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. 2017 Sep 7;22(36):30610.
doi: 10.2807/1560-7917.ES.2017.22.36.30610.

Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015

Noëleen McFarland  1   2 , Nick Bundle  2   3   4   5 , Claire Jenkins  6 , Gauri Godbole  7 , Amy Mikhail  8 , Tim Dallman  6 , Catherine O'Connor  9 , Noel McCarthy  4   10   11 , Emer O'Connell  4   12 , Juli Treacy  1 , Girija Dabke  1 , James Mapstone  13 , Yvette Landy  14 , Janet Moore  15 , Rachel Partridge  16 , Frieda Jorgensen  17 , Caroline Willis  17 , Piers Mook  4   10 , Chas Rawlings  4 , Richard Acornley  18 , Charlotte Featherstone  19 , Sharleen Gayle  20 , Joanne Edge  20 , Eleanor McNamara  21 , Jeremy Hawker  4   8   11 , Sooria Balasegaram  4
Affiliations

Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015

Noëleen McFarland et al. Euro Surveill. .

Abstract

The first documented British outbreak of Shiga toxin-producing Escherichia coli (STEC) O55:H7 began in the county of Dorset, England, in July 2014. Since then, there have been a total of 31 cases of which 13 presented with haemolytic uraemic syndrome (HUS). The outbreak strain had Shiga toxin (Stx) subtype 2a associated with an elevated risk of HUS. This strain had not previously been isolated from humans or animals in England. The only epidemiological link was living in or having close links to two areas in Dorset. Extensive investigations included testing of animals and household pets. Control measures included extended screening, iterative interviewing and exclusion of cases and high risk contacts. Whole genome sequencing (WGS) confirmed that all the cases were infected with similar strains. A specific source could not be identified. The combination of epidemiological investigation and WGS indicated, however, that this outbreak was possibly caused by recurrent introductions from a local endemic zoonotic source, that a highly similar endemic reservoir appears to exist in the Republic of Ireland but has not been identified elsewhere, and that a subset of cases was associated with human-to-human transmission in a nursery.

Keywords: Boot sock study, STEC 055; New strain; STEC; cattle testing; outbreak; pets.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Confirmed cases of Shiga toxin-producing Escherichia coli 055:H7, Dorset, July 2014−September 2015 (n=31)
Figure 2
Figure 2
Maximum likelihood phylogeny of STEC O55:H7 isolates showing the monophyletic cluster associated with the outbreak cases and closely related strains from the Republic of Ireland
Figure 3
Figure 3
Map of Dorset cattle density, major rivers, flood zones and (co) primary cases’ postcodes, outbreak of Shiga toxin-producing Escherichia coli 055:H7, Dorset, July 2014−September 2015
See this image and copyright information in PMC

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