- 期刊
Lessons Learned from Epidemiological Investigations of the Enterohemorrhagic ＂Escherichia coli＂ O104:H4 Outbreak in Germany 2011
並列摘要
In recent years, nationwide and international foodborne outbreaks have become more commonly recognized. When foodborne illness happens, public health officials investigate outbreaks, ensure the scale of diagnostic capability in laboratories for foodborne microorganisms, control it and prevent similar outbreaks from happening in the future. A large outbreak of the hemolytic-uremic syndrome associated with enterohemorrhagic ＂Escherichia coli＂ O104:H4 occurred in Germany that ultimately involved more than 4,000 persons in 16 countries. We undertook a literature search refers to the epidemiological studies of this outbreak, and discussed the methods and results of the main investigations. Early in the epidemiological studies, the team of epidemiological specialists started with initial exploratory interviews and case-control studies which linked to consumption of raw tomato, cucumber, and salad in northern Germany. Additional recipe-based restaurant cohort studies, online questionnaires, trace-back and trace-forward investigations identified sprouts produced by an organic grower in Lower Saxony as vehicle of transmission. A thorough understanding of the advantages and limitations of epidemiological studies and typing methods during outbreak investigations is of crucial importance for selecting the appropriate approaches to explicitly define outbreak strains. Recall bias with regard to sprout consumption and potential selection bias in case-control studies also need to be taken into account to avoid impacts and losses from misidentification of incriminated food.