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Investigation Update: Outbreak of Shiga toxin-producing E. coli O104 (STEC O104:H4) Infections Associated with Travel to Germany

June 6, 2011

Investigation Update: Outbreak of Shiga toxin-producing E. coli O104 (STEC O104:H4) Infections Associated with Travel to Germany
Source: Centers for Disease Control and Prevention

CDC is monitoring a large outbreak of Shiga toxin-producing Escherichia coli O104:H4 (STEC O104:H4) infections ongoing in Germany. The responsible strain shares virulence characteristics with enteroaggregative E. coli (EAEC). As of June 2, 2011, case counts confirmed by Germany’s Robert Koch Institute* include 520 patients with hemolytic uremic syndrome (HUS) – a type of kidney failure that is associated with E. coli or STEC infections – and 11 deaths.

In the United States, four suspected cases of STEC O104:H4 infections have been identified in persons who recently traveled to Hamburg, Germany, where they were likely exposed. One case of HUS has been reported in each of three states: Massachusetts, Michigan, and Wisconsin. Additionally, one case of Shiga toxin-positive diarrheal illness is still under investigation. All four cases are pending laboratory confirmation.

CDC is working with state health departments to learn more about these suspected cases and obtain bacterial isolates from them for further characterization. In addition, CDC has alerted state health departments of the ongoing outbreak and requested information about any persons with either HUS or Shiga toxin-positive diarrheal illness, with illness onset during or after travel to Germany since April 1, 2011.

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