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Open AccessArticle

Epidemiology of Shiga Toxin-Producing Escherichia coli O157 in the Province of Alberta, Canada, 2009–2016

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Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
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Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
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Provincial Laboratory for Public Health, Alberta Public Laboratories, Edmonton, AB T6G 2B7, Canada
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The Ministry of Health, Government of Alberta, Edmonton, AB T5J 1S6, Canada
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Authors to whom correspondence should be addressed.
Toxins 2019, 11(10), 613; https://doi.org/10.3390/toxins11100613
Received: 30 September 2019 / Revised: 16 October 2019 / Accepted: 19 October 2019 / Published: 22 October 2019
Shiga toxin-producing Escherichia coli (STEC) infections are the product of the interaction between bacteria, phages, animals, humans, and the environment. In the late 1980s, Alberta had one of the highest incidences of STEC infections in North America. Herein, we revisit and contextualize the epidemiology of STEC O157 human infections in Alberta for the period 2009–2016. STEC O157 infections were concentrated in large urban centers, but also in rural areas with high cattle density. Hospitalization was often required when the Shiga toxin genotype stx2a stx2c was involved, however, only those aged 60 years or older and infection during spring months (April to June) independently predicted that need. Since the late 1980s, the rate of STEC O157-associated hemolytic uremic syndrome (HUS) in Alberta has remained unchanged at 5.1%, despite a marked drop in the overall incidence of the infection. While Shiga toxin genotypes stx1a stx2c and stx2a stx2c seemed associated with HUS, only those aged under 10 years and infection during spring months were independently predictive of that complication. The complexity of the current epidemiology of STEC O157 in Alberta highlights the need for a One Health approach for further progress to be made in mitigating STEC morbidity. View Full-Text
Keywords: enterohemorrhagic Escherichia coli; Shiga toxins; virulence factors; human infection enterohemorrhagic Escherichia coli; Shiga toxins; virulence factors; human infection
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Lisboa, L.F.; Szelewicki, J.; Lin, A.; Latonas, S.; Li, V.; Zhi, S.; Parsons, B.D.; Berenger, B.; Fathima, S.; Chui, L. Epidemiology of Shiga Toxin-Producing Escherichia coli O157 in the Province of Alberta, Canada, 2009–2016. Toxins 2019, 11, 613.

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