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Possible person-to-person transmission of Escherichia coli O111--associated hemolytic uremic syndrome

B Boudailliez1, P Berquin, P Mariani-Kurkdjian

  • 1Department of Pediatrics, CHU Nord, Amiens, France.

Pediatric Nephrology (Berlin, Germany)
|February 1, 1997
PubMed

Insights

Verocytotoxin 2 (VT2)-producing E. coli O111 caused hemolytic uremic syndrome (HUS) in children. Person-to-person transmission was identified as the primary risk factor, not food or drink.

Area of Science:

  • Microbiology
  • Epidemiology
  • Pediatrics

Background:

  • An outbreak of D+ hemolytic uremic syndrome (HUS) occurred in southern Picardy over three months.
  • Ten children aged 1-13 years were affected within a 15-km radius.

Purpose of the Study:

  • To investigate the cause and transmission routes of the HUS outbreak.
  • To identify the specific pathogen and risk factors associated with the observed cases.

Main Methods:

  • Polymerase chain reaction (PCR) was used to detect verocytotoxin (VT) genes in stool samples.
  • Verocytotoxin 2 (VT2)-producing Escherichia coli (VTEC) O111 was isolated and identified.
  • Retrospective case-control and cohort studies were conducted to assess risk factors, including school absence and food/drink consumption.

Main Results:

  • VT2 genes were detected in 7 of 9 patient stool samples and 5 of 14 contact samples.
  • VTEC O111 was isolated from 5 of 9 children and 3 of 14 adults.
  • A significantly higher rate of school absence was observed in a school where cases were concentrated (Odds Ratio 2.77).
  • No association was found between food/drink consumption and gastroenteritis.

Conclusions:

  • The findings strongly suggest person-to-person transmission of VT2-producing E. coli O111.
  • Close contact was identified as the primary risk factor for HUS in this outbreak.
  • Environmental or foodborne sources were not implicated.

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