1. Epidemiological analysis of a large enterohaemorrhagic Escherichia coli O111 outbreak in Japan associated with haemolytic uraemic syndrome and acute encephalopathy
- Author
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Yuichiro Yahata, Tetsutaro Sata, Makoto Ohnishi, M Nagira, Masanori Watahiki, Koki Taniguchi, Y Ishida, Nobuhiko Okabe, E. coli O Outbreak Investigation Team, Jiro Mitobe, Junko Isobe, Yuki Tada, Jun Terajima, Sunao Iyoda, and Takako Misaki
- Subjects
Adult ,Male ,medicine.medical_specialty ,Meat ,Adolescent ,Enterohaemorrhagic Escherichia coli ,Epidemiology ,Acute encephalopathy ,Escherichia coli O157 ,Disease Outbreaks ,Foodborne Diseases ,Japan ,Risk Factors ,Internal medicine ,medicine ,Humans ,Child ,Escherichia coli Infections ,Brain Diseases ,business.industry ,Raw beef ,Infant ,Outbreak ,Odds ratio ,Middle Aged ,Original Papers ,Virology ,Confidence interval ,Electrophoresis, Gel, Pulsed-Field ,Infectious Diseases ,Case-Control Studies ,Child, Preschool ,Enterohemorrhagic Escherichia coli ,Acute Disease ,Hemolytic-Uremic Syndrome ,Food Microbiology ,Female ,Haemolytic-uraemic syndrome ,business - Abstract
SUMMARYA large outbreak of enterohaemorrhagic Escherichia coli (EHEC) O111 and O157 occurred in Japan in April 2011. We conducted an unmatched case-control study and trace-back investigation to determine the source of EHEC O111 infection and risk factors for severe complications. Pulsed-field gel electrophoresis was performed to help define cases. A total of 86 individuals met the case definition. Of these, 40% experienced haemolytic uraemic syndrome (HUS), 24% acute encephalopathy, and 6% died. Illness was significantly associated with eating the raw beef dish yukhoe (odds ratio 19·64, 95% confidence interval 7·03–54·83), the likely food vehicle. EHEC O111 and its closely related stx-negative variants were found in the beef. HUS occurred most frequently in individuals aged 5–9 years, and this age group was significantly associated with acute encephalopathy. The prevalence of HUS and acute encephalopathy was higher than in previous non-O157-related outbreaks, indicating a high risk of severe complications.
- Published
- 2015
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