Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015

Noeleen McFarland; N. Bundle; Claire Jenkins; Gauri Godbole; A. Mikhail; Tim Dallman; C. O'Connor; Noel McCarthy; E. O’Connell; J. Treacy; Girija Dabke; J. Mapstone; Y. Landy; J. Moore; R. Partridge; Frieda Jorgensen; Caroline Willis; Piers Mook; C. Rawlings; R. Acornley; C. Featherstone; S. Gayle; J. Edge; E. McNamara; Jeremy Hawker; Sooria Balasegaram

doi:10.2807/1560-7917.ES.2017.22.36.30610

Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015

Noeleen McFarland^*
, N. Bundle
, Claire Jenkins
, Gauri Godbole
, A. Mikhail
, Tim Dallman
, C. O'Connor
, Noel McCarthy
, E. O’Connell
, J. Treacy
, Girija Dabke
, J. Mapstone
, Y. Landy
, J. Moore
, R. Partridge
, Frieda Jorgensen
, Caroline Willis
, Piers Mook
, C. Rawlings
, R. Acornley

C. Featherstone, S. Gayle, J. Edge, E. McNamara, Jeremy Hawker, Sooria Balasegaram

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

24 Citations (Scopus)

Abstract

The first documented British outbreak of Shiga toxinproducing Escherichia coli (STEC) O55:H7 began in the county of Dorset, England, in July 2014. Since then, there have been a total of 31 cases of which 13 presented with haemolytic uraemic syndrome (HUS). The outbreak strain had Shiga toxin (Stx) subtype 2a associated with an elevated risk of HUS. This strain had not previously been isolated from humans or animals in England. The only epidemiological link was living in or having close links to two areas in Dorset. Extensive investigations included testing of animals and household pets. Control measures included extended screening, iterative interviewing and exclusion of cases and high risk contacts. Whole genome sequencing (WGS) confirmed that all the cases were infected with similar strains. A specific source could not be identified. The combination of epidemiological investigation and WGS indicated, however, that this outbreak was possibly caused by recurrent introductions from a local endemic zoonotic source, that a highly similar endemic reservoir appears to exist in the Republic of Ireland but has not been identified elsewhere, and that a subset of cases was associated with human-tohuman transmission in a nursery.

Original language	English
Journal	Eurosurveillance
Volume	22
Issue number	36
DOIs	https://doi.org/10.2807/1560-7917.ES.2017.22.36.30610
Publication status	Published - 7 Sept 2017

Bibliographical note

Funding Information:
Support for the investigation and enforcement of control measures was provided by the Environmental Health Officers from North Dorset, West Dorset, Weymouth, Bournemouth, Poole and New Forest councils. Regional support was provided by Jenny Harries. Hikaru Bolt, PHE Field Epidemiology Services South East and London produced network maps. Stuart Ashfield at APHA produced the Dorset cattle density map. Advice on the boot sock sampling study was provided by Iain Lake and Natalia Jones at the University of East Anglia (UEA). The boot sock study was developed in the ‘Enigma’ research programme (Principal Investigator Dr Sarah O’ Brien) and was the product of collaborative working between Liverpool, UEA and Manchester universities, funded by the Medical Research Council and other partners (through the Environmental and Social Ecology of Human Infectious Disease Initiative, ESEI). The research was in part funded, through partial salary support, by the National Institute for Health Research Health Protection Research Unit.

Publisher Copyright:
© 2017 European Centre for Disease Prevention and Control (ECDC). All rights reserved.

