title: Outbreaks of non-O157 Shiga toxin-producing Escherichia coli infection: USA.
abstract: Non-O157 Shiga toxin-producing Escherichia coli (STEC) infections are increasingly detected, but sources are not well established. We summarize outbreaks to 2010 in the USA. Single-aetiology outbreaks were defined as ⩾2 epidemiologically linked culture-confirmed non-O157 STEC infections; multiple-aetiology outbreaks also had laboratory evidence of ⩾2 infections caused by another enteric pathogen. Twenty-six states reported 46 outbreaks with 1727 illnesses and 144 hospitalizations. Of 38 single-aetiology outbreaks, 66% were caused by STEC O111 (n = 14) or O26 (n = 11), and 84% were transmitted through food (n = 17) or person-to-person spread (n = 15); food vehicles included dairy products, produce, and meats; childcare centres were the most common setting for person-to-person spread. Of single-aetiology outbreaks, a greater percentage of persons infected by Shiga toxin 2-positive strains had haemolytic uraemic syndrome compared with persons infected by Shiga toxin 1-only positive strains (7% vs. 0·8%). Compared with single-aetiology outbreaks, multiple-aetiology outbreaks were more frequently transmitted through water or animal contact.
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Luna-Gierke
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Griffin
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Gould
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: K
authors.initials: K
authors.lastname: Herman
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Bopp
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: N
authors.initials: N
authors.lastname: Strockbine
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Mody
mesh_terms: D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology*; D019453:Escherichia coli O157 / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D022622:Shiga Toxin 1 / Q000302:isolation & purification*; D054323:Shiga-Toxigenic Escherichia coli / Q000302:isolation & purification*; D014481:United States / Q000453:epidemiology
chemical_list: D022622:Shiga Toxin 1