Escherichia coli 0157: H7 reservoir, transmission, diagnosis and the African situation: a review.

ABSTRACT

OBJECTIVES: To provide an overview of the current understanding of verotoxigenic Escherichia coli 0157H7 (VTEC) and to describe clinical picture, reservoir, transmission and diagnosis and African situations of VTEC. DATA SOURCE A literature review was performed of major published series between 1980 and 2001 inclusive, using the PUB MED and MEDLINE search. Some earlier published series were also reviewed in instances where they directly led to the understanding of current review. STUDY SELECTION Data from laboratory studies on cultural and isolation, serological and molecular techniques are summarised in this review. RESULTS: Verotoxigenic Escherichia coli 0157H7 (VTEC) is an important cause of uncomplicated diarrhoea, bloody diarrhoea (BD) and haemolytic uremic syndrome (HUS) in developed countries. The incidence and importance of 0157 H7 (VTEC) infections in most developing countries are not known; however, 0157 H7 (VTEC) cases have been isolated from many sporadic cases of diarrhoea, BD and HUS, while several cases have also been associated with diarrhoeal disease outbreaks in Africa. CONCLUSION: The morbidity and mortality associated with several recent outbreaks of VTEC disease have highlighted the threat these organisms pose to public health. For this reason, there is an increasing demand for improved diagnostic procedures for detection of VTEC in clinical specimen and in particular, in foods such as meat and dairy products in developing countries.