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SDG 3 Good Health and Well-being

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10.2807/1560-7917.ES.2017.22.36.30610

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McFarland, N., Bundle, N., Jenkins, C., Godbole, G., Mikhail, A., Dallman, T., O'Connor, C., McCarthy, N., O’Connell, E., Treacy, J., Dabke, G., Mapstone, J., Landy, Y., Moore, J., Partridge, R., Jorgensen, F., Willis, C., Mook, P., Rawlings, C., ... Balasegaram, S. (2017). Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015. Eurosurveillance, 22(36). https://doi.org/10.2807/1560-7917.ES.2017.22.36.30610

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title = "Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015",

abstract = "The first documented British outbreak of Shiga toxinproducing Escherichia coli (STEC) O55:H7 began in the county of Dorset, England, in July 2014. Since then, there have been a total of 31 cases of which 13 presented with haemolytic uraemic syndrome (HUS). The outbreak strain had Shiga toxin (Stx) subtype 2a associated with an elevated risk of HUS. This strain had not previously been isolated from humans or animals in England. The only epidemiological link was living in or having close links to two areas in Dorset. Extensive investigations included testing of animals and household pets. Control measures included extended screening, iterative interviewing and exclusion of cases and high risk contacts. Whole genome sequencing (WGS) confirmed that all the cases were infected with similar strains. A specific source could not be identified. The combination of epidemiological investigation and WGS indicated, however, that this outbreak was possibly caused by recurrent introductions from a local endemic zoonotic source, that a highly similar endemic reservoir appears to exist in the Republic of Ireland but has not been identified elsewhere, and that a subset of cases was associated with human-tohuman transmission in a nursery.",

author = "Noeleen McFarland and N. Bundle and Claire Jenkins and Gauri Godbole and A. Mikhail and Tim Dallman and C. O'Connor and Noel McCarthy and E. O{\textquoteright}Connell and J. Treacy and Girija Dabke and J. Mapstone and Y. Landy and J. Moore and R. Partridge and Frieda Jorgensen and Caroline Willis and Piers Mook and C. Rawlings and R. Acornley and C. Featherstone and S. Gayle and J. Edge and E. McNamara and Jeremy Hawker and Sooria Balasegaram",

note = "Funding Information: Support for the investigation and enforcement of control measures was provided by the Environmental Health Officers from North Dorset, West Dorset, Weymouth, Bournemouth, Poole and New Forest councils. Regional support was provided by Jenny Harries. Hikaru Bolt, PHE Field Epidemiology Services South East and London produced network maps. Stuart Ashfield at APHA produced the Dorset cattle density map. Advice on the boot sock sampling study was provided by Iain Lake and Natalia Jones at the University of East Anglia (UEA). The boot sock study was developed in the {\textquoteleft}Enigma{\textquoteright} research programme (Principal Investigator Dr Sarah O{\textquoteright} Brien) and was the product of collaborative working between Liverpool, UEA and Manchester universities, funded by the Medical Research Council and other partners (through the Environmental and Social Ecology of Human Infectious Disease Initiative, ESEI). The research was in part funded, through partial salary support, by the National Institute for Health Research Health Protection Research Unit. Publisher Copyright: {\textcopyright} 2017 European Centre for Disease Prevention and Control (ECDC). All rights reserved.",

year = "2017",

month = sep,

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doi = "10.2807/1560-7917.ES.2017.22.36.30610",

language = "English",

volume = "22",

journal = "Eurosurveillance",

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McFarland, N, Bundle, N, Jenkins, C , Godbole, G, Mikhail, A, Dallman, T, O'Connor, C, McCarthy, N, O’Connell, E, Treacy, J, Dabke, G, Mapstone, J, Landy, Y, Moore, J, Partridge, R, Jorgensen, F , Willis, C, Mook, P, Rawlings, C, Acornley, R, Featherstone, C, Gayle, S, Edge, J, McNamara, E, Hawker, J & Balasegaram, S 2017, 'Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015', Eurosurveillance, vol. 22, no. 36. https://doi.org/10.2807/1560-7917.ES.2017.22.36.30610

TY - JOUR

T1 - Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015

AU - McFarland, Noeleen

AU - Bundle, N.

AU - Jenkins, Claire

AU - Godbole, Gauri

AU - Mikhail, A.

AU - Dallman, Tim

AU - O'Connor, C.

AU - McCarthy, Noel

AU - O’Connell, E.

AU - Treacy, J.

AU - Dabke, Girija

AU - Mapstone, J.

