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Attributing illness caused by Shiga toxin-producing Escherichia coli (STEC) to specific foods











FAO and WHO. 2019. Attributing illness caused by Shiga toxin-producing Escherichia coli (STEC) to specific foods. Microbiological Risk Assessment Series no. 32. Rome.




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    Book (series)
    Shiga toxin-producing Escherichia coli (STEC) and food: attribution, characterization, and monitoring
    Meeting Report
    2018
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    Shiga toxin-producing Escherichia coli (STEC) infections are a substantial health issue worldwide. Circa 2010, foodborne STEC caused > 1 million human illnesses, 128 deaths, and ~ 13,000 Disability Adjusted Life Years (DALYs). Targeting interventions appropriately relies on identifying those strains of greatest risk to human health and determining the types of foods that cause STEC infections. There are hundreds of STEC serotypes; however, based on the evidence gathered during the review, the Expert Group concluded that the serotype of the STEC strain should not be considered a virulence criterion. All STEC strains with the same serotype should not be assumed to carry the same virulence genes and to pose the same risk, as many STEC virulence genes are mobile and can be lost or transferred to other bacteria. this report proposes a set of criteria for categorizing the potential risk of severity of illness associated with a STEC in food is recommended based on evidence of virulence gene profiles and associations with clinical severity. The criteria could be applied by risk managers in a risk-based management approach to control STEC in food. While ruminants and, other land animals are considered the main reservoirs for STEC, various largescale outbreaks have been linked to other foods. Thus, the report also addresses source attribution of foodborne STEC infections globally in order to inform the development of international standards by the Codex Alimentarius on the control of STEC, and in particular identify the foods which should be the focus of those standards. Finally it provides a review of monitoring programmes and methodology for STEC which can serve as a reference for countries planning to develop such programmes.
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    Book (series)
    Control measures for Shiga toxin-producing Escherichia coli (STEC) associated with meat and dairy products
    Meeting report
    2022
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    Although Shiga toxin-producing Escherichia coli (STEC) have been isolated from a variety of food production animals, they are most commonly associated with ruminants from which we derive meat and milk. Because of the widespread and diverse nature of ruminant-derived food production, coupled with the near ubiquity of STEC worldwide, there is no single definitive solution for controlling STEC that will work alone or in all situations. Instead, the introduction of multiple interventions applied in sequence, as a “multiple-hurdle scheme” at several points throughout the food chain (including processing, transport and handling) will be most effective. This report summarises the review and evaluation of interventions applied for the control of STEC in cattle, raw beef and raw milk and raw milk cheese manufactured from cows’ milk, and also evaluated available evidence for other small ruminants, swine and other animals. The information is presented from primary production, to the end of processing, providing the reader with information on the currently available interventions based on the latest scientific evidence. This work was undertaken to support the development of guidelines for the control of STEC in beef, raw milk and cheese produced from raw milk by the Codex Committee on Food Hygiene (CCFH).
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    Document
    Call for Data for Monitoring Programs for Shiga Toxin-producing E.Coli (STEC)
    Joint FAO/WHO Expert Meetings on Microbiological Risk Assessment (JEMRA)
    2017
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    Shiga toxin-producing E. coli (STEC) are an important cause of foodborne disease. Infections have been associated with a wide range of symptoms from mild intestinal discomfort to haemolytic uremic syndrome (HUS), end-stage renal disease (ESRD) and death. In its report on the global burden of foodborne disease, WHO estimated that foodborne STEC caused more than 1 million illnesses, 128 deaths, and nearly 13,000 DALYs in 2010.

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