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. 2014 Jan;142(1):99-106.
doi: 10.1017/S0950268813000769. Epub 2013 Apr 8.

Transmission of shiga toxin-producing Escherichia coli O104:H4 at a family party possibly due to contamination by a food handler, Germany 2011

M Diercke  1 , M Kirchner, K Claussen, E Mayr, I Strotmann, J Frangenberg, A Schiffmann, G Bettge-Weller, M Arvand, H Uphoff
Affiliations

Transmission of shiga toxin-producing Escherichia coli O104:H4 at a family party possibly due to contamination by a food handler, Germany 2011

M Diercke et al. Epidemiol Infect. 2014 Jan.

Abstract

We investigated a cluster of shiga toxin-producing Escherichia coli (STEC) O104:H4 infections after a family party during a large STEC O104:H4 outbreak in Germany. To identify the vehicle we conducted a retrospective cohort study. Stool samples of party guests, and food and environmental samples from the catering company were tested for STEC. We defined cases as party guests with gastrointestinal symptoms and laboratory-confirmed STEC infection. We found 23 cases among 71 guests. By multivariable analysis consumption of salmon [odds ratio (OR) 15, 95% confidence interval (CI) 2.3-97], herb cream (OR 6.5, 95% CI 1.3-33) and bean salad (OR 6.1, 95% CI 1.4-26) were associated with STEC infection. STEC O104:H4 was detected in samples of bell pepper and salmon. The food handler developed STEC infection. Our results point towards transmission via several food items contaminated by a food handler. We recommend regular education of food handlers emphasizing their role in transmitting infectious diseases.

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Figures

Fig. 1
Fig. 1
[colour online]. Flowchart of guests attending a family party (n = 71) including number of cases (symptomatic guests with laboratory-confirmed STEC O104:H4 infection, n = 23) and non-cases (n = 48), and number of guests interviewed by questionnaire, that could be included in the cohort study (n = 69), with results of stool samples, northern Germany, 2011. STEC, Shiga toxin-producing Escherichia coli serotype O104:H4; HUS, haemolytic uraemic syndrome.
Fig. 2
Fig. 2
[colour online]. Cases of HUS (n = 4) and STEC O104:H4 infection (n = 19), as well as guests with diarrhoea (n = 4) after a family party with 71 guests, by date of onset of symptoms, northern Germany, 2011. STEC, Shiga toxin-producing Escherichia coli serotype O104:H4; HUS, haemolytic uraemic syndrome.
Fig. 3
Fig. 3
[colour online]. Map of Germany and transmission chain of STEC O104:H4 from sprout producer to probable household cases occurring after a family party, northern Germany, 2011.
See this image and copyright information in PMC

References

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