New Case Definition

Starting 8 June 2011, European Union (EU) Members States are reporting case according to a new case-definition.

Possible Epidemic Case: Any person who developed in or after 1 May 2011;

• STEC diarrhea defined as acute inset of diarrhea or bloody diarrhea AND at least one of the following criteria:

1. Isolation of an E coli strain that produces Shiga toxin 2 (Stv2) or stx2 gene.
2. Direct detection of stx2 gene nucleic acid in feces without strain isolation.

• STEC HUS defined as hemolytic uremic syndrome (HUS) defined as acute renal failure and at least one of the following clinical criteria

1. Microangiopatic hemolytic anemia
2. Thrombocytopenia

Probable Epidemic Case Any possible epidemic case of STEC diarrhea or STEC HUS AND during the exposure period of 14 days before the onset of illness, meeting at least one of the following epidemiological criteria:

• Stay in Germany or any other country where a confirmed case has probably acquired infection;
• Consumption of food product obtained from Germany;
• Close contact (e.g., in a household) with a confirmed epidemic case.

Confirmed Epidemic Case Any person meeting the criteria for a possible case, AND Isolation of a STEC strain of serotype O104:H4

OR isolation of a STEC strain of serotype O104 AND fulfilling epidemiological criteria for a probable case. EU Members States are reporting number of probable and confirmed cases and deaths.

 Epidemiological Alert: Haemolytic Uraemic Syndrome (HUS) and infection by Enterohaemorrhagic E. coli (EHEC) (Published on 8 June 2011)