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2011-04-06Zeitschriftenartikel DOI: 10.1111/j.1863-2378.2011.01405.x
Desperately seeking diarrhoea: outbreak of haemolytic uraemic syndrome caused by emerging sorbitol-fermenting shiga toxin-producing Escherichia coli O157:H-, Germany, 2009
dc.contributor.authorNielsen, Stine
dc.contributor.authorFrank, Christina
dc.contributor.authorFruth, Angelika
dc.contributor.authorSpode, Anke
dc.contributor.authorPrager, Rita
dc.contributor.authorGraff, A.
dc.contributor.authorPlenge-Bönig, A.
dc.contributor.authorLoos, S.
dc.contributor.authorLütgehetmann, M.
dc.contributor.authorMüller-Wiefel, D. E.
dc.contributor.authorWerber, Dirk
dc.date.accessioned2018-05-07T16:10:01Z
dc.date.available2018-05-07T16:10:01Z
dc.date.created2012-12-20
dc.date.issued2011-04-06none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/refclJ9Aw2O3c/PDF/27wkoB199m2us.pdf
dc.identifier.urihttp://edoc.rki.de/176904/1385
dc.description.abstractInfection with sorbitol-fermenting Shiga toxin-producing Escherichia coli O157:H- (sf STEC O157:H-) is rare, but emerging in Europe. The pathogen is typically isolated from paediatric patients with life-threatening haemolytic uraemic syndrome (HUS). It is unclear whether this observation primarily reflects the pathogen's virulence or its complex laboratory diagnosis, not routinely conducted in diarrhoeal patients. In summer 2009, four boys living in the same suburb in Germany developed diarrhoea-associated HUS: three were infected by sf STEC O157:H- and one died. We conducted two analytical epidemiological studies, an extensive search for diarrhoeal cases in potentially exposed groups, and an environmental investigation. Outbreak cases were residents of the suburb diagnosed with HUS, sf STEC O157:H- infection, or both between 24 July 2009 and 25 August 2009. Overall, we ascertained eight cases with a median age of 4 years (range: from 8 months to 9 years). Stool screening of 220 persons led to the identification of only four additional cases: two asymptomatic carriers and two diarrhoeal cases. HUS was strongly associated with visiting a local playground in July, particularly on 16th July (odds ratio = 42.7, P = 0.002). No other commonality, including food, was identified, and all environmental samples (n = 24) were negative. In this localized non-foodborne outbreak, the place of likely infection was a local playground. Sf STEC O157:H- infection apparently limits itself rarely to diarrhoeal illness and progresses frequently to HUS. Therefore, detection of and response to this hypervirulent pathogen primarily relies on HUS surveillance.eng
dc.language.isoeng
dc.publisherRobert Koch-Institut, Infektionsepidemiologie
dc.subjectChildeng
dc.subjectHumanseng
dc.subjectFemaleeng
dc.subjectDisease Outbreakseng
dc.subjectGermany/epidemiologyeng
dc.subjectMaleeng
dc.subjectRisk Factorseng
dc.subjectInfanteng
dc.subjectInterviews as Topiceng
dc.subjectHemolytic-Uremic Syndrome/microbiologyeng
dc.subjectHemolytic-Uremic Syndrome/epidemiologyeng
dc.subjectFeces/microbiologyeng
dc.subjectChild Preschooleng
dc.subjectSorbitol/metabolismeng
dc.subjectEscherichia coli Infections/epidemiologyeng
dc.subjectShiga-Toxigenic Escherichia colieng
dc.subjectDiarrhea/complicationseng
dc.subjectDiarrhea/epidemiologyeng
dc.subjectDiarrhea/microbiologyeng
dc.subjectEnvironmental Exposure/adverse effectseng
dc.subjectEscherichia coli Infections/complicationseng
dc.subjectEscherichia coli O157*/isolation & purificationeng
dc.subjectEscherichia coli O157*/pathogenicityeng
dc.subjectHemolytic-Uremic Syndrome/complicationseng
dc.subjectPlay and Playthingseng
dc.subject.ddc610 Medizin
dc.titleDesperately seeking diarrhoea: outbreak of haemolytic uraemic syndrome caused by emerging sorbitol-fermenting shiga toxin-producing Escherichia coli O157:H-, Germany, 2009
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-10028979
dc.identifier.doi10.1111/j.1863-2378.2011.01405.x
dc.identifier.doihttp://dx.doi.org/10.25646/1310
local.edoc.container-titleZoonoses and Public Health
local.edoc.container-textNielsen, S., Frank, C., Fruth, A., Spode, A., Prager, R., Graff, A., Plenge-Bönig, A., Loos, S., Lütgehetmann, M., Kemper, M.J., Müller-Wiefel, D.E., Werber, D. Desperately seeking diarrhoea: Outbreak of haemolytic uraemic syndrome caused by emerging sorbitol-fermenting shiga toxin-producing Escherichia coli O157:H-, Germany, 2009 (2011) Zoonoses and Public Health, 58 (8), pp. 567-572.
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttp://onlinelibrary.wiley.com/doi/10.1111/j.1863-2378.2011.01405.x
local.edoc.container-publisher-nameWiley-Blackwell
local.edoc.container-volume58
local.edoc.container-issue8
local.edoc.container-year2011

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