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A family outbreak of hemolytic-uremic syndrome associated with verotoxin-producingEscherichia coli serotype 0157:H7

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Abstract

All five siblings (three boys and two girls, aged 1.5–9 years) in a family developed hemolytic-uremic syndrome associated with verotoxin-producingEscherichia coli 0157:H7 at a lakeside vacation cottage during the fall of 1985. All five were hospitalized and made a full recovery. Both parents remained asymptomatic, and neither had evidence of this infection. In four children who were investigated prospectively, free verotoxin was still detectable in the stools for between 3 and 7 weeks. The prodromal diarrheal illness in the children occurred over a 10-day period. The epidemic curve was consistent with a point-source outbreak, but continuous exposure or person-toperson transmission could not be ruled out. The source of the infection was not identified.

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References

  1. Gasser C, Gautier E, Steck A, Siebmann RE, Oechslin R (1955) Hämolytisch-urämische Syndrome: bilaterale Nierenrindennekrosen bei akuten erworbenen hämolytischen Anämien. Schweiz Med Wochenschr 85:905–909

    Google Scholar 

  2. Fong JSC, Chadarevian J-P de, Kaplan BS (1982) Hemolytic-uremic syndrome. Current concepts and management. Pediatr Clin North Am 29:835–856

    Google Scholar 

  3. Drummond KN (1985) Hemolytic uremic syndrome —then and now. N Engl J Med 312:116–118

    Google Scholar 

  4. Kaplan BS, Chesney RW, Drummond KN (1975) Hemolytic uremic syndrome in families. N Engl J Med 292:1090–1093

    Google Scholar 

  5. Farr MJ, Roberts S, Morley AR, Dewar PJ, Roberts DF, Uldall PR (1975) The haemolytic uraemic syndrome — a family study. Q J Med 44:161–188

    Google Scholar 

  6. Tune BM, Groshong T, Plumer LB, Mendoza SA (1974) The hemolytic uremic syndrome in siblings: a prospective study. J Pediatr 85:682–683

    Google Scholar 

  7. Gianantonio C, Vitacco M, Mendilharzu F, Rutty A, Mendilharzu J (1964) The hemolytic-uremic syndrome. J Pediatr 64:478–491

    Google Scholar 

  8. McLean MM, Jones CH, Sutherland DA (1966) Haemolytic uraemic syndrome. A report of an outbreak. Arch Dis Child 41:76–81

    Google Scholar 

  9. Steele BT, Murphy N, Arbus GS, Rance CP (1982) An outbreak of hemolytic uremic syndrome associated with ingestion of fresh apple juice. J Pediatr 101:963–965

    Google Scholar 

  10. Karmali MA, Petric M, Lim C, Fleming PC, Arbus GS, Lior H (1985) The association between idiopathic hemolytic uremic syndrome and infection by Verotoxin-producingEscherichia coli. J Infect Dis 151:775–782

    Google Scholar 

  11. Karmali MA, Steele BT, Petric M, Lim C (1983) Sporoadic cases of haemolytic-uraemic syndrome associated with faecal cytotoxin and cytotoxin-producingEscherichia coli in stools. Lancet I:619–620

    Google Scholar 

  12. Pai CH, Ahmed N, Sims HV, Woods DE (1986) Epidemiology of hemorrhagic colitis due to Escherichia coli 0157:H7 and other Verotoxin-producingE. coli: a two-year prospective study. 26th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, 28, September-1 October

  13. Duncan L, Mai V, Carter A, Carlson JAK, Borczyk, Karmali MA (1987) Outbreak of gastrointestinal disease-Ontario. Can Dis Weekly Rep 13:5–8

    Google Scholar 

  14. Riley LW, Remis R, Helgerson, McGee HB, Wells JG, Davis BR, Hebert RJ, Olcott ES, Johnson LM, Hargrett NT, Blake PA (1983) Hemorrhagic colitis associated with a rareEscherichia coli serotype. N Engl J Med 308:681–685

    Google Scholar 

  15. Stewart PJ, Desormeaux W, Chéné J (1983) Hemorrhagic colitis in a home for the aged — Ontario. Can Dis Weekly Rep 9:29–32

    Google Scholar 

  16. Ryan C, Tauxe R, Hosek G, Hosek GW, Wells JG, Stoesz PA, McFadden HW Jr, Smith PW, Wright GF (1986)Escherichia coli 0157:H7 diarrhea in a nursing home: clinical, epidemiologial, and pathological findings. J Infect Dis 154:631–638

    Google Scholar 

  17. Pudden D, Tuttle N, Korn D, Carlson J, Carter A, Hockin J (1985) Hemorrhagic colitis in a nursing home —Ontario. Can Dis Weekly Rep 11:169–170

    Google Scholar 

  18. Spika JS, Parsons J, Nordenberg D, Wells JG, Gunn RA, Blake PA (1986) Hemolytic uremic syndrome and diarrhea associated withEscherichia coli 0157:H7 in a daycare center. J Pediatr 109:287–291

    Google Scholar 

  19. Karmali MA, Petric M, Lim C, Cheung R, Arbus GS (1985) Sensitive method for detecting low numbers of Verotoxin-producingEscherichia coli in mixed cultures by use of colony sweeps and polymyxin extraction of Verotoxin. J Clin Microbiol 22:614–619

    Google Scholar 

  20. Petric M, Karmali MA, Arbus GS, Roscoe M, Louie S, Cheung R (1987) Effects of cycloheximide and puromycin on cytotoxic activity ofEscherichia coli Verocytotoxin (Shiga-like toxin). J Clin Microbiol 25:1265–1268

    Google Scholar 

  21. Konowalchuk J, Speirs JI, Stavric S (1977) Vero response to a cytotoxin ofEscherichia coli. Infect Immun 18:775–779

    Google Scholar 

  22. Scotland S, Smith HR, Rowe B (1985) Two distinct toxins active on Vero cells fromEscherichia coli 0157. Lancet II:885–886

    Google Scholar 

  23. Wells JG, Davis BR, Wachsmuth IK, Riley RS, Remis RS, Sokolow R, Morris JG (1983) Laboratory investigation of hemorrhagic colitis outbreaks associated with a rareEscherichia coli serotype. J Clin Microbiol 18:512–520

    Google Scholar 

  24. Benenson AS (ed) (1985) Control of communicable diseases in man. American Public Health Association, Washington DC

    Google Scholar 

  25. Strockbine NA, Marques LRM, Newland JW, Smith HW, Holmes RK, O'Brien AD (1986) Two toxin-converting phages fromEscherichia coli 0157:H7 strain 933 encode antigenically distinct toxins with similar biological activities. Infect Immun 53:135–140

    Google Scholar 

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Karmali, M.A., Arbus, G.S., Ish-Shalom, N. et al. A family outbreak of hemolytic-uremic syndrome associated with verotoxin-producingEscherichia coli serotype 0157:H7. Pediatr Nephrol 2, 409–414 (1988). https://doi.org/10.1007/BF00853433

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  • DOI: https://doi.org/10.1007/BF00853433

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