6/20/2013

Laboratory preparedness for detection and monitoring of Shiga toxin 2-producing Escherichia coli O104:H4 in Europe and response to the 2011 outbreak (Euro Surveill., abstract, edited)

[Source: Eurosurveillance, full text: (LINK). Abstract, edited.]

Eurosurveillance, Volume 18, Issue 25, 20 June 2013

Surveillance and outbreak reports

Laboratory preparedness for detection and monitoring of Shiga toxin 2-producing Escherichia coli O104:H4 in Europe and response to the 2011 outbreak

P Rosin 1, T Niskanen2, D Palm1, M Struelens1, J Takkinen2, Shiga toxin-producing Escherichia coli Experts of the European Union Food- and Waterborne Diseases and Zoonoses Network3

  1. Microbiology Coordination section, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
  2. Food and Waterborne Diseases and Zoonoses Programme, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
  3. The STEC/VTEC experts of the Network, are listed at the end of this article

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Citation style for this article: Rosin P, Niskanen T, Palm D, Struelens M, Takkinen J, Shiga toxin-producing Escherichia coli Experts of the European Union Food- and Waterborne Diseases and Zoonoses Network. Laboratory preparedness for detection and monitoring of Shiga toxin 2-producing Escherichia coli O104:H4 in Europe and response to the 2011 outbreak. Euro Surveill. 2013;18(25):pii=20508. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20508  Date of submission: 10 December 2012

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A hybrid strain of enteroaggregative and Shiga toxin 2-producing Escherichia coli (EAEC-STEC) serotype O104:H4 strain caused a large outbreak of haemolytic uraemic syndrome and bloody diarrhoea in 2011 in Europe. Two surveys were performed in the European Union (EU) and European Economic Area (EEA) countries to assess their laboratory capabilities to detect and characterise this previously uncommon STEC strain. Prior to the outbreak, 11 of the 32 countries in this survey had capacity at national reference laboratory (NRL) level for epidemic case confirmation according to the EU definition. During the outbreak, at primary diagnostic level, nine countries reported that clinical microbiology laboratories routinely used Shiga toxin detection assays suitable for diagnosis of infections with EAEC-STEC O104:H4, while 14 countries had NRL capacity to confirm epidemic cases. Six months after the outbreak, 22 countries reported NRL capacity to confirm such cases following initiatives taken by NRLs and the European Centre for Disease Prevention and Control (ECDC) Food- and Waterborne Disease and Zoonoses laboratory network. These data highlight the challenge of detection and confirmation of epidemic infections caused by atypical STEC strains and the benefits of coordinated EU laboratory networks to strengthen capabilities in response to a major outbreak.

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