Child Care-Associated Outbreak of Escherichia Coli O157:h7 and Hemolytic Uremic Syndrome

Raffaelli, Ryan M.; Paladini, Marc; Hanson, Heather; Kornstein, Laura; Agasan, Alice; Slavinski, Sally; Weiss, Don; Fennelly, Glenn J.; Flynn, Joseph T.

doi:10.1097/inf.0b013e31812571f6

Cited by 20 publications

(13 citation statements)

References 20 publications

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“…2005). EHEC strains can cause various syndromes in humans: undifferentiated diarrhoea, haemorrhagic colitis and HUS (Raffaelli et al. 2007) and have been associated with significant disease outbreaks in developed countries (USA, Canada, United Kingdom, France, Japan, etc.)…”

Section: Introductionmentioning

confidence: 99%

“…Nowadays, EHEC strains are considered to have evolved from EPEC strains through the acquisition of bacteriophages encoding Stx (Reid et al 2000) (Wick et al 2005. EHEC strains can cause various syndromes in humans: undifferentiated diarrhoea, haemorrhagic colitis and HUS (Raffaelli et al 2007) and have been associated with significant disease outbreaks in developed countries (USA, Canada, United Kingdom, France, Japan, etc.) in recent years (Stirling et al 2007;Sonoda et al 2008).…”

Section: Introductionmentioning

confidence: 99%

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Enteropathogenic (EPEC), enterohaemorragic (EHEC) and verotoxigenic (VTEC) Escherichia coli in wild cervids

Bardiau

Grégoire

Muylaert

et al. 2010

Journal of Applied Microbiology

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Aims: The aim of this study was to investigate the presence of enteropathogenic (EPEC), enterohaemorragic (EHEC) and verotoxigenic (VTEC) Escherichia coli strains in free‐ranging wild ruminants in Belgium and to characterize the positive isolates (serogroups and virulence‐associated factor‐encoding genes). Methods and Results: Escherichia coli strains isolated from faeces of wild cervids were characterized by PCR targeting genes coding for the main virulence properties of EPEC, EHEC and VTEC strains. The prevalence rate of these pathogenic strains in faecal samples obtained from the wild ruminants was found to be 15%. No pathogenic isolate was found to belong to the O157, O26, O111, O103 or O145 serogroups. Moreover, a new gene, eibH, showing 88% identity with eibG was detected in VTEC strains. Conclusions: The results reveal that wild ruminants could be considered as a potential source of VTEC and EPEC infection for humans and possibly also for domestic ruminants. Significance and Impact of the Study: Our study suggests the potential risk of transmission of VTEC, EHEC and EPEC strains from wild ruminants to humans via the consumption of venison and to domestic ruminants because of sharing of the same pasture. Indeed, many serogroups other than O157 EHEC have also been shown to be responsible for outbreaks in humans in several countries, and studies focusing solely on O157:H7 EHEC tend to underestimate this risk of transmission.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Enteropathogenic (EPEC), enterohaemorragic (EHEC) and verotoxigenic (VTEC) Escherichia coli in wild cervids

Bardiau

Grégoire

Muylaert

et al. 2010

Journal of Applied Microbiology

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“…STEC infection also causes hemolytic-uremic syndrome (HUS), a life-threatening condition characterized by hemolytic anemia, thrombocytopenia, and renal failure (3,31). Transmission of STEC occurs through contaminated foods, such as ground beef, through contaminated water, and by person-to-person spread (2,6,7,15,(26)(27)(28). In the United States, O157:H7 (O157) is the most common serotype of STEC (24,27,29,30) and is the serotype most often associated with HUS (1,3,31).…”

mentioning

confidence: 99%

Shiga Toxin-Producing Escherichia coli in Children: Diagnosis and Clinical Manifestations of O157:H7 and Non-O157:H7 Infection

Hermos

Janineh

Han³

et al. 2011

J Clin Microbiol

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Shiga toxin-producing Escherichia coli (STEC), a cause of food-borne colitis and hemolytic-uremic syndrome in children, can be serotype O157:H7 (O157) or other serotypes (non-O157). E. coli O157 can be detected by culture with sorbitol-MacConkey agar (SMAC), but non-O157 STEC cannot be detected with this medium. Both O157 and non-O157 STEC can be detected by immunoassay for Shiga toxins 1 and 2. The objectives of this study were first to compare the diagnostic utility of SMAC to that of the Premier EHEC enzyme immunoassay (

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“…There are many opportunities for food workers to be infected with these two organisms. The reasons for low worker involvement in outbreaks are not apparent, especially because Campylobacter can remain viable in stool specimens for Ն7 days after patient recovery (99), and E. coli O157:H7 can remain viable for Ն10 days (160). Perhaps the low rate of worker involvement in outbreaks is due to the fact that there are relatively few asymptomatic carriers in the community, although up to 13% of apparently healthy individuals in surveys have been found to excrete Campylobacter jejuni or Campylobacter coli (99).…”

Section: Infective Doses For Foodborne and Other Enteric Pathogensmentioning

confidence: 99%

Outbreaks Where Food Workers Have Been Implicated in the Spread of Foodborne Disease. Part 4. Infective Doses and Pathogen Carriage

Todd

Greig

Bartleson³

et al. 2008

Journal of Food Protection

120

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In this article, the fourth in a series reviewing the role of food workers in foodborne outbreaks, background information on the presence of enteric pathogens in the community, the numbers of organisms required to initiate an infection, and the length of carriage are presented. Although workers have been implicated in outbreaks, they were not always aware of their infections, either because they were in the prodromic phase before symptoms began or because they were asymptomatic carriers. Pathogens of fecal, nose or throat, and skin origin are most likely to be transmitted by the hands, highlighting the need for effective hand hygiene and other barriers to pathogen contamination, such as no bare hand contact with ready-to-eat food. The pathogens most likely to be transmitted by food workers are norovirus, hepatitis A virus, Salmonella, Shigella, and Staphylococcus aureus. However, other pathogens have been implicated in worker-associated outbreaks or have the potential to be implicated. In this study, the likelihood of pathogen involvement in foodborne outbreaks where infected workers have been implicated was examined, based on infectious dose, carriage rate in the community, duration of illness, and length of pathogen excretion. Infectious dose estimates are based on volunteer studies (mostly early experiments) or data from outbreaks. Although there is considerable uncertainty associated with these data, some pathogens appear to be able to infect at doses as low as 1 to 100 units, including viruses, parasites, and some bacteria. Lengthy postsymptomatic shedding periods and excretion by asymptomatic individuals of many enteric pathogens is an important issue for the hygienic management of food workers.

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Child Care-Associated Outbreak of Escherichia Coli O157:h7 and Hemolytic Uremic Syndrome

Cited by 20 publications

References 20 publications

Enteropathogenic (EPEC), enterohaemorragic (EHEC) and verotoxigenic (VTEC) Escherichia coli in wild cervids

Enteropathogenic (EPEC), enterohaemorragic (EHEC) and verotoxigenic (VTEC) Escherichia coli in wild cervids

Shiga Toxin-Producing Escherichia coli in Children: Diagnosis and Clinical Manifestations of O157:H7 and Non-O157:H7 Infection

Outbreaks Where Food Workers Have Been Implicated in the Spread of Foodborne Disease. Part 4. Infective Doses and Pathogen Carriage

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