Did the ban on serving raw beef liver in restaurants decrease Enterohemorrhagic Escherichia coli infection in Japan?:...

Area of Science:

• Foodborne illness epidemiology
• Public health interventions
• Infectious disease surveillance

Background:

• Enterohemorrhagic Escherichia coli (EHEC) causes severe gastrointestinal illness, including hemorrhagic colitis and hemolytic uremic syndrome (HUS).
• Following an EHEC outbreak linked to uncooked beef, Japan banned raw beef liver dishes in restaurants from July 2012.
• The long-term impact of this ban on EHEC incidence required formal assessment.

Purpose of the Study:

• To evaluate the effectiveness of banning raw beef liver dishes in Japanese restaurants on EHEC infection rates.
• To assess the association between the 2012 intervention and the incidence of EHEC infections, HUS, and related deaths.

Main Methods:

• A retrospective cohort study analyzed national data from January 2008 to December 2017.
• Interrupted time-series analysis (ITSA) was employed to assess changes in EHEC incidence before and after the July 2012 ban.
• Models incorporated regulations on raw beef handling (May 2011) and seasonality to account for confounding factors.

Main Results:

• The study included 32,179 asymptomatic and 21,250 symptomatic EHEC infections, with 717 HUS cases and 26 deaths.
• ITSA revealed no statistically significant changes in the incidence of asymptomatic EHEC infections post-ban (0.45 vs. 0.51 per million person-weeks).
• Similarly, symptomatic EHEC infections showed no significant trend change (0.30 vs. 0.33 per million person-weeks).

Conclusions:

• The implemented measures, including the ban on raw beef liver, did not result in a statistically significant reduction in overall EHEC infection rates in Japan.
• Further research may be needed to explore other contributing factors or alternative interventions for EHEC prevention.