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Escherichia coli O157:H7

February 15, 2024

Escherichia coli O157:H7 is a serotype of the bacterial species Escherichia coli and is one of the Shiga-like toxin–producing types of E. coli. It is a cause of disease, typically foodborne illness, through consumption of contaminated and raw food, including raw milk and undercooked ground beef.[1][2] Infection with this type of pathogenic bacteria may lead to hemorrhagic diarrhea, and to kidney failure; these have been reported to cause the deaths of children younger than five years of age, of elderly patients, and of patients whose immune systems are otherwise compromised.

Escherichia coli O157:H7
Topographical images of colonies of E. coli O157:H7 strains (A) 43895OW (curli non-producing) and (B) 43895OR (curli producing) grown on agar for 48 h at 28°C
SpecialtyInfectious disease

Transmission is via the fecal–oral route, and most illness has been through distribution of contaminated raw leaf green vegetables, undercooked meat and raw milk.[3]

Signs and symptoms edit

E. coli O157:H7 infection often causes severe, acute hemorrhagic diarrhea (although nonhemorrhagic diarrhea is also possible) and abdominal cramps. Usually little or no fever is present, and the illness resolves in 5 to 10 days.[4] It can also sometimes be asymptomatic.[5]

In some people, particularly children under five years of age, persons whose immunologies are otherwise compromised, and the elderly, the infection can cause hemolytic–uremic syndrome (HUS), in which the red blood cells are destroyed and the kidneys fail. About 2–7% of infections lead to this complication. In the United States, HUS is the principal cause of acute kidney failure in children, and most cases of HUS are caused by E. coli O157:H7.[citation needed]

Bacteriology edit

 
E. coli O157:H7

Like the other strains of the E. coli, O157:H7 is gram-negative and oxidase-negative. Unlike many other strains, it does not ferment sorbitol, which provides a basis for clinical laboratory differentiation of the strain. Strains of E. coli that express Shiga and Shiga-like toxins gained that ability via infection with a prophage containing the structural gene coding for the toxin, and nonproducing strains may become infected and produce shiga-like toxins after incubation with shiga toxin positive strains. The prophage responsible seems to have infected the strain's ancestors fairly recently, as viral particles have been observed to replicate in the host if it is stressed in some way (e.g. antibiotics).[6][7]

All clinical isolates of E. coli O157:H7 possess the plasmid pO157.[8] The periplasmic catalase is encoded on pO157 and may enhance the virulence of the bacterium by providing additional oxidative protection when infecting the host.[9] E. coli O157:H7 non-hemorrhagic strains are converted to hemorrhagic strains by lysogenic conversion after bacteriophage infection of non-hemorrhagic cells.[citation needed]

Natural habitat edit

While it is relatively uncommