Outbreak of haemolytic uraemic syndrome due to Shiga toxin-producing Escherichia coli O104:H4 among French tourists returning from Turkey, September 2011

N Jourdan-da Silva; M Watrin; F X Weill; L A King; M Gouali; A Mailles; D van Cauteren; M Bataille; S Guettier; C Castrale; P Henry; P Mariani; V Vaillant; H de Valk

doi:10.2807/ese.17.04.20065-en

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Outbreak of haemolytic uraemic syndrome due to Shiga toxin-producing Escherichia coli O104:H4 among French tourists returning from Turkey, September 2011
N Jourdan-da Silva¹ , M Watrin² , F X Weill³ , L A King¹ , M Gouali³ , A Mailles¹ , D van Cauteren¹ , M Bataille⁴ , S Guettier⁴ , C Castrale⁵ , P Henry⁵ , P Mariani⁶ , V Vaillant¹ , H de Valk¹
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Affiliations: ¹ French Institute for Public Health Surveillance (Institut de veille sanitaire), St Maurice, France ² Regional Office of the French Institute for Public Health Surveillance, Caen, France ³ Institut Pasteur, National Reference Centre for Escherichia coli and Shigella, Paris, France ⁴ University Hospital of Caen, Neurology department, Caen, France ⁵ University Hospital of Caen, Nephrology department, Caen, France ⁶ Laboratory associated to the National Reference Centre for Escherichia coli and Shigella, Robert Debré Hospital, Paris, France

Correspondence:
L King
l.king invs.sante.fr
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Citation style for this article: Jourdan-da Silva N, Watrin M, Weill F X, King L A, Gouali M, Mailles A, van Cauteren D, Bataille M, Guettier S, Castrale C, Henry P, Mariani P, Vaillant V, de Valk H. Outbreak of haemolytic uraemic syndrome due to Shiga toxin-producing Escherichia coli O104:H4 among French tourists returning from Turkey, September 2011. Euro Surveill. 2012;17(4):pii=20065. https://doi.org/10.2807/ese.17.04.20065-en Received: 06 Jan 2012

Abstract

Eight cases of diarrhoea, including two cases of haemolytic uraemic syndrome (HUS), were identified among 22 French tourists who travelled to Turkey in September 2011. A strain of Escherichia coli O104:H4 stx2-positive, eae-negative, hlyA-negative, aggR-positive, ESBL-negative was isolated from one HUS case. Molecular analyses show this strain to be genetically similar but not indistinguishable from the E. coli O104:H4 2011 outbreak strain of France and Germany. Although the source of infection was not identified, we conclude that the HUS cases had probably been infected in Turkey.