Investigation into a national outbreak of STEC O157:H7 associated with frozen beef burgers, UK, 2017

In November 2017, Public Health England identified an outbreak of Shiga toxin-producing Escherichia coli O157:H7 in England where whole genome sequencing results indicated cases were likely to be linked to a common source, and began investigations. Hypothesis generation included a review of enhanced...

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Published in:	Epidemiology and infection Vol. 148; p. e215
Main Authors:	Byrne, Lisa, Kaindama, Lukeki, Bentley, Maria, Jenkins, Claire, Aird, Heather, Oliver, Isabel, Paranthaman, Karthik
Format:	Journal Article
Language:	English
Published:	Cambridge, UK Cambridge University Press 01.01.2020
Subjects:	Beef Cooking E coli Epidemics Epidemiology Food contamination & poisoning Food packaging Food safety Freezers Frozen foods Gene sequencing Genomes Health surveillance Hypotheses Infections Laboratories Legislation Loyalty cards Microbiology Original Paper Outbreaks Product recalls Product safety Public health Questionnaires Retail stores Salmonella Shelf life Shiga toxin Supermarkets Toxins Trawling Vehicles Whole genome sequencing United Kingdom > UK England Scotland gastrointestinal infections outbreaks Food-borne infections Shiga-like toxin-producing E. coli
ISSN:	0950-2688, 1469-4409, 1469-4409
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Abstract	In November 2017, Public Health England identified an outbreak of Shiga toxin-producing Escherichia coli O157:H7 in England where whole genome sequencing results indicated cases were likely to be linked to a common source, and began investigations. Hypothesis generation included a review of enhanced surveillance data, a case-case study and trawling interviews. The hypothesis of interest was tested through the administration of focussed questionnaires and review of shopping history using loyalty card data. Twelve outbreak cases were detected, eight were hospitalised and four developed haemolytic uraemic syndrome. Frozen beef burgers supplied by a national retailer were identified as the vehicle of the outbreak. Testing of two left-over burger samples obtained from the freezers of two separate (unlinked) cases and a retained sample from the production premises were tested and found to be positive for the outbreak strain. A voluntary recall of the burgers was implemented by the retailer. Investigations at the production premises identified no contraventions of food safety legislation. Cooking guidance on the product packaging was deemed to be adequate and interviews with the cases/carers who prepared the burgers revealed no deficiencies in cooking practices at home. Given the long-shelf life of frozen burgers, the product recall likely prevented more cases.
AbstractList	In November 2017, Public Health England identified an outbreak of Shiga toxin-producing Escherichia coli O157:H7 in England where whole genome sequencing results indicated cases were likely to be linked to a common source, and began investigations. Hypothesis generation included a review of enhanced surveillance data, a case-case study and trawling interviews. The hypothesis of interest was tested through the administration of focussed questionnaires and review of shopping history using loyalty card data. Twelve outbreak cases were detected, eight were hospitalised and four developed haemolytic uraemic syndrome. Frozen beef burgers supplied by a national retailer were identified as the vehicle of the outbreak. Testing of two left-over burger samples obtained from the freezers of two separate (unlinked) cases and a retained sample from the production premises were tested and found to be positive for the outbreak strain. A voluntary recall of the burgers was implemented by the retailer. Investigations at the production premises identified no contraventions of food safety legislation. Cooking guidance on the product packaging was deemed to be adequate and interviews with the cases/carers who prepared the burgers revealed no deficiencies in cooking practices at home. Given the long-shelf life of frozen burgers, the product recall likely prevented more cases. In November 2017, Public Health England identified an outbreak of Shiga toxin-producing Escherichia coli O157:H7 in England where whole genome sequencing results indicated cases were likely to be linked to a common source, and began investigations. Hypothesis generation included a review of enhanced surveillance data, a case-case study and trawling interviews. The hypothesis of interest was tested through the administration of focussed questionnaires and review of shopping history using loyalty card data. Twelve outbreak cases were detected, eight were hospitalised and four developed haemolytic uraemic syndrome. Frozen beef burgers supplied by a national retailer were identified as the vehicle of the outbreak. Testing of two left-over burger samples obtained from the freezers of two separate (unlinked) cases and a retained sample from the production premises were tested and found to be positive for the outbreak strain. A voluntary recall of the burgers was implemented by the retailer. Investigations at the production premises identified no contraventions of food safety legislation. Cooking guidance on the product packaging was deemed to be adequate and interviews with the cases/carers who prepared the burgers revealed no deficiencies in cooking practices at home. Given the long-shelf life of frozen burgers, the product recall likely prevented more cases. In November 2017, Public Health England identified an outbreak of Shiga toxin-producing Escherichia coli O157:H7 in England where whole genome sequencing results indicated cases were likely to be linked to a common source, and began investigations. Hypothesis generation included a review of enhanced surveillance data, a case-case study and trawling interviews. The hypothesis of interest was tested through the administration of focussed questionnaires and review of shopping history using loyalty card data. Twelve outbreak cases were detected, eight were hospitalised and four developed haemolytic uraemic syndrome. Frozen beef burgers supplied by a national retailer were identified as the vehicle of the outbreak. Testing of two left-over burger samples obtained from the freezers of two separate (unlinked) cases and a retained sample from the production premises were tested and found to be positive for the outbreak strain. A voluntary recall of the burgers was implemented by the retailer. Investigations at the production premises identified no contraventions of food safety legislation. Cooking guidance on the product packaging was deemed to be adequate and interviews with the cases/carers who prepared the burgers revealed no deficiencies in cooking practices at home. Given the long-shelf life of frozen burgers, the product recall likely prevented more cases.In November 2017, Public Health England identified an outbreak of Shiga toxin-producing Escherichia coli O157:H7 in England where whole genome sequencing results indicated cases were likely to be linked to a common source, and began investigations. Hypothesis generation included a review of enhanced surveillance data, a case-case study and trawling interviews. The hypothesis of interest was tested through the administration of focussed questionnaires and review of shopping history using loyalty card data. Twelve outbreak cases were detected, eight were hospitalised and four developed haemolytic uraemic syndrome. Frozen beef burgers supplied by a national retailer were identified as the vehicle of the outbreak. Testing of two left-over burger samples obtained from the freezers of two separate (unlinked) cases and a retained sample from the production premises were tested and found to be positive for the outbreak strain. A voluntary recall of the burgers was implemented by the retailer. Investigations at the production premises identified no contraventions of food safety legislation. Cooking guidance on the product packaging was deemed to be adequate and interviews with the cases/carers who prepared the burgers revealed no deficiencies in cooking practices at home. Given the long-shelf life of frozen burgers, the product recall likely prevented more cases.
ArticleNumber	e215
Author	Kaindama, Lukeki Paranthaman, Karthik Byrne, Lisa Bentley, Maria Oliver, Isabel Jenkins, Claire Aird, Heather
AuthorAffiliation	4 Food, Water and Environmental Laboratory, Public Health England , Block 10, NAFIC, Sand Hutton, York , YO41 ILZ , UK 1 Gastrointestinal Infections Department, National Infections Service, Public Health England , 61 Colindale Avenue, London , NW9 5EQ , UK 3 Gastrointestinal Bacteria Reference Unit, National Infections Service, Public Health England , 61 Colindale Avenue, London , NW9 5EQ , UK 5 Field Service, National Infections Service, Public Health England , 2 Rivergate, Bristol , UK 2 Environmental Health, Hambleton District Council, Civic Centre , Stone Cross, Northallerton , North Yorkshire , DL6 2UU , UK
AuthorAffiliation_xml	– name: 5 Field Service, National Infections Service, Public Health England , 2 Rivergate, Bristol , UK – name: 2 Environmental Health, Hambleton District Council, Civic Centre , Stone Cross, Northallerton , North Yorkshire , DL6 2UU , UK – name: 4 Food, Water and Environmental Laboratory, Public Health England , Block 10, NAFIC, Sand Hutton, York , YO41 ILZ , UK – name: 3 Gastrointestinal Bacteria Reference Unit, National Infections Service, Public Health England , 61 Colindale Avenue, London , NW9 5EQ , UK – name: 1 Gastrointestinal Infections Department, National Infections Service, Public Health England , 61 Colindale Avenue, London , NW9 5EQ , UK
Author_xml	– sequence: 1 givenname: Lisa orcidid: 0000-0001-5320-2085 surname: Byrne fullname: Byrne, Lisa email: lisa.byrne@phe.gov.uk organization: 1Gastrointestinal Infections Department, National Infections Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK – sequence: 2 givenname: Lukeki surname: Kaindama fullname: Kaindama, Lukeki organization: 1Gastrointestinal Infections Department, National Infections Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK – sequence: 3 givenname: Maria surname: Bentley fullname: Bentley, Maria organization: 2Environmental Health, Hambleton District Council, Civic Centre, Stone Cross, Northallerton, North Yorkshire, DL6 2UU, UK – sequence: 4 givenname: Claire orcidid: 0000-0001-8600-9169 surname: Jenkins fullname: Jenkins, Claire organization: 3Gastrointestinal Bacteria Reference Unit, National Infections Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK – sequence: 5 givenname: Heather surname: Aird fullname: Aird, Heather organization: 4Food, Water and Environmental Laboratory, Public Health England, Block 10, NAFIC, Sand Hutton, York, YO41 ILZ, UK – sequence: 6 givenname: Isabel surname: Oliver fullname: Oliver, Isabel organization: 5Field Service, National Infections Service, Public Health England, 2 Rivergate, Bristol, UK – sequence: 7 givenname: Karthik orcidid: 0000-0002-5633-8559 surname: Paranthaman fullname: Paranthaman, Karthik organization: 5Field Service, National Infections Service, Public Health England, 2 Rivergate, Bristol, UK
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Keywords	gastrointestinal infections outbreaks Food-borne infections Shiga-like toxin-producing E. coli
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Snippet	In November 2017, Public Health England identified an outbreak of Shiga toxin-producing Escherichia coli O157:H7 in England where whole genome sequencing... In November 2017, Public Health England identified an outbreak of Shiga toxin-producing Escherichia coli O157:H7 in England where whole genome sequencing...
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SubjectTerms	Beef Cooking E coli Epidemics Epidemiology Food contamination & poisoning Food packaging Food safety Freezers Frozen foods Gene sequencing Genomes Health surveillance Hypotheses Infections Laboratories Legislation Loyalty cards Microbiology Original Paper Outbreaks Product recalls Product safety Public health Questionnaires Retail stores Salmonella Shelf life Shiga toxin Supermarkets Toxins Trawling Vehicles Whole genome sequencing
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Title	Investigation into a national outbreak of STEC O157:H7 associated with frozen beef burgers, UK, 2017
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