1
|
Varga C, John P, Cooke M, Majowicz SE. Area-Level Clustering of Shiga Toxin-Producing Escherichia coli Infections and Their Socioeconomic and Demographic Factors in Ontario, Canada: An Ecological Study. Foodborne Pathog Dis 2021; 18:438-447. [PMID: 33978473 DOI: 10.1089/fpd.2020.2918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Shiga toxin-producing Escherichia coli (STEC) infections are an important health burden for human populations in Ontario and worldwide. We assessed 452 STEC cases that were reported to Ontario's reportable disease surveillance system between 2015 and 2017. A retrospective scan statistic using a Poisson model was used to detect high-rate STEC clusters at the forward sortation area (FSA; the first three digits of a postal code) level. A significant spatial cluster in the southwest region of Ontario was identified. A case-case logistic regression analysis was applied to compare FSA-level socioeconomic and demographic characteristics among STEC cases included inside the spatial cluster with cases outside of the cluster. Cases included in the spatial cluster had higher odds of living in FSAs with a low median family income, low proportion of lone-parent families, and low proportion of the visible minority population. In addition, STEC cases inside the cluster had higher odds of coming from rural FSAs. Our study demonstrated that STEC cases were spatially clustered in Ontario and their clustering was associated with FSA-level socioeconomic and demographic determinants of cases.
Collapse
Affiliation(s)
- Csaba Varga
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.,School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Patience John
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Martin Cooke
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada.,Department of Sociology and Legal Studies, University of Waterloo, Waterloo, Canada
| | - Shannon E Majowicz
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| |
Collapse
|
2
|
Socio-economic factors associated with the incidence of Shiga-toxin producing Escherichia coli (STEC) enteritis and cryptosporidiosis in the Republic of Ireland, 2008–2017. Epidemiol Infect 2021. [PMCID: PMC8365853 DOI: 10.1017/s0950268821001564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The Republic of Ireland (ROI) currently reports the highest incidence rates of Shiga-toxin producing Escherichia coli (STEC) enteritis and cryptosporidiosis in Europe, with the spatial distribution of both infections exhibiting a clear urban/rural divide. To date, no investigation of the role of socio-demographic profile on the incidence of either infection in the ROI has been undertaken. The current study employed bivariate analyses and Random Forest classification to identify associations between individual components of a national deprivation index and spatially aggregated cases of STEC enteritis and cryptosporidiosis. Classification accuracies ranged from 78.2% (STEC, urban) to 90.6% (cryptosporidiosis, rural). STEC incidence was (negatively) associated with a mean number of persons per room and percentage of local authority housing in both urban and rural areas, addition to lower levels of education in rural areas, while lower unemployment rates were associated with both infections, irrespective of settlement type. Lower levels of third-level education were associated with cryptosporidiosis in rural areas only. This study highlights settlement-specific disparities with respect to education, unemployment and household composition, associated with the incidence of enteric infection. Study findings may be employed for improved risk communication and surveillance to safeguard public health across socio-demographic profiles.
Collapse
|
3
|
Rostal MK, Cleaveland S, Cordel C, van Staden L, Matthews L, Anyamba A, Karesh WB, Paweska JT, Haydon DT, Ross N. Farm-Level Risk Factors of Increased Abortion and Mortality in Domestic Ruminants during the 2010 Rift Valley Fever Outbreak in Central South Africa. Pathogens 2020; 9:E914. [PMID: 33158214 PMCID: PMC7694248 DOI: 10.3390/pathogens9110914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/25/2020] [Accepted: 10/30/2020] [Indexed: 11/28/2022] Open
Abstract
(1) Background: Rift Valley fever (RVF) outbreaks in domestic ruminants have severe socio-economic impacts. Climate-based continental predictions providing early warnings to regions at risk for RVF outbreaks are not of a high enough resolution for ruminant owners to assess their individual risk. (2) Methods: We analyzed risk factors for RVF occurrence and severity at the farm level using the number of domestic ruminant deaths and abortions reported by farmers in central South Africa during the 2010 RVF outbreaks using a Bayesian multinomial hurdle framework. (3) Results: We found strong support that the proportion of days with precipitation, the number of water sources, and the proportion of goats in the herd were positively associated with increased severity of RVF (the numbers of deaths and abortions). We did not find an association between any risk factors and whether RVF was reported on farms. (4) Conclusions: At the farm level we identified risk factors of RVF severity; however, there was little support for risk factors of RVF occurrence. The identification of farm-level risk factors for Rift Valley fever virus (RVFV) occurrence would support and potentially improve current prediction methods and would provide animal owners with critical information needed in order to assess their herd's risk of RVFV infection.
