Abstract
The Republic of Ireland regularly reports the highest annual crude incidence rates of Shiga toxin–producing Escherichia coli (STEC) enteritis in the European Union, ≈10 times the average. We investigated spatiotemporal patterns of STEC enteritis in Ireland using multiple statistical tools. Overall, we georeferenced 2,755 cases of infection during January 2013–December 2017; we found >1 case notified in 2,340 (12.6%) of 18,641 Census Small Areas. We encountered the highest case numbers in children 0–5 years of age (n = 1,101, 39.6%) and associated with serogroups O26 (n = 800, 29%) and O157 (n = 638, 23.2%). Overall, we identified 17 space-time clusters, ranging from 2 (2014) to 5 (2017) clusters of sporadic infection per year; we detected recurrent clustering in 3 distinct geographic regions in the west and mid-west, all of which are primarily rural. Our findings can be used to enable targeted epidemiologic intervention and surveillance.
Highlights
Over the previous decade, the Republic of Ireland has frequently reported the highest incidence rates of symptomatic Shiga toxin–producing Escherichia coli (STEC) infection in the European Union (EU) [1]
Small areas (SAs) are currently the smallest spatially defined area for census reporting in the state and exist as subdivisions within electoral districts (ED) of Ireland; each covers an area of 0.001–163 km2 and holds 80–120 dwellings
Occurrence of Sporadic STEC Infection Of 2,783 confirmed sporadic cases included in the Computerised Infectious Disease Reporting (CIDR) system during 2013–2017, we successfully geolinked 2,755 (98.9%) to a distinct spatial area
Summary
The Republic of Ireland has frequently reported the highest incidence rates of symptomatic Shiga toxin–producing Escherichia coli (STEC) infection in the European Union (EU) [1]. A recent study found the incidence of confirmed sporadic (i.e., nonoutbreak) STEC O157 infection in Ireland in 2008–2013 significantly elevated in regions characterized by high reliance on private groundwater (odds ratio [OR] 18.727; p
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