infectious diseases
Infection by Escherichia coli O157:H7 and Other Enterohemorrhagic E. coli (EHEC)
Epidemiology
EHEC include>100 serotypes that produce Shiga and Shiga-like toxins (Shiga toxin–producingE. coli[STEC]; also known as verotoxin-producingE. coli[VTEC]). However, only a small number of serotypes are linked to human disease. E. coliO157:H7 is the most common STEC in North America. However, non-O157 STEC serotypes (particularly O26, O45, O91, O103, O111, O113, O121, O128, and O145) may also cause enterohemorrhagic illness, particularly outside the US. In 2011, serotype O104:H4 caused a significant, multinational outbreak in Europe. O157:H7 infection may be a more common cause of bloody diarrhea than Shigellosis or E. coliO157:H7 and other STEC have a bovine reservoir. Infection can be transmitted via food or water contaminated with cow manure, as in the outbreaks and sporadic cases that typically occur after ingestion of undercooked beef (especially ground beef, eg, hamburgers) or unpasteurized milk. In the 2011 European O104:H4 outbreak, infection was transmitted by contaminated raw bean sprouts. The organism can also be transmitted by the fecal-oral route, especially among infants in diapers (eg, via inadequately chlorinated children’s wading pools). 