Shiga-toxin producing Escherichia coli (STEC) O26:H11 is the second most common cause of severe diarrhea and hemolytic uremic syndrome worldwide. The implementation of whole genome sequencing (WGS) ...enhances the detection and in-depth characterization of these non-O157 STEC strains. The aim of this study was to compare WGS to phenotypic serotyping and pulse field gel electrophoresis (PFGE) for characterization of STECO26 strains following a zoonotic outbreak from cattle to humans.
This study evaluated seven E. coli strains; two strains isolated from two children with gastrointestinal symptoms and five strains from five calves suspected as the source of infection. Six of these isolates were serotyped phenotypically and by WGS as E. coli O26:H11 while one bovine isolate could be serotyped only by WGS as E. coli O182:H25. Stx1 was detected in two human- and two bovine-isolates using PCR and WGS. Using WGS, all four STECO26 isolates belong to sequence type (ST) 21 while the two stx1 negative E. coli O26 were ST29. All four STECO26 isolates were indistinguishable by PFGE. However, the data generated by WGS linked the two human STECO26 isolates to only one bovine STECO26 strain by having identical high-quality single nucleotide polymorphisms (hqSNPs) and identical virulence factor profiles while the remaining bovine STECO26 isolate differed by 7 hqSNPs and lacked virulence factor toxB.
These data demonstrated that WGS provided significant information beyond traditional epidemiological tools allowing for comprehensive characterization of the STEC. Using this approach, WGS was able to identify the specific source of infection in this study.
Cryptosporidium is an enteric pathogen that is transmitted through animal-to-person or person-to-person contact or through ingestion of contaminated water or food. In the United States, ...Cryptosporidium affects an estimated 750,000 persons each year; however, only approximately 11,000 cases are reported nationally (1,2). Persons infected with Cryptosporidium typically develop symptoms within 2 to 10 days after exposure. Common symptoms include watery diarrhea, abdominal cramps, nausea, vomiting, or fever, which can last 1 to 2 weeks. Cryptosporidiosis is a nationally notifiable disease in the United States. Nebraska presents a unique setting for the evaluation of this pathogen because, compared with other states, Nebraska has a greater reliance on agriculture and a higher proportion of the population residing and working in rural communities. Cryptosporidium species and subtypes are generally indistinguishable using conventional diagnostic methods. Using molecular characterization, Nebraska evaluated the genetic diversity of Cryptosporidium and found a dichotomy in the distribution of cases of cryptosporidiosis caused by Cryptosporidium parvum and Cryptosporidium hominis among rural and urban settings. Characterizing clusters of C. hominis cases revealed that several child care facilities were affected by the same subtype, suggesting community-wide transmission and indicating a need for effective exclusion policies. Several cases of cryptosporidiosis caused by non-C. parvum or non-C. hominis species and genotypes indicated unique animal exposures that were previously unidentified. This study enhanced epidemiologic data by validating known Cryptosporidium sources, confirming outbreaks, and, through repeat interviews, providing additional information to inform cryptosporidiosis prevention and control efforts.
NoroSTAT-participating states report a minimum set of data elements† to the National Outbreak Reporting System§ for all confirmed norovirus outbreaks (i.e., outbreaks with two or more ...laboratory-confirmed norovirus cases) and suspected norovirus outbreaks (i.e., outbreaks with fewer than two laboratory-confirmed norovirus cases) within 7 business days of notification. Norovirus transmission can be prevented by handwashing thoroughly with soap and water, avoiding food preparation until ≥48 hours after symptoms end, and proper cleaning and disinfection of surfaces contaminated by vomitus or diarrhea.†† NoroSTAT Network Esther Rei, Massachusetts Department of Public Health; Brandon Sabina, Massachusetts Department of Public Health; Jennifer Beggs, Michigan Department of Health and Human Services; Diana K. Riner, Michigan Department of Health and Human Services Bureau of Laboratories; Elizabeth Cebelinski, Minnesota Department of Health; Amy Saupe, Minnesota Department of Health; Amanda Bartling, Nebraska Public Health Laboratory; Brianna K.D. Loeck, Nebraska Department of Health and Human Services; Nicole Chase, New Mexico Department of Health; Jessica Houston, New Mexico Department of Health; Eric Brandt, Ohio Department of Health; Ellen Salehi, Ohio Department of Health; Emilio DeBess, Oregon Health Authority; Laura Tsaknaridis, Oregon State Public Health Laboratory; Gregory Goodwin, South Carolina Department of Health and Environmental Control Public Health Laboratory; Hani Mohamed, South Carolina Department of Health and Environmental Control; Mugdha Golwalkar, Tennessee Department of Health; Linda Thomas, Tennessee Department of Health Laboratory Services; Mary Kathryne Donnelly, Virginia Division of Consolidated Laboratory Services; Haley Greene, Virginia Department of Health; Timothy Davis, Wisconsin State Laboratory of Hygiene; Lynn Roberts, Wisconsin Department of Health Services; Rob Christensen, Wyoming Public Health Laboratory; Matthew Peterson, Wyoming Department of Health Corresponding author: J Infect 2021;82:276–316. https://doi.org/10.1016/j.jinf.2021.02.012 PMID:33581238 Wang L-P, Han J-Y, Zhou S-X, et al.; Chinese Centers for Disease Control and Prevention (CDC) Etiology of Diarrhea Surveillance Study Team.
In October 2017, the Nebraska Department of Health and Human Services (NDHHS) was notified by a local health department of a gastrointestinal illness outbreak among attendees of a wedding reception ...at facility A, an event center. Shortly thereafter, state and local public health officials began receiving reports of similar gastrointestinal illness among attendees of subsequent facility A events. An investigation was initiated to identify cases, establish the cause, assess possible transmission routes, and provide control recommendations. Overall, 159 cases consistent with norovirus infection (three confirmed and 156 probable) were identified among employees of facility A and attendees of nine facility A events during October 27-November 18, 2017. The investigation revealed a public vomiting episode at the facility on October 27 and at least one employee involved with preparing and serving food who returned to work <24 hours after symptom resolution, suggesting that a combination of contaminated environmental surfaces and infected food handlers likely sustained the outbreak. Recommendations regarding sanitation and excluding ill employees were communicated to facility A management. However, facility A performed minimal environmental cleaning and did not exclude ill employees. Consequently, transmission continued. To prevent persistent norovirus outbreaks in similar settings, public health officials should ensure that involved facilities implement a comprehensive prevention strategy as early as possible that includes extensive sanitation and strict exclusion of ill food handlers for at least 48 hours after symptom resolution (1).
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