A severe foodborne outbreak of diarrhoea linked to a canteen in Italy caused by enteroinvasive Escherichia coli, an uncommon agent

• Published in: Epidemiology and infection Vol. 142; no. 12; pp. 2559 - 2566
• Main Authors: ESCHER, M., SCAVIA, G., MORABITO, S., TOZZOLI, R., MAUGLIANI, A., CANTONI, S., FRACCHIA, S., BETTATI, A., CASA, R., GESU, G. P., TORRESANI, E., CAPRIOLI, A.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.12.2014
• Subjects: Acute Disease; Adult; Bacterial Typing Techniques - methods; Bacteriology; Biological and medical sciences; Case-Control Studies; Diarrhea; Diarrhea - epidemiology; Diarrhea - microbiology; Disease Outbreaks; Dysentery, Bacillary - epidemiology; Dysentery, Bacillary - microbiology; E coli; Employees; Epidemiology; Escherichia coli; Escherichia coli - isolation & purification; Escherichia coli Infections - epidemiology; Escherichia coli Infections - microbiology; Feces - microbiology; Female; Food; Food consumption; Foodborne Diseases - epidemiology; Foodborne Diseases - microbiology; Fundamental and applied biological sciences. Psychology; Gastroenteritis; Gastrointestinal Infection; Genes; Humans; Infections; Italy - epidemiology; Kitchens; Laboratories; Male; Meals; Microbiology; Middle Aged; Miscellaneous; Original Papers; Pathogens; Polymerase Chain Reaction; Questionnaires; Salmonella; Shigella; Shigella - isolation & purification; Symptoms; Vegetables - microbiology; Southern Europe; Italy; Europe; United States > US; MED, Italy; Italy; outbreaks; foodborne infections; Enteroinvasive Escherichia coli (EIEC); Escherichia coli; Food poisoning; Diarrhea; Bacteria; Digestive diseases; Intestinal disease; Epidemiology; Enterobacteriaceae
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268814000181

We describe a foodborne outbreak in Italy caused by enteroinvasive Escherichia coli (EIEC), an enteric pathogen uncommon in industrialized countries. On 14 April 2012 a number of employees of the city of Milan Fire Brigade (FB) were admitted to hospital with severe diarrhoea after attending their canteen. Thirty-two patients were hospitalized and a total of 109 cases were identified. A case-control study conducted on 83 cases and 32 controls attending the canteen without having symptoms identified cooked vegetables to be significantly associated with the disease. Stool samples collected from 62 subjects were screened for enteric pathogens using PCR-based commercial kits: 17 cases and two asymptomatic kitchen-workers were positive for the Shigella marker gene ipaH; an ipaH-positive EIEC strain O96:H19 was isolated from six cases. EIEC may cause serious dysentery-like outbreaks even in Western European countries. Microbiologists should be aware of microbiological procedures to detect EIEC, to be applied especially when no common enteric pathogens are identified.