Korean J Med.  2006 May;70(5):495-504.

An outbreak of inapparent non-O157 enterohemorrhagic escherichia coli infection

Affiliations
  • 1Department of Public and health hygiene, Gwangju metropolitan city, Gwangju, Korea.
  • 2Department of Microbiology, Gwangju city Health and Environment Research Institute, Gwangju metropolitan city, Gwangju Korea. skin6690@hanmail.net
  • 3Division of Epidemic Intelligence Service, Korea Center for Disease Control and Prevention, Seoul, Korea.
  • 4Division of Enteric infections, Department of Bacteriology, Korea Center for Disease Control and Prevention, Seoul, Korea.

Abstract

BACKGROUND: No outbreak of Enterohemorrhagic Escherichia coli (EHEC) infection has occurred as a group in Korea. On July 2004, an outbreak of EHEC infection occurred in an elementary school in Gwangju metropolitan city. Epidemic investigation was undertaken to track the source of infection and the mode of transmission of EHEC.
METHODS
All students and staffs of the elementary school were interviewed and completed questionnaires. We surveyed their clinical symptoms and the foods that they ate. Microbiologic examinations were also carried out on the above school-related persons and many environmental specimens. We also investigated the facilities of the school, some suppliers of food materials, and other associated institutions. All the EHEC-positive persons were isolated in 5 hospitals and tested everyday for verotoxin until they turned out to be negative twice in succession, and their family were also interviewed and tested for EHEC. Pulsed-field gel electrophoresis (PFGE) was performed to find out the genetic relationship between isolates.
RESULTS
Of the 1,643 school-related persons, 77 persons (4.7%) were positive for EHEC. Most of them were asymptomatic. All the isolated strains were non-O157 EHEC. Serotype O91 was the most frequent serotype (68 isolates), and the isolates revealing O91 serotypes showed identical PFGE patterns. The school meal was significantly associated with this outbreak (relative risk=13.29, p=0.00).
CONCLUSIONS
This is the first EHEC outbreak occurred as a group in Korea, All the isolated strains were non-O157 serotypes and the mode of transmission was most likely by school meal.

Keyword

Enterohemorrhagic E coli; Verotoxin; Asymtomatic; Outbreak

MeSH Terms

Electrophoresis, Gel, Pulsed-Field
Enterohemorrhagic Escherichia coli*
Gwangju
Humans
Korea
Meals
Shiga Toxins
Surveys and Questionnaires
Shiga Toxins
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