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Outbreak of Shiga toxin-producing E. coli in Germany (25 May 2011)

25 May 2011

Outbreak of Shiga toxin-producing E. coli in Germany
Epidemiological update, 25 May 2011

On 22 May, Germany reported a significant increase in the number of patients with haemolytic uremic syndrome (HUS) and bloody diarrhoea caused by Shiga toxin-producing E. coli (STEC). Since the end of April, 138 cases of HUS have been reported. While HUS, caused by STEC infections, is usually observed in children under 5 years of age, in this outbreak the great majority of cases are adults, with more than two thirds being women. Two of the HUS cases have died. Preliminary diagnostic investigations indicate that serogroup O104 (Stx2-positve, eae-negative) might be the causative agent.

The source of the outbreak is under investigation, but contaminated food seems the most likely vehicle of infection. There is currently no indication that raw milk or meat is associated with the outbreak.

Most cases are from, or have a history of travel to the North of Germany (mainly Hamburg, Northern Lower Saxony, Mecklenburg-Western Pomerania). Sweden is currently the only EU Member State reporting an unusual increase of STEC and HUS cases, and probable links with Germany are being investigated.

To date, this non-O157 STEC outbreak is limited to Germany, and there is no evidence that there is a risk for infection outside of the country. Identification of the vehicle of infection will further determine the assessment of this risk. Rapid identification of potential cases linked to this outbreak, within Germany or among persons who have travelled to Germany since the beginning of May, is essential to prevent the development of severe disease.

STEC is a group of pathogenic Escherichia coli (E. coli) strains capable of producing Shiga toxins, with the potential to cause severe enteric and systemic disease in humans.

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