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Shiga toxin-producing Escherichia coli (STEC) and food: attribution, characterization, and monitoring

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    Book (series)
    Attributing illness caused by Shiga toxin-producing Escherichia coli (STEC) to specific foods 2019
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    Shiga toxin-producing Escherichia coli (STEC) infections are a substantial public health issue worldwide, causing more than 1 million illnesses, 128 deaths and nearly 13 000 Disability-Adjusted Life Years (DALYs) annually. To appropriately target interventions to prevent STEC infections transmitted through food, it is important to determine the specific types of foods leading to these illnesses. An analysis of data from STEC foodborne outbreak investigations reported globally, and a systematic review and meta-analysis of case-control studies of sporadic STEC infections published for all dates and locations, were conducted. A total of 957 STEC outbreaks from 27 different countries were included in the analysis. Overall, outbreak data identified that 16% (95% UI, 2-17%) of outbreaks were attributed to beef, 15% (95% UI, 2-15%) to produce and 6% (95% UI, 1-6%) to dairy products. The food sources involved in 57% of all outbreaks could not be identified. The attribution proportions were calculated by WHO region and the attribution of specific food commodities varied between geographic regions. In the European and American sub-regions of the WHO, the primary sources of outbreaks were beef and produce. In contrast, produce and dairy were identified as the primary sources of STEC outbreaks in the WHO Western Pacific sub-region. The systematic search of the literature identified useable data from 21 publications of case-control studies of sporadic STEC infections. The results of the meta-analysis identified, overall, beef and meat-unspecified as significant risk factors for STEC infection. Geographic region and age of the study population contributed to significant sources of
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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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    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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