PRO/AH/EDR> E. coli EHEC - Irlanda (02): O26

E. COLI EHEC - IRELAND (02): O26

A ProMED-mail post <http://www.promedmail.org>

ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org>

Date: Thu 1 Apr 2021

Source: Food Safety News [edited] <https://www.foodsafetynews.com/2021/04/children-sick-in-irish-e-coli-outbreak/>

Children sick in Irish _E. coli_ outbreak

Public health officials in Ireland are searching for the source of an _E. coli_ O26 outbreak in part of the country. The Department of Public Health Mid-West of the Health Service Executive (HSE) is investigating the outbreak of Shiga toxin-producing, enterohemorrhagic _E. coli_ (EHEC) that has affected 1 setting in a region that includes Clare, Limerick, and North Tipperary. EHEC, also known as Verotoxigenic _E. coli_ (VTEC), caused the outbreak among young children in recent weeks.

It is the 1st outbreak of its kind reported in 2021 in the area. To date in 2021, there have been 14 recorded cases of EHEC in the region.

The incidence of EHEC tends to be higher in warmer weather, particularly over the summer, according to health officials, though the annual number is likely to be lower in 2021 because of the COVID-19 pandemic. In the Mid-West area, there were 128 cases in 2018; 130 in 2019; and 117 in 2020.

Public Health Mid-West would not share any details on the age and gender of patients or whether any of them had developed hemolytic uremic syndrome (HUS), citing patient confidentiality. The agency continues to consider a range of risk factors for the outbreak that it described as under control. When a child becomes infected with EHEC, there is an increased risk of person-to-person contact in daycare centers or households where there are children younger than 5 years of age.

Dr Rose Fitzgerald, specialist in Public Health Medicine at Public Health Mid-West, said: "Ireland has one of the highest incidence rates of EHEC in Europe, and the Mid-West has one of highest incidence rates in Ireland. "Anyone who is infected or is a close contact of a case requires clearance from a public health doctor to attend healthcare, childcare, or work that involves food handling. It's a serious disease that can cause serious life-changing illness in young children and the elderly. It underpins the importance of hand hygiene before and after preparing food, after contact with farm animals and their environment, and effective treatment and rehabilitation of private wells.

Communicated by: ProMED <promed@promedmail.org>

The source of this outbreak has not yet be determined but appears to be the same as in the previous posting which is reported to be occurring in "one setting", perhaps daycare centers.

The enterohemorrhagic _E. coli_ (EHEC) serotype is identified as O26, one of the non-O157 EHEC serotypes. As a reminder, other non-O157 _E. coli_ serogroups that have been associated with EHEC disease include O121, O104, and O111. Such non-O157 isolates can be obtained from sheep and cattle, and although they cause as many as 30 percent of outbreaks of EHEC (1), they appear to be somewhat less (or at least more variably) virulent in a variety of in vivo and in vitro assays (2-4).