Characteristics of the enteroaggregative Shiga toxin/verotoxin-producing Escherichia coli O104:H4 strain causing the outbreak of haemolytic uraemic syndrome in Germany, May to June 2011

Euro Surveill. 2011 Jun 16;16(24):19889. doi: 10.2807/ese.16.24.19889-en.


The Escherichia coli strain causing a large outbreak of haemolytic uraemic syndrome and bloody diarrhoea in Germany in May and June 2011 possesses an unusual combination of pathogenic features typical of enteroaggregative E. coli together with the capacity to produce Shiga toxin. Through rapid national and international exchange of information and strains the known occurrence in humans was quickly assessed.We describe simple diagnostic screening tools to detect the outbreak strain in clinical specimens and a novel real-time PCR for its detection in foods.

MeSH terms

  • Disease Outbreaks*
  • Escherichia coli / genetics
  • Escherichia coli / isolation & purification*
  • Escherichia coli / pathogenicity
  • Escherichia coli Infections / diagnosis
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / genetics
  • Germany / epidemiology
  • Hemolytic-Uremic Syndrome / epidemiology*
  • Hemolytic-Uremic Syndrome / genetics
  • Hemolytic-Uremic Syndrome / microbiology*
  • Humans
  • Shiga Toxin / biosynthesis*
  • Shiga Toxin / isolation & purification
  • Shiga Toxin / poisoning*
  • World Health Organization


  • Shiga Toxin