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EHEC
By Marie and Alicia
What is it?
E. coli is a bacterium that is found in the
intestine of humans
 EHEC = enterohaemorrhagic escherichia
coli
 strain of E. coli
 Type : O104:H4
 first recognized in 1982
 in Germany 2011

Sources
• reservoir of bacterium in ruminants ( e.g
cattle or camels)
• contaminated food like raw or uncooked meat
• person-to-person contact: oral-faecal route
(asymptomatic carriers)
• contaminated water (can survive for months)
• in this case probably contaminated vegetables
which got in contact with faeces of infected
animals
Pathogenesis
•
•
•
•
Incubation period: 3-8 days; infectious
dose may be only 10 bacteria
in the intestines bacteria attach to the villi
and produce Shiga-like toxins
toxins block protein synthesis and induces
cell death
also enter blood vessels and attach to
their walls causing the breakdown of RBCs
and platelets
HUS
hemolytic-uremic syndrome
 closely associated with EHEC and other
GIT-infections
 10-20% of patients with EHEC infections
develop this syndrome
 mortality rate with intensive care is 3-5%
 affects especially people with less distinct
immune system

Symptoms
fever
 nausea/ vomitting
 weakness
 abdominal pain

patients with HUS:
 diarrhea (progresses to bloody diarrhea)
 abdominal cramps
Clinical findings
small blood clots
 internal bleeding
 anemia and thrombocytopenia
 dyspnea (breathing difficulties)
 inflammation of the pancreas
 kidney failure
 anuria
 neurological disorders

Treatment

EHEC
– most victims recover
within 10 days
– bacterium is killed at
70°C
– no antibiotics
stimulate toxin
production
– hygiene

HUS
– intensive care
– transfusion of RBC and
platelets
– dialysis
– medication like
corticosteroids
EHEC in Germany
EHEC infections occur worldwide
 in Germany about 1000 every year,
usually affecting small children
 big outbreak in summer 2011 from may to
july

4335 EHEC infected people, 855 HUS
infected people 2987 people with acute
gastroenteritis, 48 deaths
 68% of patients were females and most
affected people were adults
 fenugreek seeds were identified as source
for the infection
 after the distribution was ceased, there
were no new infections associated with
the vehicle

Consequences

Affected people:
– dialysis throughout life
– need of donor organs

Economy:
– farmers lost income
– European Commission covered the loss by
paying 226 million € to the agricultural market
– another 12 million € for the study of the
pathogen


References:
– http://www.spiegel.de/thema/ehec/
– http://www.who.int/mediacentre/factsheets/fs125/en/
– http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001539/
– http://www.rki.de/DE/Content/InfAZ/E/EHEC/EHEC.html
Pictures:
– http://mhstatic.de/fm/1/thumbnails/SH_ehec_Bakterien_800.jpg.
2721709.jpg
– http://healthmap.org/en/
– http://www.google.de/imgres?imgurl=http://www.lgl.bayern.de/
gesundheit/pic/ehec_faelle_bayern_250711.gif&imgrefurl=http:/
/www.lgl.bayern.de/gesundheit/ehec.htm&usg