Hemorrhagic Colitis Associated with a RareEscherichia coliSerotype

Abstract

We investigated two outbreaks of an unusual gastrointestinal illness that affected at least 47 people in Oregon and Michigan in February through March and May through June 1982. The illness was characterized by severe crampy abdominal pain, initially watery diarrhea followed by grossly bloody diarrhea, and little or no fever. It was associated with eating at restaurants belonging to the same fast-food restaurant chain in Oregon (P less than 0.005) and Michigan (P = 0.0005) and with eating any of three sandwiches containing three ingredients in common (beef patty, rehydrated onions, and pickles). Stool cultures did not yield previously recognized pathogens. However, a rare Escherichia coli serotype, O157:H7, that was not invasive or toxigenic by standard tests was isolated from 9 of 12 stools collected within four days of onset of illness in both outbreaks combined, and from a beef patty from a suspected lot of meat in Michigan. The only known previous isolation of this serotype was from a sporadic case of hemorrhagic colitis in 1975. This report describes a clinically distinctive gastrointestinal illness associated with E. coli O157:H7, apparently transmitted by undercooked meat.

Commensal and pathogenic Escherichia coli use a common pilus adherence factor for epithelial cell colonization

“…Enterohemorrhagic E. coli (EHEC) O157:H7 is a potentially fatal food-borne pathogen that can cause hemorrhagic colitis (9) and the hemolytic uremic syndrome (HUS) (10). Hallmarks of EHEC pathogenicity are the production of intestinal attaching and effacing (AE) lesions (11) and the secretion of potent Shiga toxins, which are responsible for the HUS (10).…”

High Prevalence of Enterohemorrhagic Escherichia coli (EHEC) O157 from Cattle in Selected Regions of Japan

“…Human hemorrhagic colitis and hemolytic uremic syndrome caused by enterohemorrhagic Escherichia coli (EHEC) is found in many countries of the world including Japan [10,13,17,20,21], and it is one of the most problematic infectious diseases at present. The major virulence factor of EHEC is the production of Shiga toxin (Stx), which can be subdivided into Stx1 and Stx2 [11].…”

From the Cover: Correlation of enterohemorrhagic Escherichia coli O157 prevalence in feces, hides, and carcasses of beef cattle during processing

“…Human infection and outbreaks from EHEC O157:H7 have been attributed to the consumption of undercooked beef food products as well as various other foods, such as unpasteurized apple cider (3)(4)(5). Since 1982, more than 100 outbreaks of EHEC O157 have been documented (6).…”