Outbreak of shiga toxin-producing Escherichia coli O157:H7 linked to raw drinking milk resolved by rapid application of advanced pathogen characterisation methods, England, August to October 2017

Juli Treacy, Claire Jenkins, Karthikeyan Paranthaman, Frieda Jorgensen, Doris Mueller-Doblies, Muna Anjum, Lukeki Kaindama, Hassan Hartman, Miranda Kirchner, Therese Carson, Ishani Kar-Purkayastha*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)

Abstract

An outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 occurred on the Isle of Wight between August and October 2017. Of the seven cases linked to the outbreak, five were identified through the statutory notification process and two were identified through national surveillance of whole genome sequencing data. Enhanced surveillance questionnaires established a common link to a farm, and link to the likely food vehicle, raw drinking milk (RDM). Microbiological investigations, including PCR, identified the presence of STEC O157:H7 in samples of RDM. Analysis of core genome single nucleotide polymorphism (SNP) data of STEC O157:H7 from human stool specimens, animal faecal samples and RDM demonstrated a one SNP difference between isolates, and therefore close genetic relatedness. Control measures that were put in place included suspension of sales and recall of RDM, as well as restrictions on public access to parts of the farm. Successful integration of traditional epidemiological surveillance and advanced laboratory methods for the detection and characterisation of STEC O157:H7 from human, animal and environmental samples enabled prompt identification of the outbreak vehicle and provided evidence to support the outbreak control team’s decision-making, leading to implementation of effective control measures in a timely manner.

Original languageEnglish
Article number1800191
JournalEurosurveillance
Volume24
Issue number16
DOIs
Publication statusPublished - 18 Apr 2019

Bibliographical note

Funding Information:
This work was supported by the National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections and the Department for Environment, Food and Rural Affairs, Scottish Government and Welsh Government under APHA devolved surveillance contract B.

Funding Information:
We would like to thank Francesco Tripodo, Dawn Hedges and Michael Wright at GBRU; Lisa Byrne, PHE national STEC surveillance lead; Drs. Rob Davies and Nick Duggett at Animal and Plant Health Agency for epidemiological and WGS advice. We would also like to acknowledge everyone who was part of the outbreak control team, including the Food Standards Agency and its Dairy Hygiene Inspectorate, and the IOW Council Environmental and Public Health teams. This work was supported by the National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections and the Department for Environment, Food and Rural Affairs, Scottish Government and Welsh Government under APHA devolved surveillance contract B. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health, Public Health England or the Department for Environment, Food and Rural Affairs.

Publisher Copyright:
© 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

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