Possible person-to-person transmission of Escherichia coli O111--associated hemolytic uremic syndrome

Pediatr Nephrol. 1997 Feb;11(1):36-9. doi: 10.1007/s004670050229.


Over a 3-month period, ten children (aged 1-13 years) from a 15-km radius in southern Picardy developed typical D+ hemolytic uremic syndrome (HUS). Polymerase chain reaction, using two pairs of verocytotoxin 1-(VT1) and VT2-specific oligonucleotide primers and an internal control was used to detect VT genes directly from stools samples. VT2 gene was detected in seven of nine patients' stools and in 5 of 14 contacts' stool samples. A VT2-producing Escherichia coli (VTEC) O111 was isolated from five of nine children's stools and in 3 adults' stools of the 14 tested. A retrospective case-control study was performed which showed a higher rate of absence in school A, where the first four cases were detected, compared with a control school. The odds ratio for the whole school was 2.77 (confidence interval 1.46-5.26), and 15 (confidence interval 2.54-115.6) if only the nursery classes were considered. A culture of all food samples from households was always negative for VTEC. A retrospective cohort study performed in 89% of children attending school A showed no linkage between food or drink and gastroenteritis. These findings emphasize the potential for person-to-person transmission of VT2-producing E. coli O111, since the only salient risk factor was close contact.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cohort Studies
  • Diet
  • Disease Transmission, Infectious*
  • Escherichia coli / genetics
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / microbiology
  • Escherichia coli Infections / transmission*
  • Feces / microbiology
  • Female
  • France / epidemiology
  • Hemolytic-Uremic Syndrome / epidemiology
  • Hemolytic-Uremic Syndrome / etiology*
  • Hemolytic-Uremic Syndrome / microbiology
  • Humans
  • Infant
  • Male
  • Polymerase Chain Reaction
  • Retrospective Studies