Collapse
Affiliation(s)
- Melinda K. Rostal
- EcoHealth Alliance, New York, NY 10018, USA; (W.B.K.); (N.R.)
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK; (S.C.); (L.M.); (D.T.H.)
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK; (S.C.); (L.M.); (D.T.H.)
| | - Claudia Cordel
- ExecuVet PTY LTD., Bloemfontein 9301, Free State, South Africa; (C.C.); (L.v.S.)
| | - Lara van Staden
- ExecuVet PTY LTD., Bloemfontein 9301, Free State, South Africa; (C.C.); (L.v.S.)
| | - Louise Matthews
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK; (S.C.); (L.M.); (D.T.H.)
| | - Assaf Anyamba
- Universities Space Research Association, Columbia, MD 21046, USA;
- NASA Goddard Space Flight Center, Biospheric Sciences Laboratory, Greenbelt, MD 20771, USA
| | | | - Janusz T. Paweska
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg 2192, South Africa;
| | - Daniel T. Haydon
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK; (S.C.); (L.M.); (D.T.H.)
| | - Noam Ross
- EcoHealth Alliance, New York, NY 10018, USA; (W.B.K.); (N.R.)
| |
Collapse
|
4
|
Murray MH, Fidino M, Fyffe R, Byers KA, Pettengill JB, Sondgeroth KS, Killion H, Magle SB, Rios MJ, Ortinau N, Santymire RM. City sanitation and socioeconomics predict rat zoonotic infection across diverse neighbourhoods. Zoonoses Public Health 2020; 67:673-683. [PMID: 32583624 DOI: 10.1111/zph.12748] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/11/2020] [Accepted: 05/25/2020] [Indexed: 01/06/2023]
Abstract
Rat-associated zoonoses transmitted through faeces or urine are of particular concern for public health because environmental exposure in homes and businesses may be frequent and undetected. To identify times and locations with greater public health risks from rats, we investigated whether rat characteristics, environmental features, socioeconomic factors, or season could predict rat infection risk across diverse urban neighbourhoods. In partnership with a pest management company, we sampled rats in 13 community areas along an income gradient in Chicago, a large city where concern about rats has increased in recent years. We collected kidneys for Leptospira spp. testing and colon contents for aerobic bacteria such as Salmonella spp. and Escherichia coli. Of 202 sampled rats, 5% carried Leptospira spp. and 22% carried E. coli. Rats were significantly more likely to carry Leptospira spp. on blocks with more standing water complaints in higher-income neighbourhoods (OR = 6.74, 95% CI: 1.54-29.39). Rats were significantly more likely to carry E. coli on blocks with more food vendors (OR = 9.94, 2.27-43.50) particularly in low-income neighbourhoods (OR = 0.26, 0.09-0.82) and in the spring (OR = 15.96, 2.90-88.62). We detected a high diversity of E. coli serovars but none contained major virulence factors. These associations between environmental features related to sanitation and infection risk in rats support transmission through water for Leptospira spp. and faecal-oral transmission for E. coli. We also found opposing relationships between zoonotic infection risk and income for these two pathogens. Thus, our results highlight the importance of sanitation for predicting zoonotic disease risks and including diverse urban areas in pathogen surveillance to mitigate public health risks from rats.
