157 sickened from Enteroinvasive Escherichia coli in lettuce, 2014, UK

Enteroinvasive Escherichia coli (EIEC) outbreaks are uncommon in Europe. In June 2014, two EIEC outbreaks occurred in Nottingham, UK, within 2 days; outbreak A was linked to a takeaway restaurant and outbreak B to a wedding party.

lettuce.skull.e.coli.O145We conducted 2 analytical studies: a case–control study for outbreak A and a cohort study for outbreak B. We tested microbiological and environmental samples, including by using whole-genome sequencing. For both outbreaks combined, we identified 157 probable case-patients; 27 were laboratory-confirmed as EIEC O96:H19–positive. Combined epidemiologic, microbiological, and environmental findings implicated lettuce as the vehicle of infection in outbreak A, but the source of the organism remained unknown. Whole-genome sequencing identified the same organism in cases from both outbreaks, but no epidemiologic link was confirmed.

These outbreaks highlight that EIEC has the capacity to cause large and severe gastrointestinal disease outbreaks and should be considered as a potential pathogen in foodborne outbreaks in Europe.

Two linked enteroinvasive Escherichia coli outbreaks, Nottingham, UK, June 2014

Emerging Infectious Diseases, Volume 22, Number 7, July 2016, DOI: 10.3201/eid2207.152080

Newitt, V. MacGregor, V. Robbins, L. Bayliss, M.A. Chattaway, T. Dallman, D. Ready, H. Aird, R. Puleston, J. Hawker

http://wwwnc.cdc.gov/eid/article/22/7/15-2080_article