Abstract
Shiga toxin-producing Escherichia coli (STEC) infections are the product of the interaction between bacteria, phages, animals, humans, and the environment. In the late 1980s, Alberta had one of the highest incidences of STEC infections in North America. Herein, we revisit and contextualize the epidemiology of STEC O157 human infections in Alberta for the period 2009–2016. STEC O157 infections were concentrated in large urban centers, but also in rural areas with high cattle density. Hospitalization was often required when the Shiga toxin genotype stx2a stx2c was involved, however, only those aged 60 years or older and infection during spring months (April to June) independently predicted that need. Since the late 1980s, the rate of STEC O157-associated hemolytic uremic syndrome (HUS) in Alberta has remained unchanged at 5.1%, despite a marked drop in the overall incidence of the infection. While Shiga toxin genotypes stx1a stx2c and stx2a stx2c seemed associated with HUS, only those aged under 10 years and infection during spring months were independently predictive of that complication. The complexity of the current epidemiology of STEC O157 in Alberta highlights the need for a One Health approach for further progress to be made in mitigating STEC morbidity.
Highlights
Shiga toxin-producing Escherichia coli (STEC) is a major cause of foodborne disease in humans and is associated with morbidity and mortality worldwide [1]
Local incidence of STEC O157 is much lower, largely due to improved laboratory detection of cases leading to public health interventions targeting the prevention, detection, and remediation of outbreaks [7]
We report on the updated local epidemiology of STEC O157 in the context of molecular data available on a large collection of clinical isolates from our Alberta STEC surveillance program
Summary
Shiga toxin-producing Escherichia coli (STEC) is a major cause of foodborne disease in humans and is associated with morbidity and mortality worldwide [1]. While meats are frequent sources of infection, contaminated water and produce from livestock-producing areas are implicated in human disease. The burden of STEC on the health of Canadians and on the healthcare system is considerable [2,3]. This may be especially true in jurisdictions directly involved in the production of food implicated in STEC transmission. The province of Alberta continues to be the leading beef producer in Canada [4]. After detection of the first few cases of STEC in the country, Alberta established an enhanced surveillance
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