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Lookup NU author(s): Professor Sarah O'Brien
This is the authors' accepted manuscript of an article that has been published in its final definitive form by Cambridge University Press, 2018.
For re-use rights please refer to the publisher's terms and conditions.
Infection with STEC O157 is relatively rare but has potentially serious sequelae, particularly for children. Large outbreaks have prompted considerable efforts designed to reduce transmission primarily from food and direct animal contact. Despite these interventions, numbers of infections have remained constant for many years and the mechanisms leading to many sporadic infections remain unclear.Here, we show that two-thirds of all cases reported in England between 2009 and 2015 were sporadic. Crude rates of infection differed geographically and were highest in rural areas during the summer months. Living in rural areas with high densities of cattle, sheep or pigs and those served by private water supplies were associated with increased risk. Living in an area of lower deprivation contributed to increased risk but this appeared to be associated with reported travel abroad. Fresh water coverage and residential proximity to the coast were not risk factors.To reduce the overall burden of infection in England, interventions designed to reduce the number of sporadic infections with STEC should focus on the residents of rural areas with high densities of livestock and the effective management of non-municipal water supplies. The role of sheep as a reservoir and potential source of infection in humans should not be overlooked.
Author(s): Elson R, Grace K, Vivancos R, Jenkins C, Adak GK, O'Brien SJ, Lake IR
Publication type: Article
Publication status: Published
Journal: Epidemiology and Infection
Year: 2018
Volume: 146
Issue: 15
Pages: 1928-1939
Print publication date: 01/11/2018
Online publication date: 12/09/2018
Acceptance date: 12/08/2018
Date deposited: 08/08/2019
ISSN (print): 0950-2688
ISSN (electronic): 1469-4409
Publisher: Cambridge University Press
URL: https://doi.org/10.1017/S095026881800256X
DOI: 10.1017/S095026881800256X
PubMed id: 30205851
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