EHEC - Enterohemorrhagic Escherichia Coli

German-doctor – a moderator on FluTrackers – posted one of the earliest media reports on an apparent outbreak of Enterohemorrhagic Escherichia coli (EHEC) in Germany resulting in at least 3 deaths, 400 illnesses, and 80 cases of HUS (Hemolytic Uremic Syndrome) over the past couple of weeks. 

HUS is a rare but serious complication that can occur when an infection – usually E. coli O157:H7, but sometimes shigella and salmonella – produce toxins that can destroy red blood cells and cause kidney damage. 

 These toxins are usually referred to as verotoxins (or sometimes shiga-like toxins), and so the strains of E. Coli that can produce them are sometimes classified as VTEC (Verotoxin-Producing E. coli).

Not everyone who consumes verotoxin producing strains of E. coli will develop symptoms, however, and fewer still will go on to experience HUS. 

While food borne illnesses due to E. coli contamination are hardly rare, the cases reported in Germany over the past several weeks don’t fit the usual profile. 

•  First, Germany normally sees 80 or so cases a month, and the number of cases thus far in May are running more than 5 times that rate.
• Second, EHEC is mostly seen in young children, who are particularly susceptible to the toxins produced by the E. coli bacteria. In this outbreak, most of the burden has been on young, adult women.
• And third, by far the most commonly reported strain of EHEC is called 0157:H7, but early testing indicates that the causative agent is a non-O157 form of E. coli (reportedly similar o E. coli O104)

We’ve also seen reports suggesting that this strain of E. coli may be unusually resistant to antibiotics. More involved genetic testing is underway in order to better identify and understand the pathogen.