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Published on: September 10, 2014
Large Shigella flexneri outbreak linked to a takeaway, South Wales: a case-control study
Amy Plimmer1,2,3, Laia Fina3, Oghogho Orife3
1UK Health Security Agency, London.
Epidemiology and Infection
|February 14, 2025
Summary
A gastrointestinal illness outbreak in South Wales was caused by Shigella flexneri. Coleslaw was identified as the most likely food vehicle, highlighting the need to consider Shigella flexneri in foodborne outbreaks.
Area of Science:
- Foodborne illness epidemiology
- Microbial outbreak investigation
- Public health surveillance
Background:
- Gastrointestinal illness outbreaks pose significant public health challenges.
- Identifying the source and vehicle of foodborne pathogens is crucial for control.
Purpose of the Study:
- To investigate a Shigella flexneri outbreak linked to a South Wales takeaway.
- To determine the extent and vehicle of the outbreak.
- To identify risk factors associated with illness.
Main Methods:
- Descriptive and environmental investigations were conducted.
- A case-control study utilized telephone questionnaires.
- Multivariable logistic regression analysis was performed on exposure data.
Main Results:
- Shigella flexneri serotype 2a was identified as the causative agent.
- Coleslaw was strongly associated with illness (aOR: 200), with a cabbage interaction (aOR: 886).
- No Shigella were detected in staff samples, but a food handler remains a likely source.
Conclusions:
- Coleslaw was the most probable vehicle for the Shigella flexneri outbreak.
- While contamination route is unclear, a food handler is suspected.
- Shigella flexneri, though uncommon in UK foodborne outbreaks, should be considered.
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