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Syndrome Caused by E. coli Mostly in Adults Women

A quarter of symptomatic cases in German outbreak involve the hemolytic-uremic syndrome

WEDNESDAY, June 22 (HealthDay News) -- A large, ongoing outbreak of the hemolytic-uremic syndrome caused by Shiga-toxin-producing Escherichia coli (E. coli) in Germany is occurring mostly in adults, primarily women, according to a study published online June 22 in the New England Journal of Medicine.

Christina Frank, Ph.D., of the University Medical Center Hamburg-Eppendorf in Germany, and colleagues analyzed data, as of June 18, 2011, from reports in Germany of Shiga-toxin-producing E. coli gastroenteritis and the hemolytic-uremic syndrome as well as clinical information on patients presenting to the medical center. They defined an outbreak case as a reported case of the hemolytic-uremic syndrome or gastroenteritis in someone infected by Shiga-toxin-producing E. coli, serogroup O104, with disease onset on or after May 1, 2011.

As of June 18, the investigators found that 3,222 outbreak cases, including 39 deaths, of which 810 involved the hemolytic-uremic syndrome, had been reported. The hemolytic-uremic syndrome occurred primarily in adults (89 percent) and women (68 percent). Among 59 patients infected with the outbreak strain who were followed at the medical center, the hemolytic-uremic syndrome developed in 12 patients (20 percent), with no significant differences in gender or initial symptoms. The investigators identified the outbreak strain as enteroaggregative Shiga-toxin-producing E. coli O104:H4, producing extended-spectrum beta-lactamase.

"In this large outbreak of the hemolytic-uremic syndrome, caused by an unusual strain of Shiga-toxin-producing E. coli, cases have occurred predominantly in adults, with a preponderance of cases occurring in women. The hemolytic-uremic syndrome has developed in a quarter of the symptomatic outbreak cases that have been ascertained thus far," the authors write.

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