Published Date: 2005-08-04 23:50:00
Subject: PRO/AH/EDR> E. coli O157, water contamination - Switzerland (Black Forest)
Archive Number: 20050804.2269
E. COLI O157, WATER CONTAMINATION - SWITZERLAND (BLACK FOREST)
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Date: Wed 27 Jul 2005
From: Thomas Roesel <Thomas.Roesel@na.amedd.army.mil>
Source: BAG.admin.ch [translated by submitter, edited]
<http://www.bag.admin.ch/infekt/publ/wissenschaft/d/diarrhoe_05.pdf>
Epi-Notice: Bloody diarrhea and hemolytic uremic syndrome in Freiburg
-----------------------------------------------
On 12 Jul 2005, doctors from Inselspital in Bern reported to the
Federal Department of Health 2 cases of hemolytic uremic syndrome
(HUS) in children who were hospitalized within 24 hours of each other
in the same area in Freiburg.
An investigation ensued, involving the health authorities in the
canton of Freiburg, which revealed 5 further cases of bloody diarrhea
without HUS as well as other cases of "typical" gastroenteritis that
occurred. These cases came from 4 of the 5 villages in the area.
Fecal contamination of the area's drinking water supply was the
presumed cause for these cases. Infection could have been related to
bathing in springs or streams in the region. The large number of cows
found in valley fields, together with heavy rainfall during early
June 2005, may explain the contamination of the natural springs as
well as the drinking water supply and the feeder streams. No other
consumable was identified that could have caused an infection.
Analyses of samples taken from the 1st 4 patients, performed at the
National Center for Enteropathic Bacteria Reference Laboratory, led
to the isolation of large amounts of enterohemorrhagic _E. coli_
O157. Traces of verotoxin were demonstrated in water samples taken
from the area's water supply.
As soon as the fecal contamination of the water supply became known,
the cantonal health authorities, working together with area
officials, ordered countermeasures. In one of the villages, the
residents were urgently advised not to consume water that was not
first boiled.
--
Dr. Thomas R. Roesel
Walter Reed Army Medical Center
Washington, DC
<Thomas.Roesel@na.amedd.army.mil>
[ProMED thanks Dr. Roesel for this posting and translation.
Water supply and swimming areas are not commonly reported sources of
verotoxin-producing _E. coli_. As here, heavy rains over cow pastures
can wash the toxin- producing _E. coli_ into the potable or swimming
water.
It should be noted again that a recent (6 Jun 2005) article in the
journal Pediatrics reported that early recognition of infection with
_E. coli_ O157:H7, with the use of intravenous plasma expansion with
fluids, could lower the risk of developing hemolytic uremic syndrome:
Ake JA, Jelacic S, Ciol MA, et al: Relative nephroprotection during
_Escherichia coli_ O157:H7 infections: association with intravenous
volume expansion. Pediatrics 2005; 115:673-80. - Mod.LL]
See Also
E. coli O157, lake swimming - USA (MN) 20050712.1983E. coli O157, religious camp - USA (OR)(02) 20050602.1540
E. coli O157, religious camp - USA (OR) 20050531.1504
2004
----
E. coli O157, swimming pool - UK (England)(02) 20040927.2666
E. coli O157, swimming pool - UK (England) 20040920.2602
E. coli O157, water - UK (England) 20040908.2503
2003
----
E. coli O157, secondary water - USA (Utah) 20030810.1976
1999
----
E. coli, toxigenic, waterborne - USA (Washington)(02) 19990907.1560
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