Collapse
Affiliation(s)
- Maureen H Murray
- Department of Conservation and Science, Lincoln Park Zoo, Chicago, IL, USA
| | - Mason Fidino
- Department of Conservation and Science, Lincoln Park Zoo, Chicago, IL, USA
| | | | - Kaylee A Byers
- Department of Interdisciplinary Studies, University of British Columbia, Vancouver, BC, Canada.,Canadian Wildlife Health Cooperative, Animal Health Centre, Abbotsford, BC, Canada
| | - James B Pettengill
- Center for Food Safety and Applied Nutrition, United States Food and Drug Administration, College Park, MD, USA
| | | | | | - Seth B Magle
- Department of Conservation and Science, Lincoln Park Zoo, Chicago, IL, USA
| | - Maria Jazmin Rios
- Department of Conservation and Science, Lincoln Park Zoo, Chicago, IL, USA
| | - Nora Ortinau
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Rachel M Santymire
- Department of Conservation and Science, Lincoln Park Zoo, Chicago, IL, USA
| |
Collapse
|
5
|
Influence of socio-economic status on Shiga toxin-producing Escherichia coli (STEC) infection incidence, risk factors and clinical features. Epidemiol Infect 2020; 147:e215. [PMID: 31364538 PMCID: PMC6624855 DOI: 10.1017/s0950268819000864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Shiga toxin-producing Escherichia coli (STEC) infection can cause serious illness including haemolytic uraemic syndrome. The role of socio-economic status (SES) in differential clinical presentation and exposure to potential risk factors amongst STEC cases has not previously been reported in England. We conducted an observational study using a dataset of all STEC cases identified in England, 2010–2015. Odds ratios for clinical characteristics of cases and foodborne, waterborne and environmental risk factors were estimated using logistic regression, stratified by SES, adjusting for baseline demographic factors. Incidence was higher in the highest SES group compared to the lowest (RR 1.54, 95% CI 1.19–2.00). Odds of Accident and Emergency attendance (OR 1.35, 95% CI 1.10–1.75) and hospitalisation (OR 1.71, 95% CI 1.36–2.15) because of illness were higher in the most disadvantaged compared to the least, suggesting potential lower ascertainment of milder cases or delayed care-seeking behaviour in disadvantaged groups. Advantaged individuals were significantly more likely to report salad/fruit/vegetable/herb consumption (OR 1.59, 95% CI 1.16–2.17), non-UK or UK travel (OR 1.76, 95% CI 1.40–2.27; OR 1.85, 95% CI 1.35–2.56) and environmental exposures (walking in a paddock, OR 1.82, 95% CI 1.22–2.70; soil contact, OR 1.52, 95% CI 2.13–1.09) suggesting other unmeasured risks, such as person-to-person transmission, could be more important in the most disadvantaged group.
Collapse
|
6
|
Adams N, Byrne L, Rose T, Adak B, Jenkins C, Charlett A, Violato M, O'Brien S, Whitehead M, Barr B, Taylor-Robinson D, Hawker J. Sociodemographic and clinical risk factors for paediatric typical haemolytic uraemic syndrome: retrospective cohort study. BMJ Paediatr Open 2019; 3:e000465. [PMID: 31909217 PMCID: PMC6936988 DOI: 10.1136/bmjpo-2019-000465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 08/07/2019] [Accepted: 08/25/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Haemolytic uraemic syndrome (HUS) following Shiga toxin-producing Escherichia coli (STEC) infection is the the most common cause of acute renal failure among children in the UK. This study explored differential progression from STEC to HUS by social, demographic and clinical risk factors. METHODS We undertook a retrospective cohort study linking two datasets. We extracted data on paediatric STEC and HUS cases identified in the Public Health England National Enhanced Surveillance System for STEC and British Paediatric Surveillance Unit HUS surveillance from 1 October 2011 to 31 October 2014. Using logistic regression, we estimated the odds of HUS progression by risk factors. RESULTS 1059 paediatric STEC cases were included in the study, of which 207 (19.55%, 95% CI 17% to 22%) developed HUS. In the fully adjusted model, the odds of progression to HUS were highest in those aged 1-4 years (OR 4.93, 95% CI 2.30 to 10.56, compared with 10-15 years), were infected with an Shiga toxin (stx) 2-only strain (OR 5.92, 95% CI 2.49 to 14.10), were prescribed antibiotics (OR 8.46, 95% CI 4.71 to 15.18) and had bloody diarrhoea (OR 3.56, 95% CI 2.04 to 6.24) or vomiting (OR 4.47, 95% CI 2.62 to 7.63), but there was no association with progression to HUS by socioeconomic circumstances or rurality. CONCLUSION Combining data from an active clinical surveillance system for HUS with the national enhanced STEC surveillance system suggests that 20% of diagnosed paediatric STEC infections in England resulted in HUS. No relationship was found with socioeconomic status or rurality of cases, but differences were demonstrated by age, stx type and presenting symptoms.
