Abstract
Shiga toxin-producing Escherichia coli (STEC) is a significant cause of gastrointestinal infection and the haemolytic-uremic syndrome (HUS). STEC outbreaks are commonly associated with food but animal contact is increasingly being implicated in its transmission. We report an outbreak of STEC affecting young infants at a nursery in a rural community (three HUS cases, one definite case, one probable case, three possible cases and five carriers, based on the combination of clinical, epidemiological and laboratory data) identified using culture-based and molecular techniques. The investigation identified repeated animal contact (animal farming and petting) as a likely source of STEC introduction followed by horizontal transmission. Whole genome sequencing (WGS) was used for real-time investigation of the incident and revealed a unique strain of STEC O26:H11 carrying stx2a and intimin. Following a public health intervention, no additional cases have occurred. This is the first STEC outbreak reported from Israel. WGS proved as a useful tool for rapid laboratory characterization and typing of the outbreak strain and informed the public health response at an early stage of this unusual outbreak.
Original language | English |
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Pages (from-to) | 2998-3006 |
Number of pages | 9 |
Journal | Epidemiology and Infection |
Volume | 145 |
Issue number | 14 |
DOIs | |
State | Published - 1 Oct 2017 |
Keywords
- Escherichia coli
- Shigatoxin
- haemolytic-uremic syndrome
- investigation
- outbreak
- paediatric
- whole genome sequencing
ASJC Scopus subject areas
- Epidemiology
- Infectious Diseases