Enterohemorrhagic Escherichia coli O26 infection in City A in the eastern part of Ehime Prefecture in Japan

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  • 愛媛県東部地域の A 市に発生した腸管出血性大腸菌 O26 感染事例
  • エヒメケン トウブ チイキ ノ Aシ ニ ハッセイシタ チョウカン シュッケツセイ ダイチョウキン O26 カンセン ジレイ

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Abstract

Purpose An enterohemorrhagic Escherichia coli O26 infection (EHEC O26) infection occurring in A City in the eastern part of Ehime Prefecture in Japan was analyzed, and future directions for measures against EHEC infectious diseases in public health centers were studied.<br/>Method In response to a report of EHEC O26 verotoxin type I positivity (O26VT1) from a pediatric doctor of A City in a seven-years old girl on August 20th, 2005, the local public health center at once investigated the responsible meal with the patient's mother. To investigate the infection source, pulse field gel electrophoresis (PFGE) thaws applied with stool samples of the patient and other individuals.<br/>Results It was established that 14 people in three families (A, B, and C) had a meal together with roasted meat on August 15th, the beef for roasting having been bought in C Town that was adjacent to B City in the central part of Ehime Prefecture. Within three days of sharing this meal diarrhea and bloody stool appeared in a girl aged seven years and a boy aged three years in family X, and loose stool appeared in a boy aged seven years of family Y. In all cases O26VT1 was detected. In addition the mother of family Y and a girl aged four years of family Z were found to have O26VT1 detectable as asymptomatic pathogenic reservoirs. The genetic background of the bacteria was analyzed, and all the patterns agreed. To the same O26VT1 was also evident in another mother and daughter who suffered many episodes of diarrhea after eating roast beef on August 10th in a restaurant in B City.<br/>Conclusions It was concluded that secondary infection had occurred from an asymptomatic pathogenic reservoir. From this case, positive epidemiological investigations with wide-ranging stool tests at an early stage are necessary as measures to control O26VT1 infectious disease. Moreover, because confirmation of the same infection source is difficult in a diffuse outbreak, gene analysis of the pathogen by PFGE should be conducted.

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