デンマーク疫病研究所(ssi.dk)の病原性大腸菌(VTEC)O104号感染の報告

デンマーク疫病研究所の病原性大腸菌(VTEC)O104号感染の報告
Statens Serum Institut
http://www.ssi.dk/
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E.coli outbreak in Germany
 Germany is currently suffering from an unusual outbreak of the bacterium E. coli O104 VTEC.
 A samall number of Danes are also infected, and SSI are monitoring the situation.

http://www.ssi.dk/Aktuelt/Temasider/Udbrud%20med%20Escherichia%20coli%20O104.aspx

English translation from Danes by Google
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Theme Page on outbreaks of Escherichia coli O104 VTEC Germany hit by an outbreak of severe diarrhea disease caused by the bacterium E. coli O104, which is transmitted through food. Denmark has reported a number of sick, almost all have been traveling in Germany. Authorities in Germany have appointed sprouts from a north German manufacturer as the source of infection
On the outbreak of E. coli O104 VTEC in Germany The German authorities have since mid-May registered an increased number of severe diarrhea cases and cases of kidney failure (hemolytic uremic syndrome, HUS). Disease burden is especially seen in northern Germany, caused by infection with a specific E. coli bacteria - verocytotoxin-producing E. coli VTEC O104 type.
The authorities in Germany on 10 June 2011 appointed sprouts from a North German manufacturer as the source of infection to the outbreak.
Food & Drug Administration has lifted the warning against eating raw German cucumber, tomato and leaf lettuce.
Number of cases in Denmark Denmark has also reported an increased number of patients with bloody diarrhea or kidney failure. Laboratory analysis has confirmed that this is the same E. coli bacteria that has hit the German patients.
Almost all Danish patients are infected in connection with travel in Germany. The same applies to patients from other countries where patients have been diagnosed with the bacterium.
At 17 June 2011 has identified the following number of cases in Denmark that meet case definition (see definition further down the page):
• 21 patients, nine with HUS
Investigations are still underway The authorities in Germany on 10 June 2011 appointed sprouts from a North German manufacturer as the source of infection to the outbreak.
The German authorities continue to carry out microbiological and epidemiological studies because of various circumstances surrounding the outbreak has not yet been elucidated. Among others it is still unclear how the sprouts have been contaminated.
Consult a doctor if severe diarrhea disease It is important that patients with severe diarrheal disease (especially bloody diarrhea) is seeking a doctor for proper diagnosis. One should pay special attention to cases of illness among persons in May have been in Germany or have eaten food brought home from Germany.
Monitoring and special diagnostics Statens Serum Institute carries out surveillance and specialized diagnostics for E. coli VTEC O104 outbreak.
Case-definition Cases in the outbreak, patients residing in Denmark, which after 15 April 2011 has:
• confirmed infection with VTEC that is stx2 positiv1 and eae-negative and travel to Germany2 • confirmed infection with VTEC O104 • clinical HOUSE AND travel to Germany2 • clinical HUS or bloody diarrhea and epidemiological contact with patients from one of the above three categories.
1) or possibly. in the same test positive for both stx1 and stx2. 2 or instead of traveling to Germany has some connection, eg if the patient has eaten food bought in Germany. Doctors must report cases of disease of VTEC and HUS The country's doctors must ensure that patients with bloody diarrhea or symptoms of kidney failure in the form of hemolytic uremic syndrome (HUS) immediately investigated for VTEC bacteria by submitting stool sample to a clinical microbiology department that performs PCR diagnostics for VTEC.
The recommendation also covers close contacts with relevant symptoms who have had contact with possible cases of illness.
Any information about travel to Germany and / or relevant exposure to foods should be reported by submission of sample.
Remember that cases of VTEC and HUS are individually notifiable diseases.
About kidney failure (HUS) and VTEC HUS is often caused by infection with a special diarrhea-causing E. coli bacteria: VTEC, also called EHEC or STEC. In Denmark, recorded about 150 cases a year of VTEC infections. The specific bacterium O104: H4, which has now hit Germany, are exceedingly rare.
Symptoms Symptoms of VTEC infection covers a spectrum from short-lived, bloodless diarrhea of ​​severe bloody diarrhea with severe abdominal pain to serious complications such as HUS (kidney failure) and death.
HUS is seen particularly in children, but, in the current outbreak, which involved mainly adult patients.
Incubation The incubation period for VTEC infection is usually 3-4 days but can range from 2-10 days. If patients develop HUS, the symptoms appear approximately one week after they have ingested the bacteria. The incubation time will typically depend on the amount of bacteria.
Where are the bacteria?
VTEC found in cattle and other ruminants, and are often the source of contamination of beef products, non-heat-treated dairy products or foods that are contaminated with cow manure. This may be about ready to eat vegetables, salad vegetables and berries. Contaminated drinking or bathing water, or direct contact with animals is also a possible source of infection. Finally, the bacteria infected by contact between people.
Infection Hygienic precautions for bacterial diarrhea, including VTEC Hospitals The care and treatment of patients with diarrhea, the general hygienic infection (procedure related) guidelines are complied with - ie. use of gloves and plastic apron at any risk of contact with organic material.
Hand hygiene is carried out in the form of hand washing followed by hand disinfection - as with all forms of infectious diarrhea. Patients who have poor understanding of interruption of transmission routes should be isolated with access to own toilet.
Diapers are disposed of as ordinary household waste packed in plastic bag. If the diaper leaks by compression, disposed of it however as healthcare risk waste.
Refer to the infection hygiene guidelines described in National Infection Hygiene Guidelines on investigation, treatment and care of patients with infectious diseases, including isolation, see the consultation version (pdf).
The cleaned with ordinary detergents. For larger spills stain disinfected (by wiping and cleaning) with recommended disinfectants, as described in the above guidelines.
In private homes Citizens who have diarrhea, we recommend taking the following precautions:
• to make washing hands after each toilet visit and before all meals • using hand soap in liquid form, possibly. magnet suspended soap • take into rings, watches and bracelets of hand washing • that each family has their own towel, and that these frequently changed • to observe good toilet hygiene, including cleaning with ordinary detergents • To clean the toilet, including toilet flush button daily and when visibly soiled. Wash hands after cleaning the toilet • to linens, towels, etc. that are contaminated with feces washed at least 80o C. About basin Board of Health has recommendations on hand washing and a video demonstrating sink.
Statens Serum Institut has also materials about hand hygiene - directed primarily against medical and nursing staff, see our interactive program need to know about hand hygiene.
Other information about hand hygiene:
• e-Bug - interactive program for school children • Food & Drug Administration - for food and homes • Council for Better Hygiene • WHO - campaign materials about hand hygiene (English) About Laundry Around the laundry, see Board of Health memo on "Counselling on laundry in private households"
Last edited 17th June 2011

