Vero cytotoxin (VT)-producing Escherichia coli O157 (O157 VTEC) were isolated from a raw beefburger obtained from a retail source linked to a small community outbreak of O157 VTEC infection in Wales. Strains from the meat and from seven of eight patients belonged to phage type 49 and were indistinguishable by their VT-type, plasmid content and hybridization with DNA of a VT-encoding phage from an O157 VTEC strain. This first report of the isolation of O157 VTEC from a beef product in Britain supports the view that there is a bovine reservoir for this organism.
Surveillance of human VTEC O157 has been reported in several countries, based on laboratory evidence. The incidence is generally less than 10 per 100 000 (the highest incidence is in children), with regional variations and a marked seasonality. Laboratory selection criteria and reporting have contributed to, but cannot entirely explain, variations within and between countries. Surveillance data and outbreaks in definable cohorts indicate that the spectrum of illness ranges from diarrhoea through acute bloody diarrhoea, with about 5% of cases developing haemolytic uraemic syndrome; less than 50% of patients report frank blood in their stools. Studies of sporadic cases have associated illness with beef products (particularly if undercooked and eaten outside the home), cooked sliced meat meals and contact with a household member with diarrhoea. Outbreaks have been attributed to contaminated foods (including beefburgers) and water, animal contact and person‐to‐person spread. Secondary transmission by the primary case in a household is of particular concern, and household transmission has been estimated at 4%, with patients excreting for around 10 days following onset. Recommendations for control have highlighted measures on farms, in slaughterhouses, retail and catering food premises, and in the home.
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