Lessons learned from the investigation and management of an outbreak of Shigella flexneri associated with a restaurant in London, 2019–2020

K. McLarty*, K. Paranthaman, C. Jenkins, J. Sedgwick, E. Crawley-Boevey

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background: Foodborne outbreaks of Shigella flexneri infection are uncommon in the UK. In November 2019, the United Kingdom Health Security Agency investigated an outbreak of S. flexneri associated with a fast-food restaurant in London. 

Methods: Epidemiological investigations included case ascertainment and interviewing suspected cases using enhanced surveillance questionnaires. Whole-genome sequencing (WGS) was used for characterisation of human isolates. Environmental investigations included a review of food safety processes at the implicated restaurant, administration of exposure questionnaires and stool sampling of staff. 

Results: Between November 2019 and February 2020, 17 cases were confirmed as part of the outbreak by WGS in London. Among these, 15 were linked to the implicated restaurant. A review of the food safety processes at the restaurant was satisfactory. Despite initial suboptimal coverage of stool screening of staff, all staff members working at the restaurant during the sampling period were screened and an asymptomatic food handler tested positive for S.flexneri with the outbreak WGS profile. The individual underwent microbiological clearance, and no further cases were reported. It was not possible to confirm the direction of transmission for the community cases or the staff member. 

Conclusion: We report an outbreak of S. flexneri in a fast-food restaurant in London with previous inspection ratings indicating good compliance with food safety and hygiene standards. WGS was crucial in identifying cases linked to the outbreak. This outbreak highlights the importance of prompt testing of food handlers in outbreaks suspected to be associated with food businesses.

Original languageEnglish
Pages (from-to)130-132
Number of pages3
JournalPublic Health
Volume205
Early online date9 Mar 2022
DOIs
Publication statusPublished - Apr 2022

Bibliographical note

Funding information: No funding information.

Open Access: No Open Access licence.

Publisher Copyright: Crown Copyright © 2022 Published by Elsevier Ltd on behalf of The Royal Society for Public Health. All rights reserved.

Citation: McLarty, K., et al. "Lessons learned from the investigation and management of an outbreak of Shigella flexneri associated with a restaurant in London, 2019–2020." Public Health 205 (2022): 130-132.

DOI: https://doi.org/10.1016/j.puhe.2022.01.036

Keywords

  • Food handler
  • Outbreak investigation
  • Restaurant
  • Shigella flexneri
  • Shigellosis

Fingerprint

Dive into the research topics of 'Lessons learned from the investigation and management of an outbreak of Shigella flexneri associated with a restaurant in London, 2019–2020'. Together they form a unique fingerprint.

Cite this