNet. Standard Operating Procedure for PulseNet PFGE of Escherichia coli O157:H7, Escherichia coli non-O157 (STEC), Salmonella serotypes, Shigella sonnei and Shigella flexneri. Atlanta: Centers for Disease Control and Prevention. [Accessed: 6.7.2018]. Available from: http://www.cdc.gov/pulsenet/PDF/ecoli-shigella-salmonella-pfge-protocol-508c.pdf
  25. Rapid Alert System for Food and Feed (RASFF) notification details - 2016.1241. Foodborne outbreak suspected to be caused by shigatoxin-producing Escherichia coli (stx+, eae+, 3100 CFU/g) in rucola from Denmark, via Sweden. Brussels: European Commission. [Accessed: 6.7.2018. Available from: https://webgate.ec.europa.eu/rasff-window/portal/?event=notificationDetail&NOTIF_REFERENCE=2016.1241
  26. Jalava K, Kuusi M, Siitonen A, Ruutu P. Toimenpideohje EHEC-tartuntojen ehkäisemiseksi 2007. [Measures to prevent EHEC infections]. Helsinki: National Public Health Institute; 2012. Finnish. Available from: http://urn.fi/URN:NBN:fi-fe201210189464
  27. Jaakola S, Lyytikäinen O, Rimhanen-Finne R, Salmenlinna S, Savoilainen-Kopra C, Pirhonen J, et al. Tartuntataudit Suomessa 2013. [Infectious diseases in Finland 2013]. Helsinki: National Institute for Health and Welfare; 2014. Finnish. Available from: http://urn.fi/URN:ISBN:978-952-302-190-7
  28. Jaakola S, Lyytikäinen O, Huusko S, Salmenlinna S, Pirhonen J, Savolainen-Kopra C, et al. Tartuntataudit Suomessa 2014. [Infectious diseases in Finland 2014]. Helsinki: National Institute for Health and Welfare; 2015. Finnish. Available from: http://urn.fi/URN:ISBN:978-952-302-481-6
  29. Jaakola S, Lyytikäinen O, Rimhanen-Finne S, Salmenlinna S, Pirhonen J, Savolainen-Kopra C, et al. Tartuntataudit Suomessa 2015. [Infectious diseases in Finland 2015]. Helsinki: National Institute for Health and Welfare; 2016. Finnish. Available from: http://urn.fi/URN:ISBN:978-952-302-672-8
  30. Dallman TJ, Ashton PM, Byrne L, Perry NT, Petrovska L, Ellis R, et al. Applying phylogenomics to understand the emergence of Shiga-toxin-producing Escherichia coli O157:H7 strains causing severe human disease in the UK. Microb Genom. 2015;1(3):e000029. PMID: 28348814 
  31. Brandal LT, Wester AL, Lange H, Løbersli I, Lindstedt BA, Vold L, et al. Shiga toxin-producing escherichia coli infections in Norway, 1992-2012: characterization of isolates and identification of risk factors for haemolytic uremic syndrome. BMC Infect Dis. 2015;15(1):324-33.  https://doi.org/10.1186/s12879-015-1017-6  PMID: 26259588 
  32. Paunio M, Pebody R, Keskimäki M, Kokki M, Ruutu P, Oinonen S, et al. Swimming-associated outbreak of Escherichia coli O157:H7. Epidemiol Infect. 1999;122(1):1-5.  https://doi.org/10.1017/S0950268898001927  PMID: 10098778 
  33. Aguilera X, Asghar R, Benjamin G, Salgado C, Chew S, Daszak P, et al. Control of communicable diseases. 20th ed. Washington DC: American Public Health Association; 2015.
  34. Hallanvuo S, Johansson T. Elintarvikkeiden mikrobiologiset vaarat. [Microbiological hazards of food]. Helsinki: Finnish Food Safety Authority Evira; 2010. Finnish. Available from: https://www.evira.fi/globalassets/tietoa-evirasta/julkaisut/julkaisusarjat/elintarvikkeet/elintarvikkeiden_mikrobiologiset_vaarat.pdf
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