A Multistate Outbreak of Shiga Toxin-Producing Escherichia Coli O26:H11 Infections in Germany, Detected by Molecular Subtyping Surveillance

J Infect Dis. 2002 Aug 1;186(3):419-22. doi: 10.1086/341457. Epub 2002 Jul 11.


In the spring of 2000, a cluster of indistinguishable Shiga toxin-producing Escherichia coli (STEC) O26:H11 was identified in Germany by molecular subtyping surveillance. An investigation was prompted to identify a common source of exposure. A case subject was defined as a person having a polymerase chain reaction-confirmed STEC O26 infection between March and April 2000, irrespective of clinical signs, and whose isolate was indistinguishable from the index strain by use of pulsed-field gel electrophoresis. Eleven case subjects were found in 5 institutions that were supplied by 4 kitchens located in 3 states. The median age was 2 years (range, 2-31 years). No bloody diarrhea was reported, and 5 persons remained asymptomatic. Comparison of invoices revealed a certain type of beef ("Seemerrolle") as possible source of infection. This is, to our knowledge, the first multistate outbreak associated with a non-O157 STEC detected by laboratory-based surveillance. Molecular subtyping was pivotal, as disease occurrence was sporadic or family-related.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Cattle
  • Child
  • Child Day Care Centers
  • Child, Preschool
  • DNA, Bacterial / chemistry
  • DNA, Bacterial / genetics
  • Disease Outbreaks*
  • Escherichia coli / classification
  • Escherichia coli / genetics
  • Escherichia coli / metabolism*
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / metabolism
  • Escherichia coli Infections / pathology
  • Feces / microbiology
  • Female
  • Foodborne Diseases / metabolism*
  • Foodborne Diseases / microbiology
  • Foodborne Diseases / pathology
  • Germany / epidemiology
  • Humans
  • Male
  • Meat / microbiology
  • O Antigens / genetics
  • O Antigens / metabolism
  • Polymerase Chain Reaction
  • Shiga Toxins / genetics
  • Shiga Toxins / metabolism*


  • DNA, Bacterial
  • O Antigens
  • Shiga Toxins