1. Enterohaemorrhagic Escherichia Coli (EHEC) Haemolytic Uraemic Syndrome (HUS)
Kim Valea Dahmke

2. Introduction EHEC is a food-borne disease special strain of E. coli
May lead to haemolytic uraemic syndrome
Mostly caused by E. coli O157:H7
In Germany 2011: E. coli O104:H4 (has special enteroaggregative properties + multiple antibiotic resistance)

3. Epidemiology First major outbreak in 1982 in the USA 1996 in Japan
2001 in USA

4. In 2011 there was a big outbreak in Germany (May to July) with 2987 recorded cases of EHEC and 855 cases of HUS
Death was reported for 35 (4.1%) patients with HUS and for 18 (0.6%) with EHEC
Surprisingly mostly adults were affected, normaly children or older people are affected
Especially the northern part of Germany was affected
The largest outbreak of EHEC and HUS recorded worldwide

7. Cause Raw / undercooked meat, raw milk, faecal contaminated vegetables
2011 EHEC was caused by contaminated sprouts
Bacteria survive the acidic environment of the stomach and can colonize in the colon ( bacteria are enough)

8. Some bacteria die and release toxins that can cause necrosis of the epithelia (less absorption of water + destruction of capillary)
Toxins enter bloodstream and destroy endothelium (especially in kidney); causes plug of thrombocytes (thrombocytopenia)
Destroy red blood cells (haemoltic anaemia)

9. Symptoms EHEC: - abdominal cramps - diarrhoea - fever - vomiting
- irritability, lethargy + weakness
- incubation period 3-8 days
HUS: - acute renal failure
- haemolytic anaemia + thrombocytopenia
- can cause neurological complications (seizure, stroke, coma)

10. Treatment Treatment of the symptoms Dialysis
Transfusion of blood or packed red blood cells
Using of ligand for receptors of toxin to prevent the spread of toxin to extraintestinal sites
Antibodies, vaccines
Antibiotics are avoided (may increase the releasement of toxin)

11. Bibliography http://www.who.int/mediacentre/factsheets/fs125/en/