北ドイツのハンブルグ野菜市場で発生した病原性大腸菌による感染の情報
出血性大腸菌に起因する溶血性尿毒症症候群
2011年06月03日金曜日13:29 曇り/雨? 最低気温;14ºc 最高気温;21ºC BARCELONA県から
2011年05月19日発表
北ドイツのハンブルグ野菜市場でのキュウリなどの病原性大腸菌による感染
ROBERT KOCH INSTITUT
http://www.rki.de/
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Accumulation of life-threatening, caused hemolytic-uremic syndrome caused by bacteria (HUS) 03/06/2011. The Robert Koch Institute, have been since early May, 520 HUS cases submitted, including 11 deaths (as of June 2, 2011, 15 clock, detailed account, see link below for information EHEC / HUS outbreak events, as of 6/3/2011, the next update is due to commence in the 06/06/2011). The HUS-Konsiliarlabor in Münster, which is headed by Prof. Dr. Helge Karch has, from a press release 2 June 2011 Information on EHEC / HUS outbreak strain published "reports that it constitutes at the current excitation to an entirely new type are not, rightly, says Karch" (see link below). The Federal Institute for Risk Assessment should "continue to present a precaution tomatoes, cucumbers and lettuce to eat non-raw. This guidance, aimed in particular in northern Germany sold goods have remained valid as long as the investigation of the outbreak last action "(Opinion No. 016/2011 of BfR of 31 May 2011, see link below).
Further information To EHEC / HUS outbreak Done Opinion No. 016/2011 of BfR of 31 May 2011 Prof. Karch Münster analyzed the results of genome sequencing of the current outbreak of EHEC strain Call to hospitals Call for participation in the surveillance of bloody diarrhea in emergency rooms Notes on epidemiology, diagnosis, prevention and therapy EHEC / HUS sides of the Robert Koch Institute Information from citizens and BfR BZgA Federal Institute for Risk Assessment (BfR): Current information on food safety, including with tips for consumers to protect against EHEC / HUS Federal Centre for Health Education (BZgA): citizens' information EHEC infections Stand: 06.03.2011 This Page:
ゴーグルによるドイツ語から、日本語への翻訳
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生命を脅かすの蓄積は、細菌（HUS）はに起因する溶血性尿毒症症候群の原因 2011年3月6日。ロベルトコッホ研究所は5月初め以来されている、520 HUSの例は、2011年6月3日の、次の更新は、11の死（2011年6月2日、15クロック、詳細なアカウントの時点で、情報が出血性大腸菌/ HUSの発生をイベントの下のリンクを参照してくださいなど、提出2011年6月6日に開始）のために。教授して、Helgeカルチを率いているミュンスターの尿毒症- Konsiliarlaborは、あるプレスリリース2出血性大腸菌/ HUSの発生を株に2011年6月の情報（下のリンクを参照してください）"ではない、当然、カルチの言うことは、全く新しいタイプの電流励起で構成することをレポート"を発行しました。リスク評価のための連邦工科大学は、"警戒トマト、キュウリ、非生で食べるとレタスを提示し続ける必要があります。ドイツ北部の特定の目的このガイダンスは、商品が（31 BfRはの意見書第016/2011 2011年5月、下のリンクを参照してください）"アウトブレーク最後のアクションの調査限り有効残っている売却した。
より詳細な情報 出血性大腸菌/ HUSのアウトブレーク完了するには 31のBfRはの意見書第016/2011 2011年5月 教授カルチミュンスターは、出血性株の現在の流行のゲノム配列決定の結果を分析 病院への呼び出し 緊急治療室で血性下痢の監視には参加募集 疫学、診断、予防および治療に関する注意事項 ロベルトコッホ研究所の出血性/ HUSの両側 情報市民やBfRはBZgAから リスク評価のための連邦工科大学（BfRは）：食品の安全性に関する最新情報など消費者のためのヒントは、出血性/ HUSのを防ぐために 健康教育のための連邦政府センター（BZgA）：市民情報出血性大腸菌感染症 スタンド：2011年6月3日
Since early May 2011 more people from bloody diarrhea and hemolytic-uremic known as Syndrome (HUS) are ill. The Robert Koch Institute, have been since early May, a total of 520 HUS cases submitted, including 11 deaths (as of June 2, 2011, 15 clock). Since early May 2011 the RKI was provided with 1213 cases of infection with EHEC. Six sent EHEC cases have died A total of 72% of HUS cases are from Schleswig-Holstein (143), Hamburg (97), North Rhine-Westphalia (82) and Lower Saxony (51). These are all states of the HUS outbreak affected.
In the HUS cases, the earliest onset of diarrhea was 1 May, the latest onset of diarrhea at 31 May Of 2 to 8 May was the case number from 0 to 2 cases per day. On 9 May rose to the number of cases in 6 cases, and increased since then continuously up to a maximum of 43 recent cases on 21 May The decrease in the number of entries after 22 May may be due to the detection and transmission delay not deemed to fall in the number of cases ..In the case of EHEC cases, the earliest onset of diarrhea was 1 May, the latest on 30 May From 1 to 11 May was the number of cases of EHEC infections 0-8 cases a day. Then the number of cases rose steadily until, at a maximum of 104 cases, 22nd May The decrease in the number of entries after 22 May may be due to the detection and transmission delay is not considered a decline in disease rates.
