Epidemiological analysis of a large enterohaemorrhagic Escherichia coli O111 outbreak in Japan associated with haemolytic uraemic syndrome and acute encephalopathy

2015 ◽  
Vol 143 (13) ◽  
pp. 2721-2732 ◽  
Author(s):  
Y. YAHATA ◽  
T. MISAKI ◽  
Y. ISHIDA ◽  
M. NAGIRA ◽  
M. WATAHIKI ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Haemolytic Uraemic Syndrome ◽  
Case Definition ◽  
Acute Encephalopathy ◽  
Epidemiological Analysis ◽  
Enterohaemorrhagic Escherichia Coli ◽  
Trace Back ◽  
Large Outbreak ◽  
Definition Of ◽  
Control Study

SUMMARYA large outbreak of enterohaemorrhagic Escherichia coli (EHEC) O111 and O157 occurred in Japan in April 2011. We conducted an unmatched case-control study and trace-back investigation to determine the source of EHEC O111 infection and risk factors for severe complications. Pulsed-field gel electrophoresis was performed to help define cases. A total of 86 individuals met the case definition. Of these, 40% experienced haemolytic uraemic syndrome (HUS), 24% acute encephalopathy, and 6% died. Illness was significantly associated with eating the raw beef dish yukhoe (odds ratio 19·64, 95% confidence interval 7·03–54·83), the likely food vehicle. EHEC O111 and its closely related stx-negative variants were found in the beef. HUS occurred most frequently in individuals aged 5–9 years, and this age group was significantly associated with acute encephalopathy. The prevalence of HUS and acute encephalopathy was higher than in previous non-O157-related outbreaks, indicating a high risk of severe complications.

scholarly journals Web survey-based selection of controls for epidemiological analyses of a multi-prefectural outbreak of enterohaemorrhagic Escherichia coli O157 in Japan associated with consumption of self-grilled beef hanging tender

2018 ◽  
Vol 146 (4) ◽  
pp. 450-457 ◽  
Author(s):  
Y. Yahata ◽  
N. Ohshima ◽  
F. Odaira ◽  
N. Nakamura ◽  
H. Ichikawa ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Case Control Study ◽  
Case Control ◽  
Case Definition ◽  
Case Control Studies ◽  
Local Public Health ◽  
Internet Surveys ◽  
Enterohaemorrhagic Escherichia Coli ◽  
Trace Back ◽  
Control Study

AbstractAn outbreak of enterohaemorrhagic Escherichia coli O157 occurred in multiple prefectures of Japan in November 2009. We conducted two case–control studies with trace-back and trace-forward investigations to determine the source. The case definition was met by 21 individuals; 14 (66.7%) were hospitalised, but no haemolytic uraemic syndrome, acute encephalopathy or deaths occurred. Median age was 23 (range 12–48) years and 14 cases were male (66.7%). No significant associations with food were found in a case–control study by local public health centres, but our matched case–control study using Internet surveys found that beef hanging tender (or hanger steak), derived from the diaphragm of the cattle, was significantly associated with illness (odds ratio = 15.77; 95% confidence interval, 2.00–124.11). Pulsed-field gel electrophoresis analysis of isolates from patients and the suspected food showed five different patterns: two in faecal and food samples, and another three in patient faecal samples only, although there were epidemiological links to the meat consumed at the restaurants. Trace-back investigation implicated a common food processing company from outside Japan. Examination of the logistics of the meat processing company suggested that contamination did not occur in Japan. We concluded that the source of the outbreak was imported hanging tender. This investigation revealed that Internet surveys could be useful for outbreak investigations.

scholarly journals Validation of treatment strategies for enterohaemorrhagic Escherichia coli O104:H4 induced haemolytic uraemic syndrome: case-control study

BMJ ◽  
2012 ◽  
Vol 345 (jul19 1) ◽  
pp. e4565-e4565 ◽  
Author(s):  
J. Menne ◽  
M. Nitschke ◽  
R. Stingele ◽  
M. Abu-Tair ◽  
J. Beneke ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Haemolytic Uraemic Syndrome ◽  
Case Control Study ◽  
Treatment Strategies ◽  
Case Control ◽  
Enterohaemorrhagic Escherichia Coli ◽  
Control Study

scholarly journals Predictors for the development of haemolytic uraemic syndrome with Escherichia coli O157[ratio ]H7 infections: with focus on the day of illness

