2011 Georgia data summary: Shiga Toxin Producing E. coli (STEC) [Nov. 2013]

. .. 2011 Georgia Data Summary
Georgia Department of Public Health
STEC Quick Fact: STEC Infections are commonly associated with ground beef, but Illnesses and outbreaks In recent years have occurred after eating fresh produce Items.

OVERVIEW
Some kinds of E. coli cause illness by producing a toxin . The bacteria that make these toxins are called "Shiga toxin-producing E. coli or STEC for short.
Infection is often characterized by bloody diarrhea, severe abdominal cramping , vomiting and sometimes fever.
The most common serogroup is 0157 . However, there are other serogroups including 026 , 045, 0103 and 0111.

INCIDENCE
In 2011 , 120 cases of culture-confirmed STEC* were reported , for a rate of 1.24/100 ,000 persons (Figure 1). Of those 120 cases , 29 were E. coli 0157 for a rate of 0.30/100 ,000 persons (Figure 2). While the majority of STEC cases occur in metropolitan areas, the highest rates of disease are seen in rural counties (Figure 3) . Although the incidence of E.coli 0157 has remained relatively stable over time , the incidence of STEC cases overall has been increasing . This may be due to the increase in the number of labs with shiga-toxin testing capabilities.

SURVEILLANCE
All Georgia physicians, laboratories and other health care providers are required by law to report both labconfirmed and clinical diagnoses of cases of STEC to the Georgia Department of Public Health (GDPH) .
Cultures should be sent to the Georgia Public Health Laboratory for confirmation, serogroup determination , and DNA fingerprinting .

TOP SEROGROUPS IN GEORGIA, 2011

Serogroup
1 0157 2 026 3 0103 4 0111 5 0118 6 0145

# %

29 59

19 16

14 12

8

7

7

6

3

3

Culture independent diagnostic testing (ClOT) methods have become more commonly used by laboratories and are defined as reportable cases.
Active Surveillance for Shiga Toxin Producing E. coli is conducted through FoodNet, a component of the Emerging Infections Program (EIP) . For more information , please visit: );> http://dph .georgia.gov/EIP );> http://www.cdc .gov/food neU

Figure 1.
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*i ncludes 0157 , non-0157 serogroups, and STEC positive cultures from which no bacteria was recovered

Figure 2.

E.coli 0157 Cases and Rates

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Georgia Department of Public Health- 2 Peachtree Street, NW - Atlanta, GA 30303 - (404) 657-2588- http://dph.georgia.gov

Figure 3.
Rates of Confirmed STEC Cases'" GA 2011

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DEMOGRAPHICS
In 2011 , of the 120 reported culture-confirmed cases with known race and ethnicity, 79% of cases were White , 12% of cases were Black. Also , 15% of cases were of Hispanic ethnicity.
STEC infections are more commonly reported in young children (Figure 4).

Figure 4.

2011 STEC Cases by Age Group and Gender

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IMPACT OF STEC
Hospitalizations & Deaths Of the total 120 cases of culture-confirmed STEC in 2011 , 23 (19%) of individuals were hospitalized, wh ile an additional16(13%) of individuals were seen in the emergency room . There were no deaths reported.
Outbreaks In 2011 , one outbreak associated with water exposure in a child pool resulted in 3 cases of E. coli 0157:H7 and 1 case of hemolytic uremic syndrome (HUS) .
PREVENTION AND SPECIAL PROJECTS
Food Preparation Tips 1. Always treat raw poultry, beef and pork as if they are contaminated and handle accordingly:
Wrap fresh meats in plastic bags at the market to prevent juices from dripping on other foods.
Refrigerate foods promptly; minimize holding time at room temperatu re.
Cutting boards and counters used for meat preparation should be washed immediately after use to prevent cross contamination with other foods.
Avoid eating raw or undercooked meats (internal cooking temperature for ground beef should be 160 degrees F).
2. Avoid consuming raw (unpasteurized) milk. 3. Thoroughly wash raw produce items before eating.
For more information, visit: www.foodsafety.gov
Hand Washing 1. Encourage careful hand wash ing before and after food preparation . 2. Always wash hands thoroughly after handling animals (pets, zoo, etc.) or feces of any kind.
FoodNet Projects Monitoring trends in STEC Epidemiology over time Surveying laboratories about STEC ClOT STEC interview studies in cooperation with the Centers for Disease Control and Prevention to evaluate risk factors for the development of HUS and to better characterize non-0157 STEC infections
Date updated : November 2013 Visit http://dph .qeorgia.gov/epidemiology for more information about STEC in Georgia

Georgia Department of Public Health- 2 Peachtree Street, NW- Atlanta, GA 30303- (404) 657-2588 - http://dph.georgia.gov