title: A large Great Britain-wide outbreak of STEC O157 phage type 8 linked to handling of raw leeks and potatoes.
abstract: Between December 2010 and July 2011, 252 cases of STEC O157 PT8 stx1 + 2 infection were reported in England, Scotland and Wales. This was the largest outbreak of STEC reported in England and the second largest in the UK to date. Eighty cases were hospitalized, with two cases of haemolytic uraemic syndrome and one death reported. Routine investigative data were used to generate a hypothesis but the subsequent case-control study was inconclusive. A second, more detailed, hypothesis generation exercise identified consumption or handling of vegetables as a potential mode of transmission. A second case-control study demonstrated that cases were more likely than controls to live in households whose members handled or prepared leeks bought unwrapped [odds ratio (OR) 40, 95% confidence interval (CI) 2·08-769·4], and potatoes bought in sacks (OR 13·13, 95% CI 1·19-145·3). This appears to be the first outbreak of STEC O157 infection linked to the handling of leeks.
authors.affiliation: Public Health England,London,UK.
authors.forename: N
authors.initials: N
authors.lastname: Launders
authors.affiliation: Health Protection Scotland,Glasgow,Scotland,UK.
authors.forename: M E
authors.initials: ME
authors.lastname: Locking
authors.affiliation: Scottish E. coli O157/VTEC Reference Laboratory,Department of Laboratory Medicine,Royal Infirmary of Edinburgh,Edinburgh,Scotland,UK.
authors.forename: M
authors.initials: M
authors.lastname: Hanson
authors.affiliation: Public Health England,London,UK.
authors.forename: G
authors.initials: G
authors.lastname: Willshaw
authors.affiliation: Public Health England,London,UK.
authors.forename: A
authors.initials: A
authors.lastname: Charlett
authors.affiliation: Communicable Disease Surveillance Centre,Public Health Wales,Cardiff,Wales,UK.
authors.forename: R
authors.initials: R
authors.lastname: Salmon
authors.affiliation: Health Protection Scotland,Glasgow,Scotland,UK.
authors.forename: J
authors.initials: J
authors.lastname: Cowden
authors.forename: K S
authors.initials: KS
authors.lastname: Harker
authors.affiliation: Public Health England,London,UK.
authors.forename: G K
authors.initials: GK
authors.lastname: Adak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004739:England / Q000453:epidemiology; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D019453:Escherichia coli O157 / Q000235:genetics* / Q000302:isolation & purification; D005260:Female; D005516:Food Microbiology; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D018598:Minisatellite Repeats; D058885:Multilocus Sequence Typing; D019697:Onions / Q000382:microbiology*; D012606:Scotland / Q000453:epidemiology; D011198:Solanum tuberosum / Q000382:microbiology*; D014852:Wales / Q000453:epidemiology; D055815:Young Adult
keywords: Epidemiology; Shiga-like toxin-producing E. coli; food safety; foodborne infections; outbreaks