title: Epidemiology of Shiga toxin producing Escherichia coli in Australia, 2000-2010.
abstract: BACKGROUND
  Shiga toxin-producing Escherichia coli (STEC) are an important cause of gastroenteritis in Australia and worldwide and can also result in serious sequelae such as haemolytic uraemic syndrome (HUS). In this paper we describe the epidemiology of STEC in Australia using the latest available data.
  
  
  METHODS
  National and state notifications data, as well as data on serotypes, hospitalizations, mortality and outbreaks were examined.
  
  
  RESULTS
  For the 11 year period 2000 to 2010, the overall annual Australian rate of all notified STEC illness was 0.4 cases per 100,000 per year. In total, there were 822 STEC infections notified in Australia over this period, with a low of 1 notification in the Australian Capital Territory (corresponding to a rate of 0.03 cases per 100,000/year) and a high of 413 notifications in South Australia (corresponding to a rate of 2.4 cases per 100,000/year), the state with the most comprehensive surveillance for STEC infection in the country. Nationally, 71.2% (504/708) of STEC infections underwent serotype testing between 2001 and 2009, and of these, 58.0% (225/388) were found to be O157 strains, with O111 (13.7%) and O26 (11.1%) strains also commonly associated with STEC infections. The notification rate for STEC O157 infections Australia wide between 2001-2009 was 0.12 cases per 100,000 per year. Over the same 9 year period there were 11 outbreaks caused by STEC, with these outbreaks generally being small in size and caused by a variety of serogroups. The overall annual rate of notified HUS in Australia between 2000 and 2010 was 0.07 cases per 100,000 per year. Both STEC infections and HUS cases showed a similar seasonal distribution, with a larger proportion of reported cases occurring in the summer months of December to February.
  
  
  CONCLUSIONS
  STEC infections in Australia have remained fairly steady over the past 11 years. Overall, the incidence and burden of disease due to STEC and HUS in Australia appears comparable or lower than similar developed countries.
authors.affiliation: National Centre for Epidemiology and Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia. H.Vally@latrobe.edu.au
authors.forename: Hassan
authors.initials: H
authors.lastname: Vally
authors.forename: Gillian
authors.initials: G
authors.lastname: Hall
authors.forename: Amalie
authors.initials: A
authors.lastname: Dyda
authors.forename: Jane
authors.initials: J
authors.lastname: Raupach
authors.forename: Katrina
authors.initials: K
authors.lastname: Knope
authors.forename: Barry
authors.initials: B
authors.lastname: Combs
authors.forename: Patricia
authors.initials: P
authors.lastname: Desmarchelier
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004196:Disease Outbreaks; D016021:Epidemiologic Studies; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D054323:Shiga-Toxigenic Escherichia coli / Q000302:isolation & purification*; D055815:Young Adult