EHEC and human disease

Verocytotoxin (shiga toxin)-producing Escherichia coli (VTEC/STEC) are a leading cause of mortality from food-borne disease in developed countries. VTEC/STEC strains include enterohaemorrhagic E. coli (EHEC) organisms, responsible for serious diseases such as bloody diarrhoea, haemorrhagic colitis and haemolytic uraemic syndrome (HUS). Young children are particularly vulnerable to VTEC/STEC disease. HUS is the commonest cause off acute renal failure in children. The estimated incidence of HUS in Australia is 0.71 per 100 000 children under the age of 15 years. Ruminants (particularly sheep) are known to be sources of VTEC/STEC. Domestic pets may carry VTEC/STEC. STEC has been found in raw meat; non-meat foods; drinking and recreational water; unpasteurised milk products, apple juice and cider; and mayonnaise, raw vegetables and herbs. Because no specific treatment currently exists for EHEC infection, management is limited to supportive therapy (where complications necessitate). Antibiotics have generally not been shown to be useful in the management of EHEC disease and indeed may be harmful. Use of antimotility drugs in escherichiosis may be associated with an adverse outcome. (author abstract)