I was reading an article this morning: “Increased Recognition of Non-O157 Shiga Toxin–Producing Escherichia coli Infections in the United States During 2000–2010: Epidemiologic Features and Comparison with E. coli O157 Infections.” It was written by the who’s who of diarrhea in the United States. Some of the key points:

• Patients with non-O157 STEC infection were five times more likely than those with O157 STEC infection to have traveled internationally during the 7 days before specimen collection.
• Among non-O157 STEC, six serogroups were most commonly reported: O26 (26%), O103 (22%), O111 (19%), O121 (6%), O45 (5%), and O145 (4%).
• Non-O157 STEC infections are being recognized with greater frequency because of changing laboratory practices.
• During 2000–2010, FoodNet sites reported 2006 cases of non-O157 STEC infection and 5688 cases of O157 STEC infections.
• The number of reported non-O157 STEC infections increased from an incidence of 0.12 per 100,000 population in 2000 to 0.95 per 100,000 in 2010; while the rate of O157 STEC infections decreased from 2.17 to 0.95 per 100,000.

Improved understanding of the epidemiologic features of non-O157 STEC infections can inform food safety and other prevention efforts. To detect both O157 and non-O157 STEC infections, clinical laboratories should routinely and simultaneously test all stool specimens submitted for diagnosis of acute community-acquired diarrhea for O157 STEC and for Shiga toxin and ensure that isolates are sent to a public health laboratory for serotyping and subtyping.