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Published on: December 23, 2022
Trends and Risk Factors of Enterohemorrhagic Escherichia coli Infections in Gyeonggi Province, 2019-August 2025
Youjin Hong1, Kwang-Pil Ko1,2,3, Hyeree Park1,2
1Gyeonggi Infectious Disease Control Center, Seongnam, Korea.
Objectives:
This study aimed to analyze epidemiological trends in enterohemorrhagic Escherichia coli (EHEC) infections in Gyeonggi Province and explore risk factors associated with the marked increase in cases observed in 2025.
Methods:
Epidemiological investigation data collected from 2019 through August 2025 were analyzed. To assess the increase in cases in 2025, the Farrington algorithm was applied using 2019-2023 data as the baseline period. Three analytical models were compared according to the handling of 2020 data: Model 1 included all 2020 data, Model 2 excluded all 2020 data, and Model 3 excluded only outbreak-related cases from 2020. Food exposure categories were additionally reclassified into meat, ground meat products, dairy products, and vegetables/fruits according to the 2024 revision of the epidemiological investigation form.
Results:
EHEC infections occurred year-round, with the highest incidence observed from June to August. From January through August 2025, 123 cases were reported, a level comparable to the peak recorded in 2020. All three models detected statistical alerts during July-August 2025, indicating that the increase in cases was atypical regardless of how the 2020 outbreak data were handled. Meat consumption accounted for the largest proportion of reported food exposures, with yukhoe, being particularly prominent among cases in 2025. In addition, the serogroup distribution shifted from O157 dominance toward an increased prevalence of non-O157 serogroups, particularly O103 and O26.
Conclusions:
The 2025 surge appears to reflect a shift from localized outbreaks toward more widespread sporadic transmission, characterized by frequent raw beef exposure and increasing diversity of non-O157 serogroups. Strengthening multi-serogroup surveillance and refining epidemiological investigation forms, particularly by subdividing food exposure items, are essential for precise source tracking, earlier detection, and effective prevention.
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