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Kintz E, Brainard J, Vanderes M, Vivancos R, Byrne L, Butt S, Jenkins C, Elson R, Lake I, Hunter P. Animal and environmental risk factors for sporadic Shiga toxin-producing Escherichia coli (STEC) infection in England: a case control study for O157, O26 and other STEC serotypes. Pathog Glob Health 2023; 117:655-663. [PMID: 37016510 PMCID: PMC10498794 DOI: 10.1080/20477724.2023.2197672] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
Most Shiga toxin-producing E. coli (STEC) infections are sporadic. Routine enhanced surveillance questionnaires of confirmed STEC cases in England contained promising data to conduct a case-control study to identify non-food exposures linked to the risk of becoming infected with different STEC serotypes, including O157, O26 and all others; this study pulled eligible cases from the recorded enhanced surveillance data. Controls were recruited from the general population and answered a comparable postal questionnaire. Logistic regression was performed to identify risk factors associated with STEC infection for O157, O26 and other serotype cases. In adjusted models, travel outside of the U.K. and childcare occupations raised the risk of infection for all serotypes. Day trips within the UK, exposure to dogs and contact with soil were linked to lower infection risk. Resident region within England was often linked to decreased risk. Summer season was linked to O157 and O26, but not other STEC. Swimming in the sea was linked to increased risk of infection by O157, but not other types of STEC. Correlations between exposures and infection were similar when the analysis was repeated excluding participants with a history of foreign travel. As the first case-control study in England to include sporadic non-O157 STEC, the varying risk factors between O157 and non-O157 cases suggest there are potentially unique reservoirs for different serotypes.
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Affiliation(s)
- Erica Kintz
- Norwich Medical School, University of East Anglia, Norwich, UK
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - Julii Brainard
- Norwich Medical School, University of East Anglia, Norwich, UK
- NIHR Health Protection Research Unit in Emergency Preparedness, University of East Anglia, Norwich, UK
| | - Mike Vanderes
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Roberto Vivancos
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Field Epidemiology Services, UK Health Security Agency, Liverpool, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
| | - Lisa Byrne
- Gastrointestinal Pathogens Unit, UK Health Security Agency, London, UK
| | - Saira Butt
- Gastrointestinal Pathogens Unit, UK Health Security Agency, London, UK
| | - Claire Jenkins
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Gastrointestinal Pathogens Unit, UK Health Security Agency, London, UK
| | - Richard Elson
- Gastrointestinal Pathogens Unit, UK Health Security Agency, London, UK
- School of Environmental Sciences, University of East Anglia, Norwich, UK
| | - Iain Lake
- NIHR Health Protection Research Unit in Emergency Preparedness, University of East Anglia, Norwich, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
- School of Environmental Sciences, University of East Anglia, Norwich, UK
| | - Paul Hunter
- Norwich Medical School, University of East Anglia, Norwich, UK
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Emergency Preparedness, University of East Anglia, Norwich, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
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