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An international outbreak of Vero cytotoxin-producing Escherichia coli O157 infection amongst tourists; a challenge for the European infectious disease surveillance network

Published online by Cambridge University Press:  01 October 1999

R. G. PEBODY ,
C. FURTADO ,
A. ROJAS ,
N. McCARTHY ,
G. NYLEN ,
P. RUUTU ,
T. LEINO ,
R. CHALMERS ,
B. de JONG  and
M. DONNELLY
...Show all authors
R. G. PEBODY
Affiliation:
European Programme for Intervention Epidemiology Training National Public Health Institute, Helsinki, Finland
C. FURTADO
Affiliation:
European Programme for Intervention Epidemiology Training PHLS Communicable Disease Surveillance Centre, London, England
A. ROJAS
Affiliation:
Directorate-General of Public Health, Las Palmas de Gran Canaria, Spain
N. McCARTHY
Affiliation:
European Programme for Intervention Epidemiology Training Swedish Institute for Infectious Disease Control, Stockholm, Sweden
G. NYLEN
Affiliation:
European Programme for Intervention Epidemiology Training PHLS Communicable Disease Surveillance Centre, Cardiff, Wales
P. RUUTU
Affiliation:
National Public Health Institute, Helsinki, Finland
T. LEINO
Affiliation:
National Public Health Institute, Helsinki, Finland
R. CHALMERS
Affiliation:
PHLS Communicable Disease Surveillance Centre, Cardiff, Wales
B. de JONG
Affiliation:
Swedish Institute for Infectious Disease Control, Stockholm, Sweden
M. DONNELLY
Affiliation:
PHLS Communicable Disease Surveillance Centre, London, England
I. FISHER
Affiliation:
European Union, Salm-Net (Enter-net) Surveillance Network
C. GILHAM
Affiliation:
PHLS Statistics Unit, London, England
L. GRAVERSON
Affiliation:
Statens Serum Institut, Copenhagen, Denmark
T. CHEASTY
Affiliation:
PHLS Laboratory of Enteric Pathogens, London, England
G. WILLSHAW
Affiliation:
PHLS Laboratory of Enteric Pathogens, London, England
M. NAVARRO
Affiliation:
Centro National de Epidemiologia, Madrid, Spain
R. SALMON
Affiliation:
PHLS Communicable Disease Surveillance Centre, Cardiff, Wales
P. LEINIKKI
Affiliation:
National Public Health Institute, Helsinki, Finland
P. WALL
Affiliation:
PHLS Communicable Disease Surveillance Centre, London, England
C. BARTLETT
Affiliation:
PHLS Communicable Disease Surveillance Centre, London, England
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Abstract

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In March 1997, an outbreak of Vero cytotoxin-producing Escherichi coli O157 (VTEC) infection occurred amongst holidaymakers returning from Fuerteventura, Canary Islands. For the investigation, a confirmed case was an individual staying in Fuerteventura during March 1997, with either E. coli O157 VTEC isolated in stool, HUS or serological evidence of recent infection; a probable case was an individual with bloody diarrhoea without laboratory confirmation. Local and Europe-wide active case finding was undertaken through national centres, Salm-Net and the European Programme of Intervention Epidemiology, followed by a case-control study.

Fourteen confirmed and one probable case were identified from England (7), Finland (5), Wales (1), Sweden (1) and Denmark (1) staying in four hotels. Three of the four hotels were supplied with water from a private well which appeared to be the probable vehicle of transmission. The case-control study showed illness was associated with consumption of raw vegetables (OR 8·4, 95% CI 1·5–48·2) which may have been washed in well water. This investigation shows the importance of international collaboration in the detection and investigation of clusters of enteric infection.

Type
Research Article
Information
Epidemiology & Infection , Volume 123 , Issue 2 , October 1999 , pp. 217 - 223
Copyright
© 1999 Cambridge University Press