Collapse
Affiliation(s)
- Natalie Adams
- Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research, Liverpool, UK
- National Infection Service, Public Health England, London, UK
| | - Lisa Byrne
- National Infection Service, Public Health England, London, UK
| | - Tanith Rose
- Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research, Liverpool, UK
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Bob Adak
- Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research, Liverpool, UK
| | - Claire Jenkins
- Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research, Liverpool, UK
- National Infection Service, Public Health England, London, UK
| | - Andre Charlett
- National Infection Service, Public Health England, London, UK
| | - Mara Violato
- Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research, Liverpool, UK
- Health Economics Research Centre, University of Oxford, Oxford, UK
| | - Sarah O'Brien
- Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research, Liverpool, UK
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Margaret Whitehead
- Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research, Liverpool, UK
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Benjamin Barr
- Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research, Liverpool, UK
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - David Taylor-Robinson
- Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research, Liverpool, UK
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Jeremy Hawker
- Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research, Liverpool, UK
- National Infection Service, Public Health England, Birmingham, UK
| |
Collapse
|
7
|
Elson R, Davies TM, Jenkins C, Vivancos R, O'Brien SJ, Lake IR. Application of kernel smoothing to estimate the spatio-temporal variation in risk of STEC O157 in England. Spat Spatiotemporal Epidemiol 2019; 32:100305. [PMID: 32007279 DOI: 10.1016/j.sste.2019.100305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 01/27/2023]
Abstract
Identifying geographical areas with significantly higher or lower rates of infectious diseases can provide important aetiological clues to inform the development of public health policy and interventions designed to reduce morbidity. We applied kernel smoothing to estimate the spatial and spatio-temporal variation in risk of STEC O157 infection in England between 2009 and 2015, and to explore differences between the residential locations of cases reporting travel and those not reporting travel. We provide evidence that the distribution of STEC O157 infection in England is non-uniform with respect to the distribution of the at-risk population; that the spatial distribution of the three main genetic lineages infecting humans (I, II and I/II) differs significantly and that the spatio-temporal risk is highly dynamic. Our results also indicate that cases of STEC O157 reporting travel within or outside the UK are more likely to live in the south/south-east of the country, meaning that their residential location may not reflect the location of exposure that led to their infection. We suggest that the observed variation in risk reflects exposure to sources of STEC O157 that are geographically prescribed. These differences may be related to a combination of changes in the strains circulating in the ruminant reservoir, animal movements (livestock, birds or wildlife) or the behavior of individuals prior to infection. Further work to identify the importance of behaviours and exposures reported by cases relative to residential location is needed.
Collapse
Affiliation(s)
- Richard Elson
- National Infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, United Kingdom; School of Environmental Sciences, University of East Anglia, United Kingdom.
| | - Tilman M Davies
- Department of Mathematics & Statistics, University of Otago, Dunedin, New Zealand
| | - Claire Jenkins
- National Infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, United Kingdom
| | - Roberto Vivancos
- National Infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, United Kingdom; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emerging and Zoonotic Infections, United Kingdom
| | - Sarah J O'Brien
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, United Kingdom; Institute of Population Health Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Iain R Lake
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, United Kingdom; School of Environmental Sciences, University of East Anglia, United Kingdom
| |
Collapse
|
8
|
A spatial and temporal analysis of risk factors associated with sporadic Shiga toxin-producing Escherichia coli O157 infection in England between 2009 and 2015. Epidemiol Infect 2018; 146:1928-1939. [PMID: 30205851 DOI: 10.1017/s095026881800256x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
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.
