title: Importance of environmental transmission in cases of EHEC O157 causing hemolytic uremic syndrome.
abstract: A local outbreak of Shiga toxin (Stx)-producing enterohemorrhagic Escherichia coli (EHEC) O157:H7 causing severe hemolytic-uremic syndrome (HUS) was found to be caused by environmental transmission. Automated ribotyping and pulsed-field gel electrophoresis revealed that four stx2-positive EHEC isolates obtained from two unrelated children, one mother and one cow were identical. Results of an epidemiological investigation strongly suggest that both children were infected via a meadow strewn with manure containing EHEC-positive feces from the infected cow a few days prior to the onset of illness. The cow belonged to a cattle farm neighboring the meadow. This report highlights the risk of acquiring EHEC O157 through indirect contact with a farm environment.
authors.affiliation: Department of Hygiene, Microbiology and Social Medicine and Austrian Reference Laboratory for EHEC, Innsbruck Medical University, Schoepfstrasse 41, 6020 Innsbruck, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Grif
authors.forename: D
authors.initials: D
authors.lastname: Orth
authors.forename: I
authors.initials: I
authors.lastname: Lederer
authors.forename: C
authors.initials: C
authors.lastname: Berghold
authors.forename: S
authors.initials: S
authors.lastname: Roedl
authors.forename: C J
authors.initials: CJ
authors.lastname: Mache
authors.forename: M P
authors.initials: MP
authors.lastname: Dierich
authors.forename: R
authors.initials: R
authors.lastname: Würzner
mesh_terms: D000328:Adult; D000818:Animals; D002417:Cattle; D002675:Child, Preschool; D003670:Deer; D004196:Disease Outbreaks; D004783:Environmental Microbiology; D004927:Escherichia coli Infections / Q000635:transmission*; D019453:Escherichia coli O157 / Q000302:isolation & purification*; D005243:Feces / Q000382:microbiology; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D008372:Manure / Q000382:microbiology; D012756:Sheep
chemical_list: D008372:Manure