Published Date: 2005-08-18 23:50:00
Subject: PRO/EDR> E. coli O157, tourists - UK (Scotland) ex Turkey
Archive Number: 20050818.2429
E. COLI O157, TOURISTS - UK (SCOTLAND) EX TURKEY
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Date: Thu, 18 Aug 2005
From: ProMED-mail <email@example.com>
Source: Eurosurveillance.org [edited]
E. coli O157 in Scottish tourists returning from Turkey, Jul-Aug 2005
A cluster of _E. coli_ O157 infections has been identified in tourists
returning to Scotland from Turkey. Since 25 Jul 2005, 10 confirmed and 5
suspected cases of _E. coli_ O157 infection have been reported to Health
Protection Scotland. 8 cases have been confirmed as phage type (PT) 8. 7 of
these 8 cases were PT8 with genes for verocytotoxins VT1 and VT2.
7 of the 15 tourists stayed in the resorts of Marmaris, Icmeler or Turunc
in the Mugla province in southwest Turkey, which are within 10 kilometres
of each other; 3 stayed in Perili, 40 km away, but then embarked on a
sailing cruise, destination unknown; 2 stayed in Dalaman, 50 km away; 2
stayed in Alanya, over 300km away; and 1 stayed in Gumbet, 80 km away.
Onset dates are between 15 Jul and 4 Aug 2005.
participants across Europe were alerted to these cases on 15 Aug 2005 and a
message was sent to health ministries across the European Union through the
Early Warning and Response System on 16 Aug 2005. The Federation of Tour
Operators in the United Kingdom (UK) has also been informed.
Swedish Enter-net participants have informed Enter-net of one case of _E.
coli_ O157 infection in a tourist who had stayed in Marmaris and whose
symptoms started on 8 Jul 2005. The isolate contained the eae gene and
produced VT1 and VT2. Other cases of this relatively common type of _E.
coli_ O157 infection have been identified in the UK, and are being
investigated to see if there is a link with travel. However, there is a
rise in reported _E. coli_ O157 infections in many European countries in
Previous clusters of E. coli O157 infections in returning travelers have
been reported in Europe , but in general, very little data are collected
on travel-acquired infections in returning tourists .
No known links between the cases have yet been identified. The Turkish
public health authorities have been alerted.
If any other European country identifies other cases that may be associated
with travel to Turkey, particularly southwest Turkey, please contact Bill
Reilly (<firstname.lastname@example.org>) at Health Protection Scotland, who
is collecting information for the UK.
1. Pebody RG, Furtado C, Rojas A, et al: An international outbreak of Vero
cytotoxin-producing Escherichia coli O157 infection amongst tourists; a
challenge for the European infectious disease surveillance network.
Epidemiol Infect 1999 Oct; 123:217-23.
2. Cartwright R: Gastrointestinal illnesses in tourists: whose
responsibility? Euro Surveill 2004; 9(3): 5
[Byline: Smith-Palmer A(<Alison.SmithPalmer@hps.scot.nhs.uk>, Locking M,
Reilly B, Fisher I]
[ProMED awaits more information regarding the source of this outbreak. -