Collapse
|
9
|
A geostatistical investigation of agricultural and infrastructural risk factors associated with primary verotoxigenic E. coli (VTEC) infection in the Republic of Ireland, 2008-2013. Epidemiol Infect 2016; 145:95-105. [PMID: 27609320 DOI: 10.1017/s095026881600193x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Ireland reports the highest incidence of verotoxigenic Escherichia coli (VTEC) infection in Europe. This study investigated potential risk factors for confirmed sporadic and outbreak primary VTEC infections during 2008-2013. Overall, 989 VTEC infections including 521 serogroup O157 and 233 serogroup O26 were geo-referenced to 931 of 18 488 census enumeration areas. The geographical distribution of human population, livestock, unregulated groundwater sources, domestic wastewater treatment systems (DWWTS) and a deprivation index were examined relative to notification of VTEC events in 524 of 6242 rural areas. Multivariate modelling identified three spatially derived variables associated with VTEC notification: private well usage [odds ratio (OR) 6·896, P < 0·001], cattle density (OR 1·002, P < 0·001) and DWWTS density (OR 0·978, P = 0·002). Private well usage (OR 18·727, P < 0·001) and cattle density (OR 1·001, P = 0·007) were both associated with VTEC O157 infection, while DWWTS density (OR 0·987, P = 0·028) was significant within the VTEC O26 model. Findings indicate that VTEC infection in the Republic of Ireland is particularly associated with rural areas, which are associated with a ubiquity of pathogen sources (cattle) and pathways (unregulated groundwater supplies).
Collapse
|
10
|
The impact of socioeconomic status on foodborne illness in high-income countries: a systematic review. Epidemiol Infect 2015; 143:2473-85. [PMID: 25600652 DOI: 10.1017/s0950268814003847] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Foodborne illness is a major cause of morbidity and loss of productivity in developed nations. Although low socioeconomic status (SES) is generally associated with negative health outcomes, its impact on foodborne illness is poorly understood. We conducted a systematic review to examine the association between SES and laboratory-confirmed illness caused by eight important foodborne pathogens. We completed this systematic review using PubMed for all papers published between 1 January 1980 and 1 January 2013 that measured the association between foodborne illness and SES in highly developed countries and identified 16 studies covering four pathogens. The effect of SES varied across pathogens: the majority of identified studies for Campylobacter, salmonellosis, and E. coli infection showed an association between high SES and illness. The single study of listeriosis showed illness was associated with low SES. A reporting bias by SES could not be excluded. SES should be considered when targeting consumer-level public health interventions for foodborne pathogens.
Collapse
|
11
|
Abstract
ABSTRACT
We have reviewed the risk factors for the occurrence of Shiga toxin-producing
Escherichia coli
(STEC)-associated human diseases. The analysis of STEC surveillance data and trends shows differences in frequency and severity of the illnesses across countries, whereas the economic and social costs for the affected families, the community, and the health system are better estimated in developed countries. The occurrence of STEC infections is determined by the interaction of the pathogen, the reservoirs, and the biological, cultural, and behavioral aspects of the host. The main risk factors identified in earlier case-control and population-based studies were dietary behaviors and beef consumption. However, in recent years, other risky exposures have also emerged, like the consumption of raw vegetables and sprouts, working or camping in rural areas, visiting farms, and person-to-person transmission. Epidemiological changes have also been determined by the intensification of cattle production, the increase in centralized food production and distribution, and the growth in the volume of international trade of foods. The main lessons learned from recent large outbreaks are knowledge of virulence determinants of new pathogenic strains, recognition of new vehicles of infection, development of new methodologies for detecting STEC in foods and humans, improvement in food regulations and hygiene guidelines, new therapeutic approaches in the treatment of infected patients, establishment of continuous educational programs for food consumers, and enhanced cooperation and teamwork of regional and international networks.
Collapse
|
12
|
Sockett P, Goebel SE, Varela NP, Guthrie A, Wilson J, Guilbault LA, Clark WF. Verotoxigenic Escherichia coli: costs of illness in Canada, including long-term health outcomes. J Food Prot 2014; 77:216-26. [PMID: 24490915 DOI: 10.4315/0362-028x.jfp-13-177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The main objective of this study was to provide cost estimates of human Escherichia coli O157 infection to facilitate future assessment of the benefits and costs of alternative preventive strategies to reduce illness. We investigated the costs of illness to Canadians from primary human infection by verotoxigenic E. coli O157 (also called Shiga toxin-producing E. coli O157) using data from the National Notifiable Diseases Registry. We used relative risk information from peer-reviewed publications to estimate the burden of illness and associated costs for eight long-term health outcomes. National estimates of the number of cases (mean and 5th and 95th percentiles), associated costs, and a rank correlation test to identify which outcomes were associated with the highest per capita costs were calculated. An estimated 22,344 cases of primary infections occur in Canada annually, costing $26.7 million. There are 37,867 additional on-going long-term health outcomes costing $377.2 million each year. Our analysis indicated that the annual cost for primary and long-term illness is $403.9 million. The analysis supports evaluation of alternative control and prevention measures and the development and implementation of policy and practices aimed at safe food production.
