A multistate outbreak of Shiga toxin-producing Escherichia coli O26:H11 infections in Germany, detected by molecular subtyping surveillance.
In the spring of 2000, a cluster of indistinguishable Shiga toxin-producing Escherichia coli (STEC) O26:H11 was identified in Germany by molecular subtyping surveillance. An investigation was prompted to identify a common source of exposure. A case subject was defined as a person having a polymerase chain reaction-confirmed STEC O26 infection between March and April 2000, irrespective of clinical signs, and whose isolate was indistinguishable from the index strain by use of pulsed-field gel electrophoresis. Eleven case subjects were found in 5 institutions that were supplied by 4 kitchens located in 3 states. The median age was 2 years (range, 2-31 years). No bloody diarrhea was reported, and 5 persons remained asymptomatic. Comparison of invoices revealed a certain type of beef ("Seemerrolle") as possible source of infection. This is, to our knowledge, the first multistate outbreak associated with a non-O157 STEC detected by laboratory-based surveillance. Molecular subtyping was pivotal, as disease occurrence was sporadic or family-related.
Center for Infectious Disease Epidemiology, Robert Koch-Institut, 13353 Berlin, Germany. werberd@rki.de
Dirk
D
Werber
Angelika
A
Fruth
Almut
A
Liesegang
Martina
M
Littmann
Udo
U
Buchholz
Rita
R
Prager
Helge
H
Karch
Thomas
T
Breuer
Helmut
H
Tschäpe
Andrea
A
Ammon
D000293:Adolescent; D000328:Adult; D000818:Animals; D002417:Cattle; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004196:Disease Outbreaks; D004926:Escherichia coli / Q000145:classification / Q000235:genetics / Q000378:metabolism*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology; D005243:Feces / Q000382:microbiology; D005260:Female; D005517:Foodborne Diseases / Q000378:metabolism* / Q000382:microbiology / Q000473:pathology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008460:Meat / Q000382:microbiology; D019081:O Antigens / Q000235:genetics / Q000378:metabolism; D016133:Polymerase Chain Reaction; D022603:Shiga Toxins / Q000235:genetics / Q000378:metabolism*
D004269:DNA, Bacterial; D019081:O Antigens; D022603:Shiga Toxins