E COLI EHEC - GERMANY: MULTIPLE SEROTYPES, EGYPT TRAVEL, HUS
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Date: Mon 17 Jul 2023
Source: Food Safety News [edited]
https://www.foodsafetynews.com/2023/07/germany-sounds-e-coli-and-hus-alert-after-travel-to-egypt/
German public health officials have warned of a spike in cases of _E. coli_ among travelers to Egypt. Experts from the Robert Koch Institut (RKI) said they had also seen a rise in connected cases of hemolytic uremic syndrome (HUS). HUS is a severe complication associated with certain _E. coli_ infections that causes kidney failure.
Since the beginning of 2023, 31 cases of _E. coli_ and 10 of HUS in people who were likely infected while on holiday in Egypt have been reported. A large proportion of patients - 12 _E. coli_ cases and 6 HUS cases - were recorded in May and June [2023]. They had stayed in different hotels, mainly in Hurghada, which is also the most frequent travel spot in the country. In 2019 there were a similar number of _E. coli_ and HUS cases linked to Egypt in the first half of the year but in all other recent years there were significantly fewer reports.
Of _E. coli_ cases in 2023, 13 are female and 18 male. The median age is 3 with a range from 3 months to 71 years old. Of HUS cases, 6 are female and 4 male with an age range of 1 to 30 years old. At least 5 _E. coli_ and all HUS cases were hospitalized but no one has died. The _E. coli_ serotype is known for 6 cases and there are 5 different types.
Investigations so far have not provided any indications of an outbreak through one source of infection or in a single hotel but pointed to more general food or water hygiene issues. Such hotels usually offer salad and buffet food making choices, such as only eating well-cooked items and fruit they have peeled themselves, harder for travelers. Where tap water is not designated as drinking water, public health officials say bottled water should be used.
RKI officials warned of an expectation of more cases and said when people come back from Egypt with diarrhea, stool samples should be tested for enterohemorrhagic _E. coli_ and attention should be paid to the symptoms of HUS, especially in young children.
Clinical laboratories were asked to send an isolate or a stool swab of diagnosed cases in people with a history of travel to Egypt to the National Reference Center for Salmonella and other bacterial pathogens at the RKI for typing. Isolates or stool samples from HUS cases can also be sent to the laboratory for HUS at the University Hospital Münster
