Crab meat: A novel vehicle for E. coli O157 identified in an outbreak in South West England, August 2011

In August 2011, we investigated an outbreak of Escherichia coli O157 in Plymouth, England, utilizing a case-control study and food traceback. Nine cases, eight laboratory-confirmed with E. coli O157 phage type 21/28 verocytotoxin 2 and one epidemiologically linked, had onsets from 30 July 2011 to 15 August 2011. We compared cases (n = 8) with controls (n = 28) of similar age and sex (median age 61 vs. 55 years, females 75% vs. 61%). Cases were 58 times more likely to have eaten crab (88% vs. 11%; odds ratio 58, 95% confidence interval 4-2700). Eight cases consumed crab sourced from the same supplier who was not registered with the local authority. This outbreak pointed to crab as a possible vehicle of E. coli O157 infection. We ensured the withdrawal of crab meat sourced from unregistered suppliers from food venues by 25 August 2011. We also emphasized the importance of only using registered suppliers to the food venues. Since then no further associated cases have been reported.