A geostatistical investigation of agricultural and infrastructural risk factors associated with primary verotoxigenic E. coli (VTEC) infection in the Republic of Ireland, 2008-2013.
Ireland reports the highest incidence of verotoxigenic Escherichia coli (VTEC) infection in Europe. This study investigated potential risk factors for confirmed sporadic and outbreak primary VTEC infections during 2008-2013. Overall, 989 VTEC infections including 521 serogroup O157 and 233 serogroup O26 were geo-referenced to 931 of 18 488 census enumeration areas. The geographical distribution of human population, livestock, unregulated groundwater sources, domestic wastewater treatment systems (DWWTS) and a deprivation index were examined relative to notification of VTEC events in 524 of 6242 rural areas. Multivariate modelling identified three spatially derived variables associated with VTEC notification: private well usage [odds ratio (OR) 6·896, P < 0·001], cattle density (OR 1·002, P < 0·001) and DWWTS density (OR 0·978, P = 0·002). Private well usage (OR 18·727, P < 0·001) and cattle density (OR 1·001, P = 0·007) were both associated with VTEC O157 infection, while DWWTS density (OR 0·987, P = 0·028) was significant within the VTEC O26 model. Findings indicate that VTEC infection in the Republic of Ireland is particularly associated with rural areas, which are associated with a ubiquity of pathogen sources (cattle) and pathways (unregulated groundwater supplies).
Department of Public Health,Health Service Executive,Dublin,Ireland.
C
C
Óhaiseadha
Department of Civil and Structural Engineering,Dublin Institute of Technology,Dublin,Ireland.
P D
PD
Hynds
Department of Public Health,Health Service Executive,Tullamore,Ireland.
U B
UB
Fallon
Department of Life Sciences,Faculty of Science and Engineering,University of Limerick,Ireland.
J
J
O'Dwyer
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000822:Animal Husbandry; D000818:Animals; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D004323:Drainage, Sanitary; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population; D054323:Shiga-Toxigenic Escherichia coli / Q000302:isolation & purification*; D055815:Young Adult

               Escherichia coli (E. coli); gastrointestinal infections; geographical information systems; infectious disease epidemiology; water-borne infections