欧洲疾控中心-STEC感染病例-2023年年度流行病学报告

STEC infection cases Annual Epidemiological Report for 2023 Key facts •For 2023, 30 European Union/European Economic Area (EU/EEA) countries reported 10 901 confirmedcases of Shiga toxin-producingEscherichia coli (STEC) infection.•The overall EU/EEA notification rate was 3.2 cases per 100 000 population, the highest annualnotification rate since the start of the EU/EEA-wide surveillance.•In 2023, the rate was highest in children under five years of age with 13.7 cases per 100 000population for males and 13.1 cases per 100 000 population for females.•The confirmed haemolytic-uremic syndrome (HUS) cases were comparable to 2022, when casesincreased after a stable trend during the pandemic years in the EU/EEA. Among the 522 HUS casesreported, the majority were in the youngest age groups, from 0–4 years (60%) to 5–14 years (19%).However, the highest proportion of the deceased cases with HUS were over 60 years old. Introduction Shiga toxin-producingEscherichia coli (STEC) are strains of the bacteriumEscherichia coli that can produce Shigatoxins. These toxins affect small blood vessels, such as those found in the digestive tract and the kidneys. The mainreservoir of STEC is grass-feeding animals, cattle in particular. STEC infection is regularly associated with theconsumption of undercooked beef which has been contaminated with animal faeces due to poor processing methodsduring slaughter, or other contaminated food e.g. unpasteurised milk and dairy products, vegetables, and drinkingwaterparticularly from untreated water supplies. Direct contact with infected animals, for example in petting farmsand zoos, is considered an important risk of STEC infection, especially in young children. Asymptomatic carriers ofSTEC are regarded as potential source of STEC infection through person-to-person transmission. STEC infection oftencauses gastroenteritis, enterocolitis, and bloody diarrhoea, and sometimes a severe complication called haemolytic-uremic syndrome (HUS), a progressive kidney failure. Methods This report is based on data for 2023 retrieved from The European Surveillance System (TESSy) on 4 September2024. TESSy is a system for the collection, analysis and dissemination of data on communicable diseases. For a detailed description of methods used to produce this report, please refer to the Methods chapter [1].Anoverview of the national surveillance systems is available online [2]. Suggested citation: European Centre for Disease Prevention and Control. STEC infection. In: ECDC. Annual epidemiological reportfor 2023. Stockholm: ECDC; 2025. A subset of the data used for this report is available through ECDC’s online Surveillance Atlas of infectiousdiseases [3]. For 2023, data on STEC infections were reported by 30 EU/EEA countries. The notification of STEC infections ismandatory in all but three EU/EEA countries, where notification is either voluntary (Belgium and France) or basedon another type of system (Italy). Eighteen countries used the latest case definition (EU 2018) which consider aPCR positive finding as a laboratory confirmed case, four used the previous case definition from 2012, fourreported in accordance with the one from 2008 and four reported using other definitions or did not specify thecase definitions used. The surveillance systems for STEC infections have national coverage in all EU/EEA countries except for three:France, Italy, and Spain. In France, STEC surveillance is based on paediatric HUS surveillance (coverage estimatedat 85% from 2016–2017); similarly in Italy, the surveillance is primarily based on the national registry for HUS [2].Therefore, no notification rates are calculated for these two countries. The coverage of the surveillance system isestimated to be 97% in Spain in 2021–2023, so that proportion was used when calculating the national notificationrate. For 2020, not all regions in Spain reported, and case numbers might therefore be lower than expected. Noestimate of population coverage in Spain was provided prior to 2021, so notification rates were not calculated. Allcountries reported case-based data. No data for 2020–2023 were reported by the United Kingdom (UK) due to thewithdrawal of the UK from the EU on 31 January 2020. In addition to case-based surveillance, ECDC coordinates centralised analysis of whole genome sequencing (WGS)data for STEC when needed to support multi-country outbreak investigations. Epidemiology Of the 30 EU/EEA countries reporting for 2023, 29 countries reported 10 901 confirmed cases of STEC infection.One country (Cyprus) reported zero cases. The EU/EEA notification rate was 3.2 cases per 100 000 population(Table 1). This was a 22% increase compared with 2022 and the highest annual notification rate since the start ofthe EU/EEA-wide surveillance in 2007. The EU/EEA rate increase even in 2021–2022, when the data from Spainwere included for the first time (when Spain could provide an estimate of the population covered of thesurveillance system)