News
A new Danish patients in the German outbreak of VTEC O104 infections
16-06-2011
There is 16 junwe reported another Dane infected with VTEC O104
http://www.ssi.dk/Aktuelt/Nyheder/2011/2011_06_VTEC-udbrud_160611.aspx

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A new Danish patients in the German outbreak of VTEC O104 infections
16th June 2011
There is 16 June reported another Dane infected with VTEC O104

There are at. 16th June reported a new case of infection with VTEC O104 in a Danish patient who has kidney failure (HUS).
The new patient has been in Germany in mid-May, but has only now been registered as cases.

The new cases are now a total of 21 well-known Danish patients who are part of the outbreak. Of these, nine have HUS.
These are ten women and 11 men aged 23 to 81 years.

All but one case infected in connection with travel in northern Germany.

The German authorities have announced that the source of the outbreak of assured sprouts from a producer in northern Germany.

See also SSI's homepage on the outbreak of E. coli O104 VTEC.
The German VTEC O104 outbreaks areresolved
10-06-2011
The german authorities report that the source of the extensive VTEC outbreak is considered to be the north German prodeced sprouts, d
http://www.ssi.dk/Aktuelt/Nyheder/2011/2011_06_VTEC-udbrud_100611.aspx
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The German VTEC O104 outbreaks are resolved
10th June 2011
The German authorities report that the source of the extensive VTEC outbreak is considered to be the north German produced sprouts that for several days has been under suspicion

Statens Serum Institut has been in close contact with the German Robert Koch Institute, which now estimates that the epidemiological evidence is so compelling that it can safely be said that it was the germ from a manufacturer in North Germany, which was the source of the outbreak with VTEC O104.

It is among others is clear that a number of restaurants, where several people had been infected, all had been supplied with sprouts from the producer.
This also applies to the restaurant in northern Germany, where eight Danish patients known to have been infected.

Germs were withdrawn from the German market for a little over a week ago and the number of German patients are now in decline.
Germs have not been for sale in Denmark.

There are no reports of additional Danish patients. The total number is still 20th

See also SSI's homepage on the outbreak of E. coli O104 VTEC