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This article is from the NEJM Journal Watch Second-Ever Report of a Foodborne Microsporidiosis Outbreak Commentary on a second-ever report on a foodborne microsporidiosis outbreak by Hana M.
El Sahly, MD Growing More There is evidence that Enterocytozoon bieneusi can cause outbreaks of foodborne diarrhea in immunocompetent hosts
.
Microsporidiosis (mostly caused by Enteric microsporidia) is a diarrhoeal disease that occurs primarily in immunocompromised people; therefore, data on its epidemiological and clinical characteristics are scarce
.
Michlmayr and colleagues describe an outbreak of diarrhea in a company in Denmark in November 2020
.
In 49 fecal samples collected from 24 people, all common pathogens tested negative; 27 of these samples tested positive for E.
pylori
.
The cohort included 44 probable cases (employees who ate in the company cafeteria and reported gastrointestinal symptoms), 8 laboratory-confirmed cases (E.
pylori test results in stool between Nov.
4 and Dec.
13) positive employees) and 143 uninfected controls
.
The most common symptoms were diarrhea (90%), fatigue (83%), abdominal pain (78%) and nausea (71%)
.
The disease lasts 14 to 22 days (sometimes divided into two phases)
.
The duration of spore shedding ranged from 25 to 43 days in 3 individuals for whom multiple stool samples were collected
.
Significant exposures occurred in people who entered the cafeteria on November 4 and 5 (eating certain sandwiches was the most important risk factor), with the patient's onset peaking on November 13 and 14
.
No cases have been identified among food handlers, and leftover food cannot be tested due to the closure of the canteen
.
Comments This is the second report of an outbreak of foodborne microsporidiosis
.
This study provides us with a rare opportunity to understand the clinical and epidemiological characteristics of microsporidia in healthy populations
.
The pathogen in healthy hosts is characterized by a long incubation period (approximately 9 days), a long period of spore shedding, and a long duration of symptoms
.
Clinicians and public health agencies should consider microsporidiosis in healthy individuals who exhibit the above clinical features but test negative for common pathogens that cause diarrhea
.
Reviewed article Michlmayr D et al.
Incubation period, spore shedding duration, and symptoms of Enterocytozoon bieneusi genotype C infection in a foodborne outbreak in Denmark, 2020.
Clin Infect Dis 2021 Nov 13; [e-pub].
(https:// doi.
org/10.
1093/cid/ciab949) NEJM Journal Watch NEJM Journal Watch (NEJM Journal Watch) is published by the NEJM Group.
It invites internationally renowned doctors to comment on important papers in the medical field and helps doctors understand and apply the latest developments
.
"NEJM Frontiers of Medicine" translates several articles every week, publishes them on the app and official website, and selects 2-3 articles and publishes them on WeChat
.
Copyright Information This article was translated, written or commissioned by the NEJM Frontiers in Medicine, jointly created by Jiahui Medical Research and Education Group (J-Med) and The New England Journal of Medicine (NEJM)
.
The full text of the Chinese translation and the included figures are exclusively authorized by the NEJM Group
.
If you want to reprint, please leave a message or contact nejmqianyan@nejmqianyan.
cn
.
Unauthorized translation is an infringement, and the copyright owner reserves the right to pursue legal responsibility
.
El Sahly, MD Growing More There is evidence that Enterocytozoon bieneusi can cause outbreaks of foodborne diarrhea in immunocompetent hosts
.
Microsporidiosis (mostly caused by Enteric microsporidia) is a diarrhoeal disease that occurs primarily in immunocompromised people; therefore, data on its epidemiological and clinical characteristics are scarce
.
Michlmayr and colleagues describe an outbreak of diarrhea in a company in Denmark in November 2020
.
In 49 fecal samples collected from 24 people, all common pathogens tested negative; 27 of these samples tested positive for E.
pylori
.
The cohort included 44 probable cases (employees who ate in the company cafeteria and reported gastrointestinal symptoms), 8 laboratory-confirmed cases (E.
pylori test results in stool between Nov.
4 and Dec.
13) positive employees) and 143 uninfected controls
.
The most common symptoms were diarrhea (90%), fatigue (83%), abdominal pain (78%) and nausea (71%)
.
The disease lasts 14 to 22 days (sometimes divided into two phases)
.
The duration of spore shedding ranged from 25 to 43 days in 3 individuals for whom multiple stool samples were collected
.
Significant exposures occurred in people who entered the cafeteria on November 4 and 5 (eating certain sandwiches was the most important risk factor), with the patient's onset peaking on November 13 and 14
.
No cases have been identified among food handlers, and leftover food cannot be tested due to the closure of the canteen
.
Comments This is the second report of an outbreak of foodborne microsporidiosis
.
This study provides us with a rare opportunity to understand the clinical and epidemiological characteristics of microsporidia in healthy populations
.
The pathogen in healthy hosts is characterized by a long incubation period (approximately 9 days), a long period of spore shedding, and a long duration of symptoms
.
Clinicians and public health agencies should consider microsporidiosis in healthy individuals who exhibit the above clinical features but test negative for common pathogens that cause diarrhea
.
Reviewed article Michlmayr D et al.
Incubation period, spore shedding duration, and symptoms of Enterocytozoon bieneusi genotype C infection in a foodborne outbreak in Denmark, 2020.
Clin Infect Dis 2021 Nov 13; [e-pub].
(https:// doi.
org/10.
1093/cid/ciab949) NEJM Journal Watch NEJM Journal Watch (NEJM Journal Watch) is published by the NEJM Group.
It invites internationally renowned doctors to comment on important papers in the medical field and helps doctors understand and apply the latest developments
.
"NEJM Frontiers of Medicine" translates several articles every week, publishes them on the app and official website, and selects 2-3 articles and publishes them on WeChat
.
Copyright Information This article was translated, written or commissioned by the NEJM Frontiers in Medicine, jointly created by Jiahui Medical Research and Education Group (J-Med) and The New England Journal of Medicine (NEJM)
.
The full text of the Chinese translation and the included figures are exclusively authorized by the NEJM Group
.
If you want to reprint, please leave a message or contact nejmqianyan@nejmqianyan.
cn
.
Unauthorized translation is an infringement, and the copyright owner reserves the right to pursue legal responsibility
.
