First recorded food-borne outbreak of gastroenteritis caused by enteroinvasive Escherichia coli serotype O8:H19 in Thailand

An enteroinvasive Escherichia coli (EIEC) outbreak affecting 154 individuals was identified among attendees at a wedding in Loei Province, Thailand. The median time to symptom onset was 18 h (range: 7-72 h). The epidemiological evidence suggested that larb-neua-dib (spicy minced raw beef salad) was the probable source of the outbreak. The O8:H19 isolates identified in this study closely resemble the O8:H19 strains from the United States and the United Kingdom, but not the O96:H19 strains from Europe. This is the first EIEC outbreak documented in Thailand. Complexities in identifying EIEC contribute to its underreporting.