Gastro and Food Safety (One Health) Division, UK Health Security Agency, London, UK.
Health Protection Team, UK Health Security Agency, North East and Yorkshire Region, UK.
Epidemiol Infect. 2022 May 18;150:e114. doi: 10.1017/S0950268822000929.
In November 2019, an outbreak of Shiga toxin-producing O157:H7 was detected in South Yorkshire, England. Initial investigations established consumption of milk from a local dairy as a common exposure. A sample of pasteurised milk tested the next day failed the phosphatase test, indicating contamination of the pasteurised milk by unpasteurised (raw) milk. The dairy owner agreed to immediately cease production and initiate a recall. Inspection of the pasteuriser revealed a damaged seal on the flow divert valve. Ultimately, there were 21 confirmed cases linked to the outbreak, of which 11 (52%) were female, and 12/21 (57%) were either <15 or >65 years of age. Twelve (57%) patients were treated in hospital, and three cases developed haemolytic uraemic syndrome. Although the outbreak strain was not detected in the milk samples, it was detected in faecal samples from the cattle on the farm. Outbreaks of gastrointestinal disease caused by milk pasteurisation failures are rare in the UK. However, such outbreaks are a major public health concern as, unlike unpasteurised milk, pasteurised milk is marketed as 'safe to drink' and sold to a larger, and more dispersed, population. The rapid, co-ordinated multi-agency investigation initiated in response to this outbreak undoubtedly prevented further cases.
2019 年 11 月,英国南约克郡爆发了产志贺毒素的 O157:H7 疫情。初步调查确定,食用当地一家乳制品厂生产的牛奶是共同暴露源。次日,对巴氏消毒奶的样本进行检测,发现磷酸酶检测呈阳性,表明巴氏消毒奶受到未经巴氏消毒(生)奶的污染。乳制品厂老板同意立即停止生产并启动召回。对巴氏杀菌器的检查发现流量分流阀上的密封损坏。最终,有 21 例确诊病例与此次疫情有关,其中 11 例(52%)为女性,12/21 例(57%)年龄在 15 岁以下或 65 岁以上。12 例(57%)患者在医院接受治疗,3 例发展为溶血性尿毒综合征。尽管在牛奶样本中未检测到疫情菌株,但在农场牛的粪便样本中检测到了该菌株。在英国,因巴氏消毒失败导致的胃肠道疾病疫情较为罕见。然而,此类疫情是一个重大的公共卫生问题,因为与未经巴氏消毒的牛奶不同,巴氏消毒奶被宣传为“安全饮用”,并销售给更多、分布更广的人群。针对此次疫情,快速、协调的多机构调查无疑阻止了更多病例的发生。