TY - JOUR
T1 - An outbreak of Shiga toxin-producing Escherichia coli serotype O103:H2 associated with unpasteurized soft cheese, England and Wales, 2022
AU - Heinsbroek, E.
AU - Blakey, E.
AU - Simpson, A.
AU - Verlander, N. Q.
AU - Greig, D. R.
AU - Jorgensen, F.
AU - Nelson, A.
AU - Douglas, A.
AU - Balasegaram, S.
AU - Jenkins, C.
AU - Elson, R.
N1 - Data availability statement:
FASTQ reads from all sequences in this study can be found at the UKHSA Pathogens BioProject at the National Center for Biotechnology Information (accession No. PRJNA315192).
PY - 2025/1/22
Y1 - 2025/1/22
N2 - In July 2022, a genetically linked and geographically dispersed cluster of 12 cases of Shiga toxin-producing Escherichia coli (STEC) O103:H2 was detected by the UK Health Security Agency using whole genome sequencing. Review of food history questionnaires identified cheese (particularly an unpasteurized brie-style cheese) and mixed salad leaves as potential vehicles. A case-control study was conducted to investigate exposure to these products. Case food history information was collected by telephone. Controls were recruited using a market research panel and self-completed an online questionnaire. Univariable and multivariable analyses were undertaken using Firth Logistic Regression. Eleven cases and 24 controls were included in the analysis. Consumption of the brie-style cheese of interest was associated with illness (OR 57.5, 95% confidence interval: 3.10-1,060). Concurrently, the production of the brie-style cheese was investigated. Microbiological sample results for the cheese products and implicated dairy herd did not identify the outbreak strain, but did identify the presence of stx genes and STEC, respectively. Together, epidemiological, microbiological, and environmental investigations provided evidence that the brie-style cheese was the vehicle for this outbreak. Production of unpasteurized dairy products was suspended by the business operator, and a review of practices was performed.
AB - In July 2022, a genetically linked and geographically dispersed cluster of 12 cases of Shiga toxin-producing Escherichia coli (STEC) O103:H2 was detected by the UK Health Security Agency using whole genome sequencing. Review of food history questionnaires identified cheese (particularly an unpasteurized brie-style cheese) and mixed salad leaves as potential vehicles. A case-control study was conducted to investigate exposure to these products. Case food history information was collected by telephone. Controls were recruited using a market research panel and self-completed an online questionnaire. Univariable and multivariable analyses were undertaken using Firth Logistic Regression. Eleven cases and 24 controls were included in the analysis. Consumption of the brie-style cheese of interest was associated with illness (OR 57.5, 95% confidence interval: 3.10-1,060). Concurrently, the production of the brie-style cheese was investigated. Microbiological sample results for the cheese products and implicated dairy herd did not identify the outbreak strain, but did identify the presence of stx genes and STEC, respectively. Together, epidemiological, microbiological, and environmental investigations provided evidence that the brie-style cheese was the vehicle for this outbreak. Production of unpasteurized dairy products was suspended by the business operator, and a review of practices was performed.
KW - Shiga-like toxin-producing E. coli
KW - food safety
KW - foodborne infections
KW - outbreaks
KW - whole genome sequencing
UR - https://www.scopus.com/pages/publications/85216520499
U2 - 10.1017/S0950268824001523
DO - 10.1017/S0950268824001523
M3 - Article
SN - 0950-2688
VL - 152
SP - e172
JO - Epidemiology and Infection
JF - Epidemiology and Infection
M1 - e172
ER -