Imported spring onions related to the first recorded outbreak of enteroinvasive Escherichia coli in Denmark, November to December 2021
Between November and December 2021, the first ever recorded outbreak of enteroinvasive in Denmark occurred at national scale. We describe the investigation of this outbreak, which was initially recognised in early December 2021. A total of 88 cases (58 female; 30 male) with a median age of 52 years...
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| Veröffentlicht in: | Euro surveillance : bulletin européen sur les maladies transmissibles 2023-04, Vol.28 (15), p.2 |
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| creator | Torpdahl, Mia White, Emily Dibba Schjørring, Susanne Søby, Malene Engberg, Jørgen Engsbro, Anne Line Holt, Hanne M Lemming, Lars Lützen, Lisbeth Olesen, Bente Coia, John E Kjelsø, Charlotte Müller, Luise |
| description | Between November and December 2021, the first ever recorded outbreak of enteroinvasive
in Denmark occurred at national scale. We describe the investigation of this outbreak, which was initially recognised in early December 2021. A total of 88 cases (58 female; 30 male) with a median age of 52 years (range: 0-91) were detected by PCR-based diagnostic methods. Case ascertainment was complicated by current culture-free diagnostic procedures, with only 34 cases confirmed by culture, serotyping and whole genome sequencing. Isolates from cases grouped into two serotypes (O136:H7 and O96:H19), which was supported by whole-genome-sequence-phylogeny, also yielding two clusters. Interviews of 42 cases and traceback investigation pointed towards consumption of ready-to-eat salads as the outbreak cause. While the ready-to-eat salads comprised different vegetables, imported spring onions were the only common ingredient and thus the likely source. Environmental investigations failed to recover outbreak strains. This report highlights the value of fast typing (here O-typing) to confirm cases in an outbreak situation. Timely communication and data sharing are also important, and were facilitated by the national collaboration between relevant laboratories, the public health institute and the veterinary and food administration. High hygiene standards for imported fresh vegetables intended for ready-to-eat products are essential. |
| doi_str_mv | 10.2807/1560-7917.ES.2023.28.15.2200572 |
| format | Article |
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in Denmark occurred at national scale. We describe the investigation of this outbreak, which was initially recognised in early December 2021. A total of 88 cases (58 female; 30 male) with a median age of 52 years (range: 0-91) were detected by PCR-based diagnostic methods. Case ascertainment was complicated by current culture-free diagnostic procedures, with only 34 cases confirmed by culture, serotyping and whole genome sequencing. Isolates from cases grouped into two serotypes (O136:H7 and O96:H19), which was supported by whole-genome-sequence-phylogeny, also yielding two clusters. Interviews of 42 cases and traceback investigation pointed towards consumption of ready-to-eat salads as the outbreak cause. While the ready-to-eat salads comprised different vegetables, imported spring onions were the only common ingredient and thus the likely source. Environmental investigations failed to recover outbreak strains. This report highlights the value of fast typing (here O-typing) to confirm cases in an outbreak situation. Timely communication and data sharing are also important, and were facilitated by the national collaboration between relevant laboratories, the public health institute and the veterinary and food administration. High hygiene standards for imported fresh vegetables intended for ready-to-eat products are essential.</description><identifier>ISSN: 1560-7917</identifier><identifier>ISSN: 1025-496X</identifier><identifier>EISSN: 1560-7917</identifier><identifier>DOI: 10.2807/1560-7917.ES.2023.28.15.2200572</identifier><identifier>PMID: 37052680</identifier><language>eng</language><publisher>Sweden: Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS)</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Denmark - epidemiology ; Disease Outbreaks ; E coli ; Epidemics ; Escherichia coli ; Escherichia coli Infections - diagnosis ; Escherichia coli Infections - epidemiology ; Female ; Food contamination & poisoning ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Onions ; Outbreaks ; Public health ; Vegetables ; Young Adult</subject><ispartof>Euro surveillance : bulletin européen sur les maladies transmissibles, 2023-04, Vol.28 (15), p.2</ispartof><rights>Copyright Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) Apr 13, 2023</rights><rights>This article is copyright of the authors or their affiliated institutions, 2023. 