Abstract
The Escherichia coli strain causing a large outbreak of haemolytic uraemic syndrome and bloody diarrhoea in Germany in May and June 2011 possesses an unusual combination of pathogenic features typical of enteroaggregative E. coli together with the capacity to produce Shiga toxin. Through rapid national and international exchange of information and strains the known occurrence in humans was quickly assessed.We describe simple diagnostic screening tools to detect the outbreak strain in clinical specimens and a novel real-time PCR for its detection in foods.
Highlights
Sequence of eventsHaving received the first Early Warning Response System (EWRS) alert issued by the Robert Koch Institute (RKI) in Germany on 23 May about an increase in the number of patients presenting with haemolytic uraemic syndrome (HUS) and bloody diarrhoea caused by Shiga toxin-producing Escherichia coli (STEC) with more than 30 possible cases reported since the second week of May, the World Health Organization Collaborating Centre (WHO CC) for Reference and Research on Escherichia and Klebsiella at Statens Serum Institut (SSI) in Denmark issued an alert to the Danish E. coli network of regional hospitals on the same day
The Escherichia coli strain causing a large outbreak of haemolytic uraemic syndrome and bloody diarrhoea in Germany in May and June 2011 possesses an unusual combination of pathogenic features typical of enteroaggregative E. coli together with the capacity to produce Shiga toxin
Having received the first Early Warning Response System (EWRS) alert issued by the Robert Koch Institute (RKI) in Germany on 23 May about an increase in the number of patients presenting with haemolytic uraemic syndrome (HUS) and bloody diarrhoea caused by Shiga toxin-producing Escherichia coli (STEC) with more than 30 possible cases reported since the second week of May, the World Health Organization Collaborating Centre (WHO CC) for Reference and Research on Escherichia and Klebsiella at Statens Serum Institut (SSI) in Denmark issued an alert to the Danish E. coli network of regional hospitals on the same day
Summary
Having received the first Early Warning Response System (EWRS) alert issued by the Robert Koch Institute (RKI) in Germany on 23 May about an increase in the number of patients presenting with haemolytic uraemic syndrome (HUS) and bloody diarrhoea caused by Shiga toxin-producing Escherichia coli (STEC) with more than 30 possible cases reported since the second week of May, the World Health Organization Collaborating Centre (WHO CC) for Reference and Research on Escherichia and Klebsiella at Statens Serum Institut (SSI) in Denmark issued an alert to the Danish E. coli network of regional hospitals on the same day. Members of the networks contributed with their existing knowledge of E. coli strains of serotype O104:H4, thereby collectively adding to the existing knowledge of this pathogen and describing the relevant characteristics of the reported strains for public health investigation
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