USA – Persistent Strain of E. coli O157:H7 (REPEXH01) Linked to Multiple Sources



REPEXH01 is a persistent strain of Shiga toxin-producing E. coli O157:H7 bacteria that has caused illnesses and outbreaks in the United States.

Illness caused by this strain was first reported to PulseNet in 2017. Illnesses caused by this strain occur year-round but are less common in winter.

In the past, the REPEXH01 strain has spread to people through contaminated food and contaminated recreational water.

This strain is relatively diverse genetically. Bacteria in this strain are within 21 allele differences of one another by whole genome sequencing, which is more diverse than typical multistate foodborne outbreaks where bacteria generally fall within 10 allele differences of one another.

Identified outbreak sources*

*Confirmed sources were implicated by epidemiologic
plus traceback or laboratory data. Suspected sources
were implicated by epidemiologic data only. More info

  • Recreational water (confirmed): 1 outbreak
  • Romaine lettuce (confirmed): 1 outbreak
  • Leafy greens (suspected): 1 outbreak
  • Ground beef (suspected): 2 outbreaks

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