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Title: The epidemiology of Shiga toxin-producing Escherichia coli (STEC) in England, and the impact of advanced diagnostics on our understanding and control
Author: Byrne, Lisa Anne
ISNI:       0000 0004 7967 4859
Awarding Body: University of Warwick
Current Institution: University of Warwick
Date of Award: 2017
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Shiga toxin-producing E. coli (STEC) are associated with human illness and are defined by the presence of phage encoded Shiga toxin genes. While a relatively rare cause of gastrointestinal illness, they have potential to cause severe illness including bloody diarrhoea and Haemolytic Ureamic Syndrome (HUS), a serious and life threatening condition affecting the blood and kidneys and the most common cause of acute renal failure in children in the UK. The main reservoir for STEC is cattle and transmission can occur through direct or indirect contact with animals, consumption of contaminated food or water and through person to person spread. STEC first emerged as a pathogen of concern in the early 1980's and have since persisted as a pathogen of public health concern. Despite this, there was a paucity of published epidemiological data on STEC cases in the UK and elsewhere. In 2009, Public Health England introduced an enhanced surveillance system for STEC collecting standardised and detailed microbiological, clinical and epidemiological data on all cases in England. Recent advances in microbiological methods for the detection and typing of STEC have occurred. In this thesis by published works, I use six publications utilising these methodological advancements. Together, these papers provide a detailed update on the epidemiology of STEC infection in England, including an assessment of the impact of molecular methods (PCR, MLVA and WGS), on our understanding and control of STEC. Specifically, I comprehensively describe the past and current epidemiology of STEC in England including clinical impact, and assess the impact of the recent introduction of advanced detection and typing techniques in England. The body of work as a whole provides a future perspective on where research is needed as well as informing operational implications for detecting and managing sporadic cases and clusters of infection.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: QR Microbiology