Transmission of shiga toxin-producing Escherichia coli O104:H4 at a family party possibly due to contamination by a food handler, Germany 2011

Epidemiol Infect. 2014 Jan;142(1):99-106. doi: 10.1017/S0950268813000769. Epub 2013 Apr 8.

Abstract

We investigated a cluster of shiga toxin-producing Escherichia coli (STEC) O104:H4 infections after a family party during a large STEC O104:H4 outbreak in Germany. To identify the vehicle we conducted a retrospective cohort study. Stool samples of party guests, and food and environmental samples from the catering company were tested for STEC. We defined cases as party guests with gastrointestinal symptoms and laboratory-confirmed STEC infection. We found 23 cases among 71 guests. By multivariable analysis consumption of salmon [odds ratio (OR) 15, 95% confidence interval (CI) 2.3-97], herb cream (OR 6.5, 95% CI 1.3-33) and bean salad (OR 6.1, 95% CI 1.4-26) were associated with STEC infection. STEC O104:H4 was detected in samples of bell pepper and salmon. The food handler developed STEC infection. Our results point towards transmission via several food items contaminated by a food handler. We recommend regular education of food handlers emphasizing their role in transmitting infectious diseases.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Contact Tracing
  • Disease Outbreaks*
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / microbiology
  • Escherichia coli Infections / transmission*
  • Feces / microbiology
  • Female
  • Food Handling*
  • Foodborne Diseases / epidemiology
  • Foodborne Diseases / microbiology*
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Shiga-Toxigenic Escherichia coli / isolation & purification*
  • Surveys and Questionnaires