{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T04:48:37Z","timestamp":1794545317399,"version":"4.9.1"},"reference-count":44,"publisher":"Cambridge University Press (CUP)","issue":"16","license":[{"start":{"date-parts":[[2015,4,29]],"date-time":"2015-04-29T00:00:00Z","timestamp":1430265600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Between 1 January 2009 and 31 December 2012 in England, a total of 3717 cases were reported with evidence of Shiga toxin-producing<jats:italic>E. coli<\/jats:italic>(STEC) infection, and the crude incidence of STEC infection was 1\u00b780\/100 000 person-years. Incidence was highest in children aged 1\u20134 years (7\u00b763\/100 000 person-years). Females had a higher incidence of STEC than males [rate ratio (RR) 1\u00b724,<jats:italic>P<\/jats:italic>&lt; 0\u00b7001], and white ethnic groups had a higher incidence than non-white ethnic groups (RR 1\u00b743,<jats:italic>P<\/jats:italic>&lt; 0\u00b7001). Progression to haemolytic uraemic syndrome (HUS) was more frequent in females and children. Non-O157 STEC strains were associated with higher hospitalization and HUS rates than O157 STEC strains. In STEC O157 cases, phage type (PT) 21\/28, predominantly indigenously acquired, was also associated with more severe disease than other PTs, as were strains encoding<jats:italic>stx2<\/jats:italic>genes. Incidence of STEC was over four times higher in people residing in rural areas than urban areas (RR 4\u00b739,<jats:italic>P<\/jats:italic>&lt; 0\u00b7001). Exposure to livestock and\/or their faeces was reported twice as often in cases living in rural areas than urban areas (<jats:italic>P<\/jats:italic>&lt; 0\u00b7001). Environmental\/animal contact remains an important risk factor for STEC transmission and is a significant driver in the burden of sporadic STEC infection. The most commonly detected STEC serogroup in England was O157. However, a bias in testing methods results in an unquantifiable under-ascertainment of non-O157 STEC infections. Implementation of PCR-based diagnostic methods designed to detect all STEC, to address this diagnostic deficit, is therefore important.<\/jats:p>","DOI":"10.1017\/s0950268815000746","type":"journal-article","created":{"date-parts":[[2015,4,29]],"date-time":"2015-04-29T08:53:04Z","timestamp":1430297584000},"page":"3475-3487","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":113,"title":["The epidemiology, microbiology and clinical impact of Shiga toxin-producing<i>Escherichia coli<\/i>in England, 2009\u20132012"],"prefix":"10.1017","volume":"143","author":[{"given":"L.","family":"BYRNE","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"JENKINS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"LAUNDERS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"ELSON","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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