Real-time genomic investigation underlying the public health response to a Shiga toxin-producing Escherichia coli O26:H11 outbreak in a nursery

J. Moran-Gilad, A. Rokney, D. Danino, M. Ferdous, F. Alsana, M. Baum, L. Dukhan, V. Agmon, E. Anuka, L. Valinsky, R. Yishay, I. Grotto, J. W.A. Rossen, M. Gdalevich

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

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 languageEnglish
Pages (from-to)2998-3006
Number of pages9
JournalEpidemiology and Infection
Volume145
Issue number14
DOIs
StatePublished - 1 Oct 2017

Keywords

  • Escherichia coli
  • Shigatoxin
  • haemolytic-uremic syndrome
  • investigation
  • outbreak
  • paediatric
  • whole genome sequencing

ASJC Scopus subject areas

  • Epidemiology
  • Infectious Diseases

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