Collapse
Affiliation(s)
- P Sockett
- University of Guelph, 50 Stone Road, Guelph, Ontario, Canada N1G 2W1
| | - S E Goebel
- Bioniche Life Sciences, 231 Dundas Street E., Belleville, Ontario, Canada K8N 1E2.
| | - N P Varela
- University of Guelph, 50 Stone Road, Guelph, Ontario, Canada N1G 2W1
| | - A Guthrie
- Novometrix Research, Inc., Moffat, Ontario, Canada L0P 1J0
| | - J Wilson
- Novometrix Research, Inc., Moffat, Ontario, Canada L0P 1J0
| | - L A Guilbault
- BIOptima Consulting, Inc., Saint-Bruno, Québec, Canada J3V 6G8
| | - W F Clark
- London Health Sciences Centre, London, Ontario, Canada N6A 5W9
| |
Collapse
|
13
|
Imported dengue cases, weather variation and autochthonous dengue incidence in Cairns, Australia. PLoS One 2013; 8:e81887. [PMID: 24349148 PMCID: PMC3862568 DOI: 10.1371/journal.pone.0081887] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 10/27/2013] [Indexed: 11/23/2022] Open
Abstract
Background Dengue fever (DF) outbreaks often arise from imported DF cases in Cairns, Australia. Few studies have incorporated imported DF cases in the estimation of the relationship between weather variability and incidence of autochthonous DF. The study aimed to examine the impact of weather variability on autochthonous DF infection after accounting for imported DF cases and then to explore the possibility of developing an empirical forecast system. Methodology/principal finds Data on weather variables, notified DF cases (including those acquired locally and overseas), and population size in Cairns were supplied by the Australian Bureau of Meteorology, Queensland Health, and Australian Bureau of Statistics. A time-series negative-binomial hurdle model was used to assess the effects of imported DF cases and weather variability on autochthonous DF incidence. Our results showed that monthly autochthonous DF incidences were significantly associated with monthly imported DF cases (Relative Risk (RR):1.52; 95% confidence interval (CI): 1.01–2.28), monthly minimum temperature (oC) (RR: 2.28; 95% CI: 1.77–2.93), monthly relative humidity (%) (RR: 1.21; 95% CI: 1.06–1.37), monthly rainfall (mm) (RR: 0.50; 95% CI: 0.31–0.81) and monthly standard deviation of daily relative humidity (%) (RR: 1.27; 95% CI: 1.08–1.50). In the zero hurdle component, the occurrence of monthly autochthonous DF cases was significantly associated with monthly minimum temperature (Odds Ratio (OR): 1.64; 95% CI: 1.01–2.67). Conclusions/significance Our research suggested that incidences of monthly autochthonous DF were strongly positively associated with monthly imported DF cases, local minimum temperature and inter-month relative humidity variability in Cairns. Moreover, DF outbreak in Cairns was driven by imported DF cases only under favourable seasons and weather conditions in the study.
