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A gastroenteritis outbreak primarily caused by enteropathogenic Escherichia coli: a retrospective field epidemiological investigation
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Zhanhao FU1, Xinyu ZHANG1, Beibei YU1, Yihong ZHU1, Yang LU1, Yujian LU2, Keqin DING3
Chinese Journal of Public Health | 2026, 42(8) : 993 - 998
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Chinese Journal of Public Health | 2026, 42(8): 993-998
• Public Health Field Report •
A gastroenteritis outbreak primarily caused by enteropathogenic Escherichia coli: a retrospective field epidemiological investigation
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Zhanhao FU1, Xinyu ZHANG1, Beibei YU1, Yihong ZHU1, Yang LU1, Yujian LU2, Keqin DING3
Affiliations
  • 1Health Monitoring Department of Yuyao City Center for Disease Prevention and Control, Yuyao 315400, China
  • 2Jiangbei District Center for Disease Control and Prevention, Ningbo 315000, China
  • 3Ningbo Center for Disease Control and Prevention, Ningbo 315000, China
Published: 2026-08-10 doi: 10.11847/zgggws1148605
Outline
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Objective

To investigate the epidemiological characteristics and causative agents of a gastroenteritis outbreak at a team-building facility, providing a scientific basis for developing targeted prevention and control measures.

Methods

A field epidemiological investigation was conducted regarding a gastroenteritis outbreak that occurred on April 26, 2025, at a team-building facility in Ningbo city. Medical records were reviewed, and on-site interviews and questionnaire surveys were conducted to establish a case definition. According to this definition, cases were identified, and data were collected to describe the epidemiological distribution characteristics of the cases. A case-control study was performed through propensity score matching (PSM) to match 69 cases with 69 controls at a ratio of 1 : 1, and potential causative factors were analyzed. Anal swab samples from cases and restaurant staff, food samples retained for testing, and environmental samples from the kitchen were collected for fluorescence quantitative PCR and bacteria isolation. Whole genome sequencing was performed for the isolates to trace the sources.

Results

A total of 525 individuals were involved in the investigation. Seventy cases (including probable and confirmed cases) were identified, with an attack rate of 13.3%. The primary clinical symptoms were diarrhea (100.0%, 70/70) and abdominal pain (65.7%, 46/70), while vomiting was rare (4.3%, 3/70). The epidemic curve showed a point source exposure pattern, with a median incubation period of 14 h (range of 2–26 h). Multivariate logistic regression analysis showed that beer duck (OR = 3.028, 95%CI: 1.331–6.887), stir-fried vegetables (OR = 3.184, 95%CI: 1.461–6.936), and scrambled eggs with tomatoes (OR = 4.160, 95%CI: 1.715–10.089) increased the risk of disease. Laboratory tests found that among the 10 diarrheagenic Escherichia coli (DEC) nucleic acid-positive case samples, enteropathogenic Escherichia coli (EPEC), enteroaggregative E. coli (EAEC), and enterotoxigenic E. coli (ETEC) accounted for 80.0% (8/10), 10.0% (1/10), and 10.0% (1/10), respectively. EPEC nucleic acid was detected in multiple food and environmental samples such as stir-fried vegetables and stir-fried pork. The EPEC strains from the two cases were highly homologous (0 allele difference).

Conclusions

This is an outbreak of gastroenteritis caused by polytype DEC (mainly EPEC) contaminating various dishes in the lunch of a team-building facility.

foodborne disease  /  outbreak  /  diarrheagenic Escherichia coli (DEC)  /  case-control study  /  pathogenic factor  /  Yuyao city
符展豪, 张新宇, 俞贝贝, 祝一鸿, 陆阳, 陆毓剑, 丁克琴. 一起由EPEC为主引起的胃肠炎暴发事件:基于现场流行病学回顾性调查. 中国公共卫生, 2026 , 42 (8) : 993 -998 . DOI: 10.11847/zgggws1148605
Zhanhao FU, Xinyu ZHANG, Beibei YU, Yihong ZHU, Yang LU, Yujian LU, Keqin DING. A gastroenteritis outbreak primarily caused by enteropathogenic Escherichia coli: a retrospective field epidemiological investigation[J]. Chinese Journal of Public Health, 2026 , 42 (8) : 993 -998 . DOI: 10.11847/zgggws1148605
Year 2026 volume 42 Issue 8
68
25
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Article Info
doi: 10.11847/zgggws1148605
  • Receive Date:2025-08-06
  • Online Date:2026-10-23
  • Published:2026-08-10
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History
  • Received:2025-08-06
  • Revised:2025-10-07
  • Accepted:2026-03-28
Affiliations
    1Health Monitoring Department of Yuyao City Center for Disease Prevention and Control, Yuyao 315400, China
    2Jiangbei District Center for Disease Control and Prevention, Ningbo 315000, China
    3Ningbo Center for Disease Control and Prevention, Ningbo 315000, China

Corresponding:

DING Keqin, E-mail:
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表12种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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