ANNEX IIU.K.

3. CASE DEFINITIONS OF COMMUNICABLE DISEASES U.K.

3.40.SHIGA TOXIN/VEROCYTOTOXIN-PRODUCING E. COLI INFECTION (STEC/VTEC), INCLUDING HAEMOLYTIC-URAEMIC SYNDROME (HUS)U.K.

Clinical Criteria U.K.
STEC/VTEC diarrhoea U.K.

Any person with at least one of the following two:

  • Diarrhoea

  • Abdominal pain

HUS U.K.

Any person with acute renal failure and at least one of the following two:

  • Microangiopatic haemolytic anaemia

  • Thrombocytopenia

Laboratory Criteria U.K.

At least one of the following four:

  • Isolation/cultivation of Escherichia coli that produces Shiga toxin/verocytotoxin or harbours stx1/vtx1 or stx2/vtx2 gene(s)

  • Isolation of non-sorbitol-fermenting (NSF) Escherichia coli O157 (without testing for the toxin or toxin-producing genes)

  • Direct detection of stx1/vtx1 or stx2/vtx2 gene(s) nucleic acid

  • Direct detection of free Shiga toxin/verocytotoxin in faeces

Only for HUS the following can be used as a laboratory criterion to confirm STEC/VTEC:

  • Escherichia coli serogroup-specific (LPS) antibody response

Epidemiological Criteria U.K.

At least one of the following five epidemiological links:

  • Human to human transmission

  • Exposure to a common source

  • Animal to human transmission

  • Exposure to contaminated food/drinking water

  • Environmental exposure

Case Classification U.K.
A.

Possible case of STEC-associated HUS

Any person meeting the clinical criteria for HUS

B.

Probable case of STEC/VTEC

Any person meeting the clinical criteria with an epidemiological link

C.

Confirmed case of STEC/VTEC

Any person meeting the clinical and the laboratory criteria

Note: If the national surveillance system is not capturing clinical symptoms, all laboratory-confirmed individuals should be reported as confirmed cases.U.K.