Collapse
|
14
|
Jaros P, Cookson AL, Campbell DM, Besser TE, Shringi S, Mackereth GF, Lim E, Lopez L, Dufour M, Marshall JC, Baker MG, Hathaway S, Prattley DJ, French NP. A prospective case-control and molecular epidemiological study of human cases of Shiga toxin-producing Escherichia coli in New Zealand. BMC Infect Dis 2013; 13:450. [PMID: 24079470 PMCID: PMC3854066 DOI: 10.1186/1471-2334-13-450] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 09/26/2013] [Indexed: 11/14/2022] Open
Abstract
Background Shiga toxin-producing Escherichia coli (STEC) O157:H7 and related non-O157 STEC strains are enteric pathogens of public health concern worldwide, causing life-threatening diseases. Cattle are considered the principal hosts and have been shown to be a source of infection for both foodborne and environmental outbreaks in humans. The aims of this study were to investigate risk factors associated with sporadic STEC infections in humans in New Zealand and to provide epidemiological information about the source and exposure pathways. Methods During a national prospective case–control study from July 2011 to July 2012, any confirmed case of STEC infection notified to regional public health units, together with a random selection of controls intended to be representative of the national demography, were interviewed for risk factor evaluation. Isolates from each case were genotyped using pulsed-field gel electrophoresis (PFGE) and Shiga toxin-encoding bacteriophage insertion (SBI) typing. Results Questionnaire data from 113 eligible cases and 506 controls were analysed using multivariate logistic regression. Statistically significant animal and environmental risk factors for human STEC infections were identified, notably 'Cattle livestock present in meshblock’ (the smallest geographical unit) (odds ratio 1.89, 95% CI 1.04–3.42), 'Contact with animal manure’ (OR 2.09, 95% CI 1.12–3.90), and 'Contact with recreational waters’ (OR 2.95, 95% CI 1.30–6.70). No food-associated risk factors were identified as sources of STEC infection. E. coli O157:H7 caused 100/113 (88.5%) of clinical STEC infections in this study, and 97/100 isolates were available for molecular analysis. PFGE profiles of isolates revealed three distinctive clusters of genotypes, and these were strongly correlated with SBI type. The variable 'Island of residence’ (North or South Island of New Zealand) was significantly associated with PFGE genotype (p = 0.012). Conclusions Our findings implicate environmental and animal contact, but not food, as significant exposure pathways for sporadic STEC infections in humans in New Zealand. Risk factors associated with beef and dairy cattle suggest that ruminants are the most important sources of STEC infection. Notably, outbreaks of STEC infections are rare in New Zealand and this further suggests that food is not a significant exposure pathway.
Collapse
Affiliation(s)
- Patricia Jaros
- Molecular Epidemiology and Public Health Laboratory, Hopkirk Research Institute, Massey University, Private Bag, 11 222, Palmerston North 4442, New Zealand.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Foodborne illness incidence rates and food safety risks for populations of low socioeconomic status and minority race/ethnicity: a review of the literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3634-52. [PMID: 23955239 PMCID: PMC3774461 DOI: 10.3390/ijerph10083634] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 08/07/2013] [Accepted: 08/08/2013] [Indexed: 12/05/2022]
Abstract
While foodborne illness is not traditionally tracked by race, ethnicity or income, analyses of reported cases have found increased rates of some foodborne illnesses among minority racial/ethnic populations. In some cases (Listeria, Yersinia) increased rates are due to unique food consumption patterns, in other cases (Salmonella, Shigella, Campylobacter) it is unclear why this health disparity exists. Research on safe food handling knowledge and behaviors among low income and minority consumers suggest that there may be a need to target safe food handling messages to these vulnerable populations. Another possibility is that these populations are receiving food that is less safe at the level of the retail outlet or foodservice facility. Research examining the quality and safety of food available at small markets in the food desert environment indicates that small corner markets face unique challenges which may affect the quality and potential safety of perishable food. Finally, a growing body of research has found that independent ethnic foodservice facilities may present increased risks for foodborne illness. This review of the literature will examine the current state of what is known about foodborne illness among, and food safety risks for, minority and low socioeconomic populations, with an emphasis on the United States and Europe.
Collapse
|
16
|
Climatic, ecological and socioeconomic factors as predictors of Sindbis virus infections in Finland. Epidemiol Infect 2012; 141:1857-66. [DOI: 10.1017/s095026881200249x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYMosquito-borne Sindbis virus (SINV) causes rash-arthritis syndrome in Finland. Major outbreaks with approximately 7-year cycles have caused substantial burden of illness. Forest dwelling grouse are suspected to be amplifying hosts, with the infection transmitted to humans by mosquito bites. SINV infection surveillance data for 1984–2010 were used to create a negative binomial hurdle model, with seasonality, long-term cycles, climatic, ecological and socioeconomic variables. Climatic factors during early summer and amount of snow in April described the occurrence and incidence of SINV infections. Regulated water shore and hatch-year black grouse density described the occurrence, while population working in agriculture, agricultural land (negative) and income (negative) described the incidence of the disease. The prediction for 2009 was 85 cases (95% prediction interval 2-1187), while the actual occurrence was 106. We identified novel and known risk factors. The prevention of SINV infections in regulated water areas by infected mosquito populations should be targeted.
Collapse
|