Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 3, Number 4—December 1997

Vero Cytotoxin-Producing Escherichia coli O157 Outbreaks in England and Wales, 1995: Phenotypic Methods and Genotypic Subtyping

Geraldine A. Willshaw*, Henry R. Smith*, Thomas Cheasty*, Patrick G. Wall†, and Bernard Rowe*
Author affiliations: *Central Public Health Laboratory, London, United Kingdom; †Communicable Disease Surveillance Centre, London, United Kingdom

Main Article


Outbreak of infection with O157 VTEC in England and Wales 1995, properties of outbreak strains

No. Month Region/setting (ref)a Cases (HUS/
Fatal) Phage type VT probeb VT2 subtypec
RFLPformula image
PFGE XbaIe Likely transmission of infection
1 Jan Northern/nursing home 7 (0/2) 2 2 2+2c PT2-A PT2-1 Person-to-person
2 May Wessex/Community; hospital 26 (2/0) 2 2 2 PT2-C PT2-2 Foodborne
3 Jul N.W. Thames/Hotel 5 (0/0) 1 1+2 2 PT1-A PT1-1 Foodborne
4 Jul N. Western/Residential home; hospital 3 (1/3) 2 2 2+2c PT2-A PT2-1 Person-to-person
5 Jul Northern/Community (11) 12 (0/1) 2 2 2+2c PT2-A PT2-4 Foodborne
6 Jul Northern/Restaurant 5 (1/0) 2 2 2+2c PT2-A PT2-1a Foodborne
7 Jul East Anglia/HolidayCamp 4 (0/1) 49 2 2+2C PT49-A PT49-1 Foodborne
8 Aug Wales/Day nursery; community 49 (2/0) 2 2 2+2c PT2-B PT2-3 Foodborne, person-to-person
9 Oct W. Midlands/Community (12) 11 (4/0) 2 2 2+2c PT2-Avar PT2-1b Foodborne
10 Oct Various/Community 3 (0/0) RDNCf 1+2 2+2c RDNC-A RDN C-1 Unknown
11 Dec Northern/Day nursery 2 (0/0) 49 2 2+2c PT49-B PT49-2 Unknown

HUS=hemolytic uremic syndrome; VT= Vero cytotoxin; RFLP=restriction fragment length polymorphisms; PFGE=pulsed field gel electrophoresis
aInvestigation of the epidemiology of two outbreaks has been reported previously (11,12)
bDetermined by hybridization with digoxigenin-labeled polynucleotide probes for VT1 and VT2 genes (2,3).
cBased on polymerase chain reaction amplification with a sense primer specific for either the VT2 or VT2c sequence and a degenerate antisense primer that would anneal to known VT2 sequences (14).
dHybridization with a probe comprising digoxigenin-labelled fragments of the VT2-encoding bacteriophage from strain E32511(15). Patterns were designated according to the phage type of the strain and a letter denoting a unique pattern type. The PT2-Avar pattern differed from PT2-A by the possession of a single extra hybridizing fragment.
eProfiles of XbaI digested genomic DNA. Patterns were designated according to the phage type of the strain and differentiated by number. Thus patterns PT2-1, PT2-2, PT2-3, and PT2-4 differed from each other by at least three fragment positions. Where there were single unique band differences from PT2-1 these were designated PT2-1a, etc.
fThe designation RDNC indicates that the strain reacts with the typing phages but does not conform to a currently defined pattern.

