Shiga toxin-producing Escherichia coli O26:H11 associated with a cluster of haemolytic uraemic syndrome cases following the mid-July 2021 floods in Belgium

IF 4 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-07-31 DOI:10.1016/j.jiph.2025.102916

Florence Crombé , Tiffany Dierinck , Angel Rosas , Alessandro Pellegrino , Laurence Delbrassinne , Catherine Ragimbeau , Joel Mossong , Naïma Hammami , Cedric Van Cleemputte , Arnaud Rouelle , Francis Delloye , Bram Vanmechelen , Denis Piérard

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引用次数: 0

Abstract

Background

Flood-related waterborne diseases are an acute consequence of natural disasters, primarily due to contamination of drinking water supplies. With climate change driving an increase in extreme weather events, such as floods, the risk of waterborne disease outbreak is expected to rise. This report summarizes an outbreak investigation of Shiga toxin-producing Escherichia coli (STEC) O26:H11 in the Belgian-Luxembourg following the mid-July 2021 floods.

Methods

In summer 2021, STEC O26 isolates referred to the Belgian National Reference Centre (NRC) were first characterized with IS621-typing, followed by whole genome sequencing (WGS)-based core genome multilocus sequence typing (cgMLST). As an outbreak was suspected, a national-level investigation was initiated. A retrospective analysis compared STEC incidence between flooded and non-flooded municipalities in Wallonia.

Results

The NRC identified a cluster of ten cases infected with STEC O26:H11 (stx_2a⁺ and eae⁺), with identical IS621-profile. Six were confirmed by WGS; all six isolates of sequence type (ST) 21 were closely related. All six cases developed haemolytic uraemic syndrome (HUS) and resided in the Belgian-Luxembourg, heavily impacted by the mid-July 2021 floods. Retrospective analysis showed an increase in STEC cases in flooded areas of Wallonia. Surveillance questionnaires linked the illness to contaminated tap water that was consumed by all cases. Phylogenetic analysis revealed cross-border spread in the neighbouring Grand Duchy (GD) of Luxembourg. Five Luxembourgish cases, including two STEC-HUS cases, were epidemiologically linked to a same daycare centre.

Conclusions

This report describes an HUS cluster of STEC O26:H11 (ST21, stx_2a⁺, eae⁺) in Belgium following severe mid-July 2021 floods. Contaminated tap water was identified as the probable source of infection of the Belgian-Luxembourg cases, with possible secondary person-to-person transmission to children in a GD Luxembourgish daycare centre. This outbreak highlights the importance of sharing molecular typing data between countries and the need for rapid public health interventions following climate-driven disasters.

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产志贺毒素的大肠杆菌O26:H11与2021年7月中旬比利时洪水后的溶血性尿毒综合征聚集性病例有关

与洪水有关的水传播疾病是自然灾害的严重后果，主要是由于饮用水供应受到污染。随着气候变化导致洪水等极端天气事件增加，预计水传播疾病爆发的风险将上升。本报告总结了2021年7月中旬洪水后比利时-卢森堡产志贺毒素大肠杆菌O26:H11暴发调查。方法于2021年夏季，对比利时国家参考中心（NRC）的STEC O26分离株进行is621分型鉴定，然后进行基于全基因组测序（WGS）的核心基因组多位点序列分型（cgMLST）鉴定。由于怀疑发生了疫情，因此启动了国家级调查。一项回顾性分析比较了瓦隆尼亚洪水和非洪水城市之间产志贺毒素大肠杆菌的发病率。结果NRC鉴定出10例感染STEC O26:H11 （stx2a+和eae+）的聚集性病例，具有相同的is621型。经WGS确认6例；6株序列型（ST） 21亲缘关系密切。所有6例均出现溶血性尿毒综合征（HUS），居住在比利时-卢森堡，受到2021年7月中旬洪水的严重影响。回顾性分析显示，瓦隆尼亚洪水地区产志贺毒素大肠杆菌病例有所增加。监测问卷将疾病与所有病例饮用的受污染的自来水联系起来。系统发育分析显示跨界传播在邻近的卢森堡大公国（GD）。在流行病学上，卢森堡的5个病例，包括2个stech - hus病例与同一日托中心有关。本报告描述了2021年7月中旬比利时发生严重洪水后发生的产毒毒素大肠杆菌O26:H11 （ST21, stx2a+, eae+）聚集性尿毒综合征。受污染的自来水被确定为比利时-卢森堡病例的可能感染源，并可能继发性人际传播给卢森堡政府日托中心的儿童。这次疫情突出了各国之间共享分子分型数据的重要性，以及在气候驱动的灾害发生后迅速采取公共卫生干预措施的必要性。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.