2023 The authors or their affiliated institutions</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-bd60318bb50da5207bd4eaac0efd727525d56456744d9fffc112d6382cce415a3</citedby><cites>FETCH-LOGICAL-c470t-bd60318bb50da5207bd4eaac0efd727525d56456744d9fffc112d6382cce415a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10103548/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10103548/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37052680$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Torpdahl, Mia</creatorcontrib><creatorcontrib>White, Emily Dibba</creatorcontrib><creatorcontrib>Schjørring, Susanne</creatorcontrib><creatorcontrib>Søby, Malene</creatorcontrib><creatorcontrib>Engberg, Jørgen</creatorcontrib><creatorcontrib>Engsbro, Anne Line</creatorcontrib><creatorcontrib>Holt, Hanne M</creatorcontrib><creatorcontrib>Lemming, Lars</creatorcontrib><creatorcontrib>Lützen, Lisbeth</creatorcontrib><creatorcontrib>Olesen, Bente</creatorcontrib><creatorcontrib>Coia, John E</creatorcontrib><creatorcontrib>Kjelsø, Charlotte</creatorcontrib><creatorcontrib>Müller, Luise</creatorcontrib><title>Imported spring onions related to the first recorded outbreak of enteroinvasive Escherichia coli in Denmark, November to December 2021</title><title>Euro surveillance : bulletin européen sur les maladies transmissibles</title><addtitle>Euro Surveill</addtitle><description>Between November and December 2021, the first ever recorded outbreak of enteroinvasive
in Denmark occurred at national scale. We describe the investigation of this outbreak, which was initially recognised in early December 2021. A total of 88 cases (58 female; 30 male) with a median age of 52 years (range: 0-91) were detected by PCR-based diagnostic methods. Case ascertainment was complicated by current culture-free diagnostic procedures, with only 34 cases confirmed by culture, serotyping and whole genome sequencing. Isolates from cases grouped into two serotypes (O136:H7 and O96:H19), which was supported by whole-genome-sequence-phylogeny, also yielding two clusters. Interviews of 42 cases and traceback investigation pointed towards consumption of ready-to-eat salads as the outbreak cause. While the ready-to-eat salads comprised different vegetables, imported spring onions were the only common ingredient and thus the likely source. Environmental investigations failed to recover outbreak strains. This report highlights the value of fast typing (here O-typing) to confirm cases in an outbreak situation. Timely communication and data sharing are also important, and were facilitated by the national collaboration between relevant laboratories, the public health institute and the veterinary and food administration. High hygiene standards for imported fresh vegetables intended for ready-to-eat products are essential.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Denmark - epidemiology</subject><subject>Disease Outbreaks</subject><subject>E coli</subject><subject>Epidemics</subject><subject>Escherichia coli</subject><subject>Escherichia coli Infections - diagnosis</subject><subject>Escherichia coli Infections - epidemiology</subject><subject>Female</subject><subject>Food contamination & poisoning</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Onions</subject><subject>Outbreaks</subject><subject>Public health</subject><subject>Vegetables</subject><subject>Young Adult</subject><issn>1560-7917</issn><issn>1025-496X</issn><issn>1560-7917</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcFu1DAYhC0EoqXwCsgSBziw4bcT29kTQu0ClSo4FM6WY__puk3sxU5W4gV4bhx1WQonW-PxaEYfIa8ZVLwF9Y4JCSu1ZqraXFcceF3kiomKcwCh-CNyenQ8fnA_Ic9yvgVoaljzp-SkViC4bOGU_LocdzFN6GjeJR9uaAw-hkwTDmZRp0inLdLepzwV0cbkihrnqUto7mjsKYYJU_Rhb7LfI91ku8Xk7dYbauPgqQ_0AsNo0t1b-iXucewwLbEXaO_vZQZ7Tp70Zsj44nCeke8fN9_OP6-uvn66PP9wtbKNgmnVOQk1a7tOgDOCg-pcg8ZYwN4prgQXTshGSNU0bt33vWWMO1m33FpsmDD1GXl_n7ubuxGdLeWTGXSZXgr-1NF4_e9L8Ft9E_eaAYNaNG1JeHNISPHHjHnSo88Wh8EEjHPWBRNIrmS7WF_9Z72Ncwpl3-Li0HIh27-VbIo5J-yPbRgsPqUXjHrBqDfXeoFe5CLqA_SS8PLhqOP_P5Tr38sEqxQ</recordid><startdate>20230413</startdate><enddate>20230413</enddate><creator>Torpdahl, Mia</creator><creator>White, Emily