"The BfR recommends this stage, remain precaution tomatoes, cucumbers and lettuce to eat no raw. This guidance, aimed in particular in northern Germany sold goods have remained valid as long as the investigation of the outbreak last action "(Opinion No. 016/2011 of BfR of 31 May 2011). A show of Robert Koch Institute in cooperation with the Hamburg health authorities carried out epidemiological study that the current EHEC outbreak affected patients significantly more often raw tomatoes, cucumber and lettuce were eaten as a healthy study participants. It is not yet clear whether only want one or more of these three foods with the outbreak events in context (see text information about the study of 25 May 2011).
In the current events is one of the world's largest so far described outbreaks of EHEC or HUS and the largest outbreak in Germany, whereby in particular the age and gender distribution unusual. As before, especially adults, mostly women, are affected. At other times, mainly children develop this severe clinical picture: In 2010, for example, were the Robert Koch Institute, 65 HUS cases submitted, 6 were affected more than 18 years.
• In connection with current events are the RKI recommends:• The consumption recommendation of the Federal Institute for Risk Assessment (www.bfr.bund.de) should be considered. How far is that all persons with diarrhea should make sure that strict hand-hygiene is maintained, especially against persons and immunocompromised infants. The recommendations for good food hygiene, as described by the Federal Institute for Risk Assessment in its fact sheet for the prevention of EHEC infection (www.bfr.bund.de), remain valid.• persons with bloody diarrhea should immediately consult a doctor.• Physicians should strive for these patients EHEC detection (in the chair). EHEC infections can run without clinical symptoms or cause a watery diarrhea. A smaller proportion of EHEC infections developing as a severe form with cramping abdominal pain, bloody diarrhea. These patients should monitor their physicians with regard to the possible development of HUS closely and pay at the first signs of HUS to appropriate treatment centers. Symptoms of EHEC-associated HUS disease begin within a week after the onset of diarrhea. The period between infection and the first diarrheal symptoms is on average three to four days.• Laboratories should be diagnosed by detection of pathogens appropriate to send samples to the National Reference Center for Salmonella enteritis and others at the Robert Koch Institute (Wernigerode). Laboratories and physicians are required by the Infection Protection Act, both microbiologically documented EHEC infections, as well as the clinical picture of HUS (also already suspected disease) immediately to the local health department reported.Studies in the National Reference Center for Salmonella and other bacterial enteritis at the Robert Koch Institute, as well as the one with the Robert Koch Institute cooperating Konsiliarlaboratorium for hemolytic uremic syndrome (HUS) at the Institute of Hygiene, University of Münster (Prof. H. Karch) have shown that the currently circulating strain with characteristics of two different types of pathogenic Escherichia coli. In addition, specific resistance traits are present (http://www.rki.de/DE/Content/InfAZ/E/EHEC/EHEC__Diagnostik.html) Such recombination pathogenic properties and the inclusion of resistance genes is known in Eschcherichia coli.
Since 2 June 2011 are now available additional extensive information on the bacteria from genome sequencing of the current outbreak strain. They confirm the existence of these properties that are for the attachment of bacteria to the intestinal mucosa and, on the triggering of severe complications (HUS) made the other responsible. The HUS-Konsilarlabor in Munster writes in a press release of 2 June 2011: "Our studies were supported in order:. This is combined with the outbreak strain is a hybrid clone, the virulence of different pathogens," reports that constitutes it is the current excitation to an entirely new type, are not applicable, Karch stressed: "HUSEC041 (O104: H4) is the confirmed outbreak strain. We have collected in Münster results of H-antigen-encoding genes (flicH4) and the sequence type ST 678 on 26 May 2011, together with colleagues from the Robert Koch Institute and other scientists published (www.eurosurveillance.org). We now have our results in more than 60 HUS patient isolates confirmed. Strains that are not part of HUSEC041, they also occurred earlier. However, they are extremely rare worldwide, "
The National Reference Laboratory in Wernigerode identified in 247 patient samples to the outbreak strain (molecular confirmation of Virulenzprofils, serotyping, PFGE). The Konsiliarlabor for HUS in Münster has operated its results to more than 60 patient profiles. The Institute of Hygiene, Hamburg has typed more than 196 samples and strains as an outbreak strain.
The strain shows an increased resistance to cephalosporins of the 3rd Generation (ESBL), and a wide including multiple resistance to trimethoprim / sulphonamide, and tetracycline. However, this is not clinically significant as EHEC infections should not be treated with antibiotics. An anti-bacterial therapy may prolong the excretion of bacteria and stimulate the production of toxins lead.The Institute of Hygiene in the University of Muenster studied strains are also positive for stx2, eae-negative and classified according to sequence typing as O104.
The HUS is a severe and sometimes fatal complication that can occur with bacterial infections of the intestines called enterohemorrhagic Escherichia coli (EHEC). Each year, the Robert Koch Institute will be sent about 1,000 cases of EHEC. The full picture of HUS is characterized by acute renal failure, anemia by the disintegration of red blood cells and a lack of blood platelets. In 2010, the Robert Koch Institute were sent to two deaths.The HUS-causing EHEC, the bacteria are directly or indirectly from animals to humans. considered as reservoir ruminants, mainly cattle, sheep, goats. The transmission to humans by fecal-oral route, the excitation is collected by contact with animal feces, through contaminated food or water, but also by direct contact from person to person (contact infection).There is no evidence that any raw meat or raw milk, which are related to EHEC often identified as an intermediary foods, the cause of the current outbreak.
The next update of this outbreak information is for 6 June 2011 provided.
More information• www.rki.de> Infectious diseases AZ> EHECOn the subject ofFederal Institute for Risk AssessmentOpinion No. 016/2011 of BfR of 31 May 2011Preliminary results of the EHEC / HUS study 14/2011, 05/25/2011Current information and assistance to the RKI EHEC diagnostics (PDF, 99 KB)Stand: 06.03.2011
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