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Volume 44, Number 5, October 2011

A new health threat in Europe: Shiga toxin–producing Escherichia coli O104:H4 infections

Chi-Jung Wu, Po-Ren Hsueh, Wen-Chien Ko

Received: July 4, 2010    Revised: July 13, 2010    Accepted: August 10, 2010   


Corresponding author:

Wen-Chien Ko, Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, Tainan, Taiwan
Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan


Background and purpose: 

Since early May 2011, a large outbreak of enterohemorrhagic gastroenteritis and hemolytic uremic syndrome (HUS) related to infections with Shiga toxin-producing Escherichia coli O104:H4 (STEC O104:H4) had been reported in Germany, which marks one of the largest outbreaks ever described of the HUS worldwide. The HUS outbreak was unusual, and there were important differences between this outbreak and previous large outbreaks, primarily those of STEC O157:H7 both clinically and microbiologically. This outbreak highlights the importance of collaboration of all aspects of public health to detect the outbreak, to identify and characterize the causative agent, to find the vehicles of transmission, and to control the infection.


Key words:

Escherichia coli O104:H4, Hemolytic uremic syndrome, Shiga toxin