Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar;25(9):1900466.
doi: 10.2807/1560-7917.ES.2020.25.9.1900466.

Outbreak of gastroenteritis highlighting the diagnostic and epidemiological challenges of enteroinvasive Escherichia coli, County of Halland, Sweden, November 2017

Nina Lagerqvist  1   2 , Emma Löf  1   3 , Theresa Enkirch  1   2 , Peter Nilsson  4 , Adam Roth  1 , Cecilia Jernberg  1
Affiliations

Outbreak of gastroenteritis highlighting the diagnostic and epidemiological challenges of enteroinvasive Escherichia coli, County of Halland, Sweden, November 2017

Nina Lagerqvist et al. Euro Surveill. 2020 Mar.

Abstract

An outbreak of gastroenteritis with 83 cases occurred at a conference venue in November 2017 in Halland County, Sweden. Stool samples from two venue visitors and a symptomatic secondary case attributed to household transmission were PCR-positive for the ipaH gene, a target found in both Shigella spp. and enteroinvasive Escherichia coli (EIEC). EIEC was isolated from stool samples and whole genome sequencing analysis confirmed EIEC O96:H19 to be the aetiological agent. A cohort study was conducted among venue attendees and employees and the findings implicated contaminated leafy greens as the vehicle of infection, however, no microbiological evidence could support the study results. Here, we report the investigation into the first recorded EIEC outbreak in Sweden and illustrate the challenges associated with the differential laboratory diagnostics of Shigella/EIEC in an outbreak setting.

Keywords: EIEC; Shigella; food borne outbreak; ipaH; whole genome sequencing.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure
Figure
Onset of gastroenteritis symptoms of outbreak cases among conference and hotel venue attendees and personnel, County of Halland, Sweden, November 2017 (n = 83)
See this image and copyright information in PMC

References

    1. Croxen MA, Law RJ, Scholz R, Keeney KM, Wlodarska M, Finlay BB. Recent advances in understanding enteric pathogenic Escherichia coli. Clin Microbiol Rev. 2013;26(4):822-80. 10.1128/CMR.00022-13 - DOI - PMC - PubMed
    1. Baker S, The HC. Recent insights into Shigella. Curr Opin Infect Dis. 2018;31(5):449-54. 10.1097/QCO.0000000000000475 - DOI - PMC - PubMed
    1. DuPont HL, Formal SB, Hornick RB, Snyder MJ, Libonati JP, Sheahan DG, et al. Pathogenesis of Escherichia coli diarrhea. N Engl J Med. 1971;285(1):1-9. 10.1056/NEJM197107012850101 - DOI - PubMed
    1. Taylor DN, Echeverria P, Pál T, Sethabutr O, Saiborisuth S, Sricharmorn S, et al. The role of Shigella spp., enteroinvasive Escherichia coli, and other enteropathogens as causes of childhood dysentery in Thailand. J Infect Dis. 1986;153(6):1132-8. 10.1093/infdis/153.6.1132 - DOI - PubMed
    1. Vieira N, Bates SJ, Solberg OD, Ponce K, Howsmon R, Cevallos W, et al. High prevalence of enteroinvasive Escherichia coli isolated in a remote region of northern coastal Ecuador. Am J Trop Med Hyg. 2007;76(3):528-33. 10.4269/ajtmh.2007.76.528 - DOI - PMC - PubMed

MeSH terms