title: Secondary transmissions during the outbreak of Shiga toxin-producing Escherichia coli O104 in Hesse, Germany, 2011.
abstract: During the recent outbreak of Shiga toxin-producing Escherichia coli (STEC) O104:H4 in Germany most cases notified in the State of Hesse (6 million inhabitants) were linked to satellite clusters or had travelled to the outbreak area in northern Germany. Intensified surveillance was introduced to rapidly identify cases not linked to known clusters or cases and thus to obtain timely information on possible further contaminated vehicles distributed in Hesse, as well to describe the risk of secondary transmission among known cases. As of 2 August 2011* [corrected], 56 cases of haemolytic uraemic syndrome (HUS) including two fatal cases, and 124 cases of STEC gastroenteritis meeting the national case definitions have been reported in Hesse. Among the 55 HUS and 81 STEC gastroenteritis cases thatmet the outbreak case definition, one HUS case and eight STEC gastroenteritis cases may have acquired their infection through secondary transmission. They include six possible transmissions within the family, two possible nosocomial and one possible laboratory transmission. Our results do not suggest an increased transmissibility of the outbreak strain compared to what is already known about E. coli O157 and other STEC serotypes.
authors.affiliation: Hesse State Health Office, Dillenburg, Germany. anja.hauri@hlpug.hessen.de
authors.forename: Am
authors.initials: A
authors.lastname: Hauri
authors.forename: U
authors.initials: U
authors.lastname: Gotsch
authors.forename: I
authors.initials: I
authors.lastname: Strotmann
authors.forename: J
authors.initials: J
authors.lastname: Krahn
authors.forename: G
authors.initials: G
authors.lastname: Bettge-Weller
authors.forename: Hj
authors.initials: H
authors.lastname: Westbrock
authors.forename: O
authors.initials: O
authors.lastname: Bellinger
authors.forename: H
authors.initials: H
authors.lastname: Uphoff
mesh_terms: D000328:Adult; D000368:Aged; D003967:Diarrhea / Q000175:diagnosis / Q000453:epidemiology; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D005191:Family Characteristics; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000382:microbiology*; D005858:Germany / Q000453:epidemiology; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012703:Serotyping; D022621:Shiga Toxin / Q000096:biosynthesis; D054323:Shiga-Toxigenic Escherichia coli / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D022621:Shiga Toxin