By Andy Muirhead – Company Microbiologist, ALS Food & Pharmaceutical (UK)
As mentioned in previous bulletins, surveillance data can take a while to compile and cumulative data from across Europe for 2018 has only recently been released. The European Centre for Disease Prevention and Control’s (ECDC) annual surveillance report states that the Shiga toxin-producing E. coli infection rate in Europe increased by 40 percent in 2018 compared to the previous year.
After a stable period from 2014 to 2017, the rate increased by 41 percent in 2018. This made STEC the third most common zoonosis in Europe after Campylobacter and Salmonella.
A contributing factor may be an increased levels of more reliable testing, with the shift from culture to culture-independent diagnostic methods. The report states that PCR methods are now more commonly used to diagnose cases.
Most infections were reported by Germany and the U.K., which together accounted for 47 percent of all cases. The former had 2,226 infections while the latter recorded 1,840. Bulgaria, Cyprus and Lithuania all reported no infections.
A total of 36 percent of 3,536 STEC patients were hospitalised and eleven people died. The five most common serogroups were O157, O26, O103, O91 and O145. As in previous years, O157 was the most common serogroup in 2018 and accounted for most of the increase. Like in 2016, O26 was a more common cause of haemolytic uremic syndrome (HUS) than O157.
Among the 8,257 confirmed STEC cases for which gender was reported, 46 percent were males and 54 percent females.
The highest rate of confirmed cases was in the age group 0 to 4 years. This group accounted for 2,274, or more than a quarter, of the patients for whom information on age was available. An even larger proportion of children was seen among the HUS cases, where two-thirds were reported in 0 to 4 year-olds.
In 2018, 48 STEC outbreaks were reported to the European Food Safety Authority (EFSA), involving 381 cases in 10 countries. Five of the 43 strong-evidence foodborne outbreaks had a known vehicle: two were caused by cheese and one each by milk, red meat, and vegetables.