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Enterohemorrhagic Escherichia coli (EHEC)
2000 Case Definition
- Enterohemorrhagic Escherichia coli O157:
H7
- Enterohemorrhagic Escherichia coli shiga
toxinpositive (not serogrouped)
- Enterohemorrhagic Escherichia coli shiga
toxinpositive (serogroup non-O157)
Clinical description
An infection of variable severity characterized by
diarrhea (often bloody) and abdominal cramps. Illness may be complicated
by hemolytic uremic syndrome (HUS)
or thrombotic thrombocytopenic purpura (TTP); asymptomatic infections
also may occur.
Laboratory criteria for diagnosis
- Isolation of Escherichia coli O157:H7 from a specimen,
or
- Isolation of Shiga toxin-producing E. coli from
a clinical specimen*
Case classification
Suspect: A case of postdiarrheal
HUS or TTP (see HUS case definition)
Probable:
- A case with isolation of E. coli O157 from a clinical
specimen, pending confirmation of H7 or Shiga toxin production, or
- A clinically compatible case that is epidemiologically
linked to a confirmed or probable case, or
- Identification of Shiga toxin in a specimen from a clinically
compatible case, or
- Definitive evidence of an elevated antibody titer to a
known EHEC serotype from a clinically compatible case
Confirmed: A case that meets the laboratory criteria
for diagnosis.
Comment
Laboratory-confirmed isolates are reported via the Public
Health Laboratory Information System (PHLIS), which is managed by the Foodborne
and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases,
National Center for Infectious Diseases, CDC. Both probable and confirmed
cases are reported to the National Notifiable Diseases Surveillance System
(NNDSS), but only confirmed cases are reported to PHLIS. Confirmation is
based primarily on laboratory findings.
See also:
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