2000 ◽  
Vol 124 (3) ◽  
pp. 343-349 ◽  
Author(s):  
K. IKEDA ◽  
O. IDA ◽  
K. KIMOTO ◽  
T. TAKATORIGE ◽  
N. NAKANISHI ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Primary Schools ◽  
Haemolytic Uraemic Syndrome ◽  
Escherichia Coli O157 ◽  
School Lunches ◽  
E Coli ◽  
Reactive Protein ◽  
Large Outbreak ◽  
Using Data ◽  
Wbc Count

A large outbreak of Escherichia coli O157 infections via school lunches occurred at primary schools in 1996 in Sakai City, Japan. As many as 10000 patients suffered from diarrhoea, haemorrhagic colitis and haemolytic uraemic syndrome (HUS). Using data on 288 inpatient school children affected by this outbreak, of whom 36 presented complete HUS and the remaining 252 tested positive for E. coli O157 culture, we attempted to identify predictors for the progression to HUS. Within the first 5 days of illness, clinical features associated with inpatients who developed HUS compared with those without HUS included a C reactive protein (CRP) level higher than 1·2 mg/dl (OR 44·26; 95% CI 5·83–336·23), a white blood cell (WBC) count greater than 11·0 × 109/1 (OR 5·03; 95% CI 27·13–11·87) and a temperature higher than 38·0 °C (OR 5·00; 95% CI 2·25–117·08). It can be concluded that these three factors are predictive factors for the development of HUS in patients with E. coli O157 infection, and patients who have two or all of these factors should be observed closely.

scholarly journals The Health Implication of Enterohaemorrhagic Escherichia coli (EHEC) 0157:H7: A Review on Haemolytic Uraemic Syndrome

2019 ◽  
pp. 1-10
Author(s):  
Onengiyeofori Ibama ◽  
Edna O. Ibegbulem ◽  
Donatus Onwuli ◽  
Adline Ben-Chioma
Keyword(s):  
Escherichia Coli ◽  
Haemolytic Anaemia ◽  
Bacterial Strain ◽  
Haemolytic Uraemic Syndrome ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Kidney Injury ◽  
Electrolyte Imbalance ◽  
Health Concern ◽  
Enterohaemorrhagic Escherichia Coli

Consumption of foods, water, vegetables, fruits, undercooked/ground/raw meat, unpasteurized milk or milk products contaminated with the bacterium strain Escherichia coli 0157:H7 has become a serious public health concern. This strain naturally inhabits the digestive tract of healthy cattle, and is released into the environment through the faeces of the animal. This strain cause haemorrhagic enterocolitis or gastroenteritis, and then haemolytic uraemic syndrome (HUS). HUS is a disorder characterised by haemolytic anaemia, low platelet count and acute kidney failure, and this disorder is a consequence of the production and action of Shiga-like toxin produced mainly by this bacterial strain (accounting for 90 percent of all cases), and occurs mainly in children less than five (5) years of age, but also occurs in the elderly. After infection with this bacterial strain, the disorder begins with intestinal perforation and ulceration leading to bloody diarrhoea, and consequently acute kidney injury, thrombocytopenia and microangiopathic haemolytic anaemia. In conjunction with clinical manifestations, several laboratory investigations (haematological, biochemical and microbiological assays) are implicated in the diagnosis of HUS. There is currently no specific treatment for HUS; however, supportive care (such as treatment of hypertension, fluid and electrolyte imbalance, haemodialysis, blood transfusion, etc) happens to be the only ameliorative measure for this disorder.

scholarly journals A large outbreak of Salmonella enteritidis phage type 4 associated with eggs from overseas

1989 ◽  
Vol 103 (3) ◽  
pp. 425-433 ◽  
Author(s):  
A. Stevens ◽  
C. Joseph ◽  
J. Bruce ◽  
D. Fenton ◽  
M. O'Mahony ◽  
...  
Keyword(s):  
United Kingdom ◽  
Incubation Period ◽  
Salmonella Enteritidis ◽  
Phage Type ◽  
Case Definition ◽  
Unusual Feature ◽  
Source Of Infection ◽  
The United Kingdom ◽  
Large Outbreak ◽  
Definition Of

SUMMARYIn February 1989 the largest reported outbreak to date in the United Kingdom of Salmonella enteritidis phage type 4 (PT4) infection occurred following a wedding reception at a hotel. One hundred and seventy-three people met the case definition of illness of whom 118 had the organism isolated from their stools. A further 17 were found to be S. enteritidis PT4 positive, but were asymptomatic. Lightly-cooked, egg-based sauces were the epidemiologically proven vehicles of infection. Investigations showed this outbreak to be the first to implicate imported European eggs as the source of infection. An unusual feature of this outbreak was a reported incubation period of less than 3 h for some of the confirmed cases of salmonellosis.

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