Foodborne Pathogens and Disease · 2013 · 343 citations · 17 references
Veterinary MedicineInfectious Disease ControlInfectious DiseasesFoodborne Disease EpidemiologyInfectious Disease EpidemiologyPublic Health SurveillanceBacterial EpidemiologyBacterial InfectionsFoodborne Disease SurveillanceFoodborne InfectionsFoodborne PathogensSurveillance Of Foodborne IllnessAcute Infectious DiarrheaEpidemiology Of Bacterial InfectionsFoodborne Bacterial Disease EpidemiologyFoodborne Bacterial PathogensFoodborne Pathogen SurveillancePopulation-based Sentinel SurveillanceSurveillance Of Foodborne BacteriaSurveillance Of Gastrointestinal Infections
BACKGROUND: Shiga toxin-producing Escherichia coli (STEC) are an important cause of diarrhea and the major cause of postdiarrheal hemolytic uremic syndrome. Non-O157 STEC infections are being recognized with greater frequency because of changing laboratory practices. METHODS: Foodborne Diseases Active Surveillance Network (FoodNet) site staff conducted active, population-based surveillance for laboratory-confirmed STEC infections. We assessed frequency and incidence of STEC infections by serogroup and examined and compared demographic factors, clinical characteristics, and frequency of international travel among patients. RESULTS: During 2000-2010, FoodNet sites reported 2006 cases of non-O157 STEC infection and 5688 cases of O157 STEC infections. The number of reported non-O157 STEC infections increased from an incidence of 0.12 per 100,000 population in 2000 to 0.95 per 100,000 in 2010; while the rate of O157 STEC infections decreased from 2.17 to 0.95 per 100,000. Among non-O157 STEC, six serogroups were most commonly reported: O26 (26%), O103 (22%), O111 (19%), O121 (6%), O45 (5%), and O145 (4%). Non-O157 STEC infections were more common among Hispanics, and infections were less severe than those caused by O157 STEC, but this varied by serogroup. Fewer non-O157 STEC infections were associated with outbreaks (7% versus 20% for O157), while more were associated with international travel (14% versus 3% for O157). CONCLUSIONS: Improved understanding of the epidemiologic features of non-O157 STEC infections can inform food safety and other prevention efforts. To detect both O157 and non-O157 STEC infections, clinical laboratories should routinely and simultaneously test all stool specimens submitted for diagnosis of acute community-acquired diarrhea for O157 STEC and for Shiga toxin and ensure that isolates are sent to a public health laboratory for serotyping and subtyping.
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M Rivas, E Miliwebsky, Isabel Chinen et al. · Foodborne Pathogens and Disease · 2006 · 151 citations