I look forward to Thursdays because a new issue of Eurosurveillance appears and they always have outbreak summaries of interest.

French health-types report eight cases of diarrhea, including two cases of hemolytic uremic syndrome (HUS), 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, the authors concluded the HUS cases had probably been infected in Turkey but there was no evidence to link this STEC O104:H4 outbreak to the consumption of fenugreek sprouts, as was the case for the German and French outbreaks in May to June 2011. None of the 22 travel group members reported the consumption of sprouts before and during their trip to Turkey.

Except that over there, sprouts are added to everything, more so than a Jimmy John’s sandwich.

Turkey is among several destinations where European tourists had previously travelled before developing STEC O104 infection between 2004 and 2009 (n=4), along with Afghanistan, Egypt and Tunisia. This outbreak supports data suggesting that the STEC serogroup O104 circulates in these areas. Further evidence is provided by the three additional cases that were subsequently identified in Germany and Denmark among persons also returning from Turkey within the same approximate time frame. Public health authorities and clinicians should be vigilant for possible STEC O104 infection in individuals returning from these areas who present with post-diarrheal HUS.

The complete paper is available at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20065.

Outbreak of haemolytic uraemic syndrome due to Shiga toxin-producing Escherichia coli O104:H4 among tourists returning from Turkey, September 2011
26.jan.12
Eurosurveillance, Volume 17, Issue 4
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