Enterohemorrhagic Escherichia coli O157:H7 — Xuzhou City, Jiangsu Province, China, 2001–2021

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC? The largest and longest outbreak of diarrhea, which was complicated with hemolytic uremic syndrome (HUS) caused by enterohemorrhagic Escherichia coli (EHEC) O157:H7, occurred in Xuzhou City and its adjacent areas from 1999 to 2000 in China. WHAT IS ADDED BY THIS REPORT? According to surveillance results from 2001 to 2021, there was a significant decrease in the isolation rate of O157:H7, and cattle and sheep remained the primary hosts. However, non-Shiga toxin-producing O157:H7 emerged as the dominant strain, with stx2+stx1- strains following closely behind. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE? National surveillance of O157:H7 effectively serves as an early warning system and guidance for assessing the intensity and trend of disease epidemics. It is crucial to raise awareness of the public health risks associated with Shiga toxin-producing E. coli.