title: Investigation of travel-related cases in a multinational outbreak: example of the Shiga-toxin producing E. coli outbreak in Germany, May-June 2011.
abstract: Early investigation of travel-related cases in an outbreak of an emerging infectious disease can provide useful information to epidemiologists to characterize the exposure, while they may differ in demographic profiles from cases reported in the country where the outbreak has occurred. During the spring 2011 E. coli outbreak in Germany, we proposed a methodological approach to collect a minimal set of demographic and clinical data that are relatively easy to obtain and available at an early stage of an outbreak investigation. Ninety-eight STEC O104 travel-related cases were reported in a survey by seven EU countries, Switzerland, Canada and the USA. We found a mean incubation period (n = 50) of 8·5 days, which confirmed previous estimations communicated by the Robert Koch Institute. No significant association was found between the duration of the incubation period and possible demographic and clinical factors, although the older the age, the shorter the incubation period that was observed. Such approach and observations are informative for further investigations of outbreaks of enterohaemorrhagic E. coli or other emerging infectious diseases.
authors.affiliation: European Centre for Disease Prevention and Control,Solna,Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Devaux
authors.affiliation: European Centre for Disease Prevention and Control,Solna,Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Varela-Santos
authors.affiliation: European Centre for Disease Prevention and Control,Solna,Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Payne-Hallström
authors.affiliation: European Centre for Disease Prevention and Control,Solna,Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Takkinen
authors.affiliation: European Centre for Disease Prevention and Control,Solna,Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Bogaardt
authors.affiliation: European Centre for Disease Prevention and Control,Solna,Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Coulombier
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D055256:Infectious Disease Incubation Period; D008297:Male; D008875:Middle Aged; D065288:Serogroup; D054323:Shiga-Toxigenic Escherichia coli / Q000145:classification / Q000302:isolation & purification*; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors; D014195:Travel; D014481:United States / Q000453:epidemiology
keywords: Escherichia coli (E. coli); investigation; outbreaks; travellers' infection