AU - Landy, Y.

AU - Moore, J.

AU - Partridge, R.

AU - Jorgensen, Frieda

AU - Willis, Caroline

AU - Mook, Piers

AU - Rawlings, C.

AU - Acornley, R.

AU - Featherstone, C.

AU - Gayle, S.

AU - Edge, J.

AU - McNamara, E.

AU - Hawker, Jeremy

AU - Balasegaram, Sooria

N1 - Funding Information: Support for the investigation and enforcement of control measures was provided by the Environmental Health Officers from North Dorset, West Dorset, Weymouth, Bournemouth, Poole and New Forest councils. Regional support was provided by Jenny Harries. Hikaru Bolt, PHE Field Epidemiology Services South East and London produced network maps. Stuart Ashfield at APHA produced the Dorset cattle density map. Advice on the boot sock sampling study was provided by Iain Lake and Natalia Jones at the University of East Anglia (UEA). The boot sock study was developed in the ‘Enigma’ research programme (Principal Investigator Dr Sarah O’ Brien) and was the product of collaborative working between Liverpool, UEA and Manchester universities, funded by the Medical Research Council and other partners (through the Environmental and Social Ecology of Human Infectious Disease Initiative, ESEI). The research was in part funded, through partial salary support, by the National Institute for Health Research Health Protection Research Unit. Publisher Copyright: © 2017 European Centre for Disease Prevention and Control (ECDC). All rights reserved.

PY - 2017/9/7

Y1 - 2017/9/7

N2 - The first documented British outbreak of Shiga toxinproducing Escherichia coli (STEC) O55:H7 began in the county of Dorset, England, in July 2014. Since then, there have been a total of 31 cases of which 13 presented with haemolytic uraemic syndrome (HUS). The outbreak strain had Shiga toxin (Stx) subtype 2a associated with an elevated risk of HUS. This strain had not previously been isolated from humans or animals in England. The only epidemiological link was living in or having close links to two areas in Dorset. Extensive investigations included testing of animals and household pets. Control measures included extended screening, iterative interviewing and exclusion of cases and high risk contacts. Whole genome sequencing (WGS) confirmed that all the cases were infected with similar strains. A specific source could not be identified. The combination of epidemiological investigation and WGS indicated, however, that this outbreak was possibly caused by recurrent introductions from a local endemic zoonotic source, that a highly similar endemic reservoir appears to exist in the Republic of Ireland but has not been identified elsewhere, and that a subset of cases was associated with human-tohuman transmission in a nursery.

AB - The first documented British outbreak of Shiga toxinproducing Escherichia coli (STEC) O55:H7 began in the county of Dorset, England, in July 2014. Since then, there have been a total of 31 cases of which 13 presented with haemolytic uraemic syndrome (HUS). The outbreak strain had Shiga toxin (Stx) subtype 2a associated with an elevated risk of HUS. This strain had not previously been isolated from humans or animals in England. The only epidemiological link was living in or having close links to two areas in Dorset. Extensive investigations included testing of animals and household pets. Control measures included extended screening, iterative interviewing and exclusion of cases and high risk contacts. Whole genome sequencing (WGS) confirmed that all the cases were infected with similar strains. A specific source could not be identified. The combination of epidemiological investigation and WGS indicated, however, that this outbreak was possibly caused by recurrent introductions from a local endemic zoonotic source, that a highly similar endemic reservoir appears to exist in the Republic of Ireland but has not been identified elsewhere, and that a subset of cases was associated with human-tohuman transmission in a nursery.

UR - https://www.scopus.com/pages/publications/85029891389

U2 - 10.2807/1560-7917.ES.2017.22.36.30610

DO - 10.2807/1560-7917.ES.2017.22.36.30610

M3 - Article

C2 - 28920571

AN - SCOPUS:85029891389

SN - 1025-496X

VL - 22

JO - Eurosurveillance

JF - Eurosurveillance

IS - 36

ER -

Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015

Abstract

Bibliographical note

UN SDGs

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