title: Foodborne general outbreaks of Shiga toxin-producing Escherichia coli O157 in England and Wales 1992-2002: where are the risks?
abstract: Between 1 January 1992 and 31 December 2002, Shiga toxin-producing Escherichia coli O157 (STEC O157) accounted for 44 of the 1645 foodborne general outbreaks of infectious intestinal disease reported to the Health Protection Agency Communicable Disease Surveillance Centre. These outbreaks, although rare, were characterized by severe infection, with 169 hospital admissions and five deaths reported. STEC O157 outbreaks were compared with other pathogens to identify factors associated with this pathogen. Single risk variable analysis and logistic regression were employed. Two distinct aetiologies were identified. Foodborne outbreaks of STEC O157 infection in England and Wales were independently associated with farms, which related to milk and milk products, and with red meats/meat products, which highlighted butchers' shops as a cause for concern. The introduction and adherence to effective control measures, based on the principles of hazard analysis, provide the best means of minimizing the risk of foodborne infection with this pathogen.
authors.affiliation: Gastrointestinal Diseases Department, Health Protection Agency Communicable Disease Surveillance Centre, London, UK. Iain.Gillespie@hpa.org.uk
authors.forename: I A
authors.initials: IA
authors.lastname: Gillespie
authors.forename: S J
authors.initials: SJ
authors.lastname: O'Brien
authors.forename: G K
authors.initials: GK
authors.lastname: Adak
authors.forename: T
authors.initials: T
authors.lastname: Cheasty
authors.forename: G
authors.initials: G
authors.lastname: Willshaw
mesh_terms: D004196:Disease Outbreaks; D004739:England / Q000453:epidemiology; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D019453:Escherichia coli O157 / Q000145:classification / Q000302:isolation & purification*; D005516:Food Microbiology; D006801:Humans; D012307:Risk Factors; D022621:Shiga Toxin / Q000302:isolation & purification; D014852:Wales / Q000453:epidemiology
chemical_list: D022621:Shiga Toxin