School outbreak of Escherichia coli O157 with high levels of transmission, Staffordshire, England, February 2012

Laura Bayliss, Robert Carr, Obaghe Edeghere*, Elizabeth Knapper, Kathy Nye, Gareth Harvey, Goutam Adak, Harsh Duggal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background Verocytotoxin-producing Escherichia coli (VTEC) are bacteria that cause infectious gastroenteritis and in certain settings can cause widespread infection due to secondary transmission. We describe the findings of an investigation of a school-based outbreak of VTEC in Staffordshire, England. Methods Outbreak investigation at a school in February 2012 after two children were diagnosed with VTEC infection. Cases were defined as pupils and staff (or their household contacts) with gastrointestinal symptoms or asymptomatic screened persons, with laboratory confirmed VTEC O157 infection (phage type 32, verocytotoxin 2) occurring on or after 1 February 2012. Microbiological tests of food and faecal samples plus screening of asymptomatic contacts were undertaken. Epidemiological and clinical data were descriptively analysed. Results Thirty-eight cases were detected. Nineteen were asymptomatic and identified via screening of 191 pupils. Infection was introduced into the school from an earlier household cluster, followed by extensive person-to-person transmission within the nursery/infant group with limited spread to the wider school population. Conclusions Control measures included several interventions, in particular, universal screening of pupils and staff. Screening during school outbreaks is not underpinned by guidance but proved to be a key control measure. Screening of asymptomatic contacts should be considered in similar outbreaks.

Original languageEnglish
Pages (from-to)e247-e253
JournalJournal of Public Health (United Kingdom)
Issue number3
Publication statusPublished - 1 Sep 2016

Bibliographical note

Funding Information:
We are grateful to all the members of the OCT: Public Health England (PHE) West Midlands North Health Protection Team, West Midlands Field Epidemiology Team, West Midlands Public Health Laboratory, University Hospital North Staffordshire Microbiology Department, EHOs at Newcastle-under-Lyme Borough Council, Staffordshire County Council's Education department, Gastrointestinal & Zoonotic Infections Unit (GEZI) and staff members and parents of pupils at the Primary School.

Publisher Copyright:
© 2015 Crown copyright 2015.


  • communicable diseases
  • epidemiology
  • public health


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