Dibba</creator><creator>Schjørring, Susanne</creator><creator>Søby, Malene</creator><creator>Engberg, Jørgen</creator><creator>Engsbro, Anne Line</creator><creator>Holt, Hanne M</creator><creator>Lemming, Lars</creator><creator>Lützen, Lisbeth</creator><creator>Olesen, Bente</creator><creator>Coia, John E</creator><creator>Kjelsø, Charlotte</creator><creator>Müller, Luise</creator><general>Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS)</general><general>European Centre for Disease Prevention and Control (ECDC)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230413</creationdate><title>Imported spring onions related to the first recorded outbreak of enteroinvasive Escherichia coli in Denmark, November to December 2021</title><author>Torpdahl, Mia ; White, Emily Dibba ; Schjørring, Susanne ; Søby, Malene ; Engberg, Jørgen ; Engsbro, Anne Line ; Holt, Hanne M ; Lemming, Lars ; Lützen, Lisbeth ; Olesen, Bente ; Coia, John E ; Kjelsø, Charlotte ; Müller, Luise</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-bd60318bb50da5207bd4eaac0efd727525d56456744d9fffc112d6382cce415a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Denmark - epidemiology</topic><topic>Disease Outbreaks</topic><topic>E coli</topic><topic>Epidemics</topic><topic>Escherichia coli</topic><topic>Escherichia coli Infections - diagnosis</topic><topic>Escherichia coli Infections - epidemiology</topic><topic>Female</topic><topic>Food contamination & poisoning</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Onions</topic><topic>Outbreaks</topic><topic>Public health</topic><topic>Vegetables</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Torpdahl, Mia</creatorcontrib><creatorcontrib>White, Emily Dibba</creatorcontrib><creatorcontrib>Schjørring, Susanne</creatorcontrib><creatorcontrib>Søby, Malene</creatorcontrib><creatorcontrib>Engberg, Jørgen</creatorcontrib><creatorcontrib>Engsbro, Anne Line</creatorcontrib><creatorcontrib>Holt, Hanne M</creatorcontrib><creatorcontrib>Lemming, Lars</creatorcontrib><creatorcontrib>Lützen, Lisbeth</creatorcontrib><creatorcontrib>Olesen, Bente</creatorcontrib><creatorcontrib>Coia, John E</creatorcontrib><creatorcontrib>Kjelsø, Charlotte</creatorcontrib><creatorcontrib>Müller, Luise</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Euro surveillance : bulletin européen sur les maladies transmissibles</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Torpdahl, Mia</au><au>White, Emily Dibba</au><au>Schjørring, Susanne</au><au>Søby, Malene</au><au>Engberg, Jørgen</au><au>Engsbro, Anne Line</au><au>Holt, Hanne M</au><au>Lemming, Lars</au><au>Lützen, Lisbeth</au><au>Olesen, Bente</au><au>Coia, John E</au><au>Kjelsø, Charlotte</au><au>Müller, Luise</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Imported spring onions related to the first recorded outbreak of enteroinvasive Escherichia coli in Denmark, November to December 2021</atitle><jtitle>Euro surveillance : bulletin européen sur les maladies transmissibles</jtitle><addtitle>Euro Surveill</addtitle><date>2023-04-13</date><risdate>2023</risdate><volume>28</volume><issue>15</issue><spage>2</spage><pages>2-</pages><issn>1560-7917</issn><issn>1025-496X</issn><eissn>1560-7917</eissn><abstract>Between November and December 2021, the first ever recorded outbreak of enteroinvasive
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| ispartof | Euro surveillance : bulletin européen sur les maladies transmissibles, 2023-04, Vol.28 (15), p.2 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adolescent Adult Aged Aged, 80 and over Child Child, Preschool Denmark - epidemiology Disease Outbreaks E coli Epidemics Escherichia coli Escherichia coli Infections - diagnosis Escherichia coli Infections - epidemiology Female Food contamination & poisoning Humans Infant Infant, Newborn Male Middle Aged Onions Outbreaks Public health Vegetables Young Adult |
| title | Imported spring onions related to the first recorded outbreak of enteroinvasive Escherichia coli in Denmark, November to December 2021 |
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