Outbreak of haemolytic uraemic syndrome in Norway caused by stx2a-positive Escherichia coli O103:H25 traced to cured mutton sausages
On 20-21 February 2006, six cases of diarrhoea-associated haemolytic uraemic syndrome (HUS) were reported by paediatricians to the Norwegian Institute of Public Health. We initiated an investigation to identify the etiologic agent and determine the source of the outbreak in order to implement control measures.
Methods: A case was defined as a child with diarrhoea-associated HUS or any person with an infection with the outbreak strain of E.
coli O103 (defined by the multi-locus variable number tandem repeats analysis (MLVA) profile) both with illness onset after January 1st 2006 in Norway. After initial hypotheses-generating interviews, we performed a case-control study with the first fifteen cases and three controls for each case matched by age, sex and municipality.
Suspected food items were sampled, and any E. coli O103 strains were typed by multi-locus variable number tandem repeats analysis (MLVA).
Results: Between 20 February and 6 April 2006, 17 cases were identified, of which 10 children developed haemolytic uremic syndrome, including one fatal case.
After trawling interviews, a matched case-control study was performed indicating an association between a traditional cured sausage (odds ratio 19.4 (95% CI: 2.4-156)) and STEC infection. E.
coli O103:H25 identical to the outbreak strain defined by MLVA profile was found in the product and traced back to contaminated mutton.
Conclusions: We report an outbreak caused by a rare EHEC variant (O103:H25, stx2a-positive).
More than half of the diagnosed patients developed HUS, indicating that the causative organism is particularly virulent. Small ruminants continue to be important reservoirs for human-pathogen STEC.
Improved slaughtering hygiene and good manufacturing practices for cured sausage products are needed to minimise the possibility of STEC surviving through the entire sausage production process.
Author: Barbara Schimmer, Karin Nygard, Hanne MERETE Eriksen, Jorgen Lassen, Bjorn ARNE Lindstedt, Lin T Brandal, Georg Kapperud and Preben Aavitsland
Credits/Source: BMC Infectious Diseases 2008, 8:41
Published on: 2008-04-03
Limited copyright is granted for you to use and/or republish any story on this site for
any legitimate media purpose as long as you reference 7thSpace and any source mentioned in the story above. Please
make sure to read our disclaimer prior to contacting 7thSpace Interactive. To contact our editors, visit our online helpdesk. If you wish submit your own press release, click here.
Social Bookmarking
Digg this! | Post to del.icio.us | Post to Furl | Add to Netscape | Add to Yahoo! | Rojo
|
|
