title: Outbreak of diarrhoea due to Escherichia coli O111:B4 in schoolchildren and adults: association of Vi antigen-like reactivity.
abstract: During six days in November, 1987, 611 pupils (age range 7-19 years) and 39 adults (23-57) at a school complex in southern Finland had diarrhoea due to Escherichia coli O111:B4. Diarrhoea developed in 137 other household members during the two weeks after the school outbreak. The source of the organism remains unknown. The outbreak strains, when incubated at 22 degrees C or exposed to ampicillin, lost the lipopolysaccharide O antigen and began to react with antisera against Salmonella typhi Vi antigen. The Vi antigen-like reactivity increased the adherence of the organisms to Hep-2 cells. These results indicate that E coli O111:B4, and possibly other enteropathogenic E coli strains, should be considered in the diagnosis of all diarrhoea cases and not only in infantile diarrhoea. Expression of Vi antigen in E coli may play a part in virulence by enhancing adherence to the intestinal epithelium.
authors.affiliation: Department of Medical Microbiology, University of Turku, Finland.
authors.forename: M K
authors.initials: MK
authors.lastname: Viljanen
authors.forename: T
authors.initials: T
authors.lastname: Peltola
authors.forename: S Y
authors.initials: SY
authors.lastname: Junnila
authors.forename: L
authors.initials: L
authors.lastname: Olkkonen
authors.forename: H
authors.initials: H
authors.lastname: Järvinen
authors.forename: M
authors.initials: M
authors.lastname: Kuistila
authors.forename: P
authors.initials: P
authors.lastname: Huovinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000372:Agglutination Tests; D000668:Ampicillin Resistance; D000942:Antigens, Bacterial / Q000032:analysis*; D001422:Bacterial Adhesion; D002648:Child; D003967:Diarrhea / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D004196:Disease Outbreaks; D004926:Escherichia coli / Q000145:classification* / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011135:Polysaccharides, Bacterial; D012485:Salmonella typhi / Q000276:immunology; D012703:Serotyping / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000942:Antigens, Bacterial; D011135:Polysaccharides, Bacterial