title: A national outbreak of verotoxin-producing Escherichia coli O157 associated with consumption of lemon-and-coriander chicken wraps from a supermarket chain.
abstract: A national outbreak of verotoxin-producing Escherichia coli O157 infection affected five English regions and Wales. Twelve cases were associated with lemon-and-coriander chicken wrap from a single supermarket chain consumed over a 5-day period. An outbreak investigation aimed to identify the source of infection. Descriptive epidemiology and phenotypic and genotypic tests on human isolates indicated a point-source outbreak; a case-control study showed a very strong association between consumption of lemon-and-coriander chicken wrap from the single supermarket chain and being a case (OR 46.40, 95% CI 5.39-infinity, P=0.0002). Testing of raw ingredients, products and faecal samples from staff in the food production unit did not yield any positive results. The outbreak was probably caused by one contaminated batch of an ingredient in the chicken wrap. Even when current best practice is in place, ready-to-eat foods can still be a risk for widespread infection.
authors.affiliation: Health Protection Agency, North West, Liverpool. paula.whittaker@manchester.nhs.uk
authors.forename: P J
authors.initials: PJ
authors.lastname: Whittaker
authors.forename: W
authors.initials: W
authors.lastname: Sopwith
authors.forename: C
authors.initials: C
authors.lastname: Quigley
authors.forename: I
authors.initials: I
authors.lastname: Gillespie
authors.forename: G A
authors.initials: GA
authors.lastname: Willshaw
authors.forename: C
authors.initials: C
authors.lastname: Lycett
authors.forename: S
authors.initials: S
authors.lastname: Surman-Lee
authors.forename: D
authors.initials: D
authors.lastname: Baxter
authors.forename: G K
authors.initials: GK
authors.lastname: Adak
authors.forename: Q
authors.initials: Q
authors.lastname: Syed
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002645:Chickens / Q000382:microbiology*; D002957:Citrus / Q000382:microbiology*; D028526:Coriandrum / Q000382:microbiology*; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004927:Escherichia coli Infections / Q000453:epidemiology*; D005260:Female; D005506:Food Contamination; D005511:Food Handling; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D054323:Shiga-Toxigenic Escherichia coli / Q000302:isolation & purification*