Outbreak of gastroenteritis highlighting the diagnostic and epidemiological challenges of enteroinvasive Escherichia coli, County of Halland, Sweden, November 2017
Open Access
- 5 March 2020
- journal article
- research article
- Published by European Centre for Disease Control and Prevention (ECDC) in Eurosurveillance
- Vol. 25 (9), 23-30
- https://doi.org/10.2807/1560-7917.ES.2020.25.9.1900466
Abstract
An outbreak of gastroenteritis with 83 cases occurred at a conference venue in November 2017 in Halland County, Sweden. Stool samples from two venue visitors and a symptomatic secondary case attributed to household transmission were PCR-positive for the ipaH gene, a target found in both Shigella spp. and enteroinvasive Escherichia coli (EIEC). EIEC was isolated from stool samples and whole genome sequencing analysis confirmed EIEC O96:H19 to be the aetiological agent. A cohort study was conducted among venue attendees and employees and the findings implicated contaminated leafy greens as the vehicle of infection, however, no microbiological evidence could support the study results. Here, we report the investigation into the first recorded EIEC outbreak in Sweden and illustrate the challenges associated with the differential laboratory diagnostics of Shigella/EIEC in an outbreak setting.This publication has 32 references indexed in Scilit:
- Foodborne outbreaks of shigellosis in the USA, 1998–2008Epidemiology and Infection, 2012
- Inadequacies of Minimum Spanning Trees in Molecular EpidemiologyJournal of Clinical Microbiology, 2011
- Differentiation between Shigella, enteroinvasive Escherichia coli (EIEC) and noninvasive Escherichia coliEuropean Journal of Clinical Microbiology & Infectious Diseases, 2011
- The growing burden of foodborne outbreaks due to contaminated fresh produce: risks and opportunitiesEpidemiology and Infection, 2009
- A Multicentre Study of Shigella Diarrhoea in Six Asian Countries: Disease Burden, Clinical Manifestations, and MicrobiologyPLoS Medicine, 2006
- A Review of Outbreaks of Foodborne Disease Associated with Passenger Ships: Evidence for Risk ManagementPublic Health Reports, 2004
- Detection of Shigellae and EnteroinvasiveEscherichia coliby Amplification of the Invasion Plasmid Antigen H DNA Sequence in Patients with DysenteryThe Journal of Infectious Diseases, 1993
- The Role of Shigella spp., Enteroinvasive Escherichia coli, and Other Enteropathogens as Causes of Childhood Dysentery in ThailandThe Journal of Infectious Diseases, 1986
- Enteropathogenic, enterotoxigenic and enteroinvasive Escherichia coli isolated from acute gastroenteritis patients in Lagos, NigeriaTransactions of the Royal Society of Tropical Medicine and Hygiene, 1982
- AN OUTBREAK OF ENTEROPATHOGENIC ESCHERICHIA COLI FOODBORNE DISEASE TRACED TO IMPORTED FRENCH CHEESEThe Lancet, 1973