"International Outbreak of E. Coli Associated with Travel to Germany" is a great example of a paper on infections. Escherichia Coli (E. coli) is a bacterium that is normally seen in human colonic flora. However, invasion of the colon by pathogenic strains of E. coli like Enterohemorrhagic Escherichia Coli (EHEC) has become a public health concern for the last 3 decades. Amongst the enteropathogenic E. coli, EHEC is the dreadful one as it involves multiple organs through a powerful toxin known as verotoxin or Shiga like a toxin, resulting in hemorrhagic colitis and sometimes life-threatening condition of Hemolytic Uremic Syndrome (HUS). Every year outbreaks of EHEC are reported in different parts of the world but the one which Germany experienced in 2011 was the biggest the world has experienced after 1996.
According to World Health Organisation (WHO) sources, the outbreak was around 40 days affecting approximately 3000 people with 22 deaths. This epidemic of EHEC was the most intense, Europe has ever seen; recording the highest number of HUS cases. The outbreak which started in Hamburg, Northern Germany in May 2011 due to the consumption of raw foods, mainly sprouts; was transmitted globally. 13 other European countries have reported both EHEC and HUS cases, however, there was only one death reported and it was in Sweden.
Most of the patients confirmed to travel to the Northern parts of Germany. The 2011 outbreak of Germany has got epidemiological significance. The bacterial strain detected was E. coli – O104:H4 which is very rare, (O157:H7 was responsible for previous outbreaks) and has emerged as a virulent enteroaggregative pathotype of E. coli. The age and sex distribution pattern is seen in the 2011 outbreak showed a maximum number of patients between 20-49 years of age, which is atypical for EHEC.
Apart from those who traveled to Germany no incidence of cases in other parts of the world, confirming the source of infection seen only in Germany.
Harrison. Principles of internal medicine (17th ed, vol 1), (pp 938-941).
Rasko D.A., Webster D.R.,Sahl J.W.,Bashir A.,Boison N., Scheutz F......Waldor M. K., 2011.
Origin of the E coli strain causing an outbreak of hemolytic uremic syndrome
in Germany. New England Journal of Medicine; 365: 709-711.
European center for disease control and prevention rapid risk assessment, 27 May 2011
Outbreak of shiga toxin- producing E. Coli (SETC) in Germany.
World Health Organization, (December 2011.)
Enterohemorrhagic E.coli (EHEC); Fact sheet N0 125.
World Health Organisation - Europe, 10 June 2011
Public health review of the enterohemorrhagic Escherichia coli outbreak in