Main Article

  1. Karmali  MA. Infection by Verocytotoxin-producing Escherichia coli. Clin Microbiol Rev. 1989;2:1538.PubMedGoogle Scholar
  2. Thomas  A, Chart  H, Cheasty  T, Smith  HR, Frost  JA, Rowe  B. Vero cytotoxin-producing Escherichia coli, particularly serogroup O157, associated with human infections in the United Kingdom: 1989 to 1991. Epidemiol Infect. 1993;110:591600. DOIPubMedGoogle Scholar
  3. Thomas  A, Cheasty  T, Frost  JA, Chart  H, Smith  HR, Rowe  B. Vero cytotoxin-producing Escherichia coli, particularly serogroup O157, associated with human infections in England and Wales: 1992-4. Epidemiol Infect. 1996;117:110. DOIPubMedGoogle Scholar
  4. Advisory Committee on the Microbiological Safety of Food. Report on Verocytotoxin-producing Escherichia coli. London: HMSO; 1995.
  5. Sharp  JCM, Reilly  WJ, Coia  JE, Curnow  J, Synge  BA. Escherichia coli O157 infection in Scotland: an epidemiological overview, 1984-94. PHLS Microbiology Digest. 1995;12:13440.
  6. Chapman  PA, Siddons  CA, Harkin  MA. Sheep as a potential source of verocytotoxin-producing Escherichia coli O157. Vet Rec. 1996;138:234.PubMedGoogle Scholar
  7. Griffin  PM, Tauxe  RV. The epidemiology of infections caused by Escherichia coli O157:H7, other enterohemorrhagic E. coli, and the associated hemolytic uremic syndrome. Epidemiol Rev. 1991;13:6098.PubMedGoogle Scholar
  8. Neill  MA, Tarr  PI, Taylor  DN, Trofa  AF. Escherichia coli. In: Hui YH, Gorham JR, Murrell KD, Oliver DO, editors. Foodborne disease handbook 1994. New York: Marcel Dekker; 1994. p. 169-213.
  9. Khakhria  R, Duck  D, Lior  H. Extended phage-typing scheme for Escherichia coli O157:H7. Epidemiol Infect. 1990;105:51120. DOIPubMedGoogle Scholar
  10. Wall  PG, McDonnell  RJ, Adak  GK, Cheasty  T, Smith  HR, Rowe  B. General outbreaks of Vero cytotoxin-producing Escherichia coli O157 in England and Wales from 1992-1994. Commun Dis Rep CDR Rev. 1996;6:R2633.PubMedGoogle Scholar
  11. Stevenson  J, Hanson  S. Outbreak of Escherichia coli O157 phage type 2 infection associated with eating precooked meats. Commun Dis Rep CDR Rev. 1996;6:R1168.PubMedGoogle Scholar
  12. Gammie  AJ, Mortimer  PR, Hatch  L, Brierley  AFM, Chada  N, Walters  JB. Outbreak of Vero cytotoxin-producing Escherichia coli O157 associated with cooked ham from a single source. PHLS Microbiology Digest. 1996;13:1425.
  13. Thomas  A, Smith  HR, Rowe  B. Use of digoxigenin-labelled oligonucleotide DNA probes for VT2 and VT2 human variant genes to differentiate Vero cytotoxin-producing Escherichia coli strains of serogroup O157. J Clin Microbiol. 1993;31:17003.PubMedGoogle Scholar
  14. Thomas  A, Cheasty  T, Chart  H, Rowe  B. Isolation of Vero cytotoxin-producing Escherichia coli serotypes O9ab:H- and O101:H- carrying VT2 variant gene sequences from a patient with haemolytic uraemic syndrome. Eur J Microbiol Infect Dis. 1994;13:10746. DOIGoogle Scholar
  15. Willshaw  GA, Thirlwell  J, Jones  AP, Parry  S, Salmon  RL, Hickey  M. Vero cytotoxin-producing Escherichia coli O157 in beefburgers linked to an outbreak of diarrhoea, haemorrhagic colitis and haemolytic uraemic syndrome in Britain. Lett Appl Microbiol. 1994;19:3047. DOIPubMedGoogle Scholar
  16. Barrett  TJ, Lior  H, Green  JH, Khakhria  R, Wells  JG, Bell  BP, Laboratory investigation of a multistate food-borne outbreak of Escherichia coli O157:H7 by using pulsed-field gel electrophoresis and phage typing. J Clin Microbiol 1994;32:3013-7. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, Swaminathan B. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:2233-9. bender jb, hedberg cw, besser jm, boxrud dj, macdonald kl, osterholm mt. surveillance for Escherichia coli O157 infections in Minnesota by molecular subtyping. N Engl J Med. 1997;337:38894. DOIPubMedGoogle Scholar
  17. Trevena  WB, Willshaw  GA, Cheasty  T, Wray  C, Gallagher  J. Vero cytotoxin-producing E. coli O157 infection associated with farms. Lancet. 1996;347:601. DOIPubMedGoogle Scholar

Main Article

Page created: December 21, 2010
Page updated: December 21, 2010
Page reviewed: December 21, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.