title: Possible person-to-person transmission of Escherichia coli O111--associated hemolytic uremic syndrome.
abstract: Over a 3-month period, ten children (aged 1-13 years) from a 15-km radius in southern Picardy developed typical D+ hemolytic uremic syndrome (HUS). Polymerase chain reaction, using two pairs of verocytotoxin 1-(VT1) and VT2-specific oligonucleotide primers and an internal control was used to detect VT genes directly from stools samples. VT2 gene was detected in seven of nine patients' stools and in 5 of 14 contacts' stool samples. A VT2-producing Escherichia coli (VTEC) O111 was isolated from five of nine children's stools and in 3 adults' stools of the 14 tested. A retrospective case-control study was performed which showed a higher rate of absence in school A, where the first four cases were detected, compared with a control school. The odds ratio for the whole school was 2.77 (confidence interval 1.46-5.26), and 15 (confidence interval 2.54-115.6) if only the nursery classes were considered. A culture of all food samples from households was always negative for VTEC. A retrospective cohort study performed in 89% of children attending school A showed no linkage between food or drink and gastroenteritis. These findings emphasize the potential for person-to-person transmission of VT2-producing E. coli O111, since the only salient risk factor was close contact.
authors.affiliation: Department of Pediatrics, CHU Nord, Amiens, France.
authors.forename: B
authors.initials: B
authors.lastname: Boudailliez
authors.forename: P
authors.initials: P
authors.lastname: Berquin
authors.forename: P
authors.initials: P
authors.lastname: Mariani-Kurkdjian
authors.forename: D
authors.initials: D
authors.lastname: Ilef
authors.forename: B
authors.initials: B
authors.lastname: Cuvelier
authors.forename: I
authors.initials: I
authors.lastname: Capek
authors.forename: B
authors.initials: B
authors.lastname: Tribout
authors.forename: E
authors.initials: E
authors.lastname: Bingen
authors.forename: C
authors.initials: C
authors.lastname: Piussan
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004032:Diet; D018562:Disease Transmission, Infectious; D004926:Escherichia coli / Q000235:genetics; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D005243:Feces / Q000382:microbiology; D005260:Female; D005602:France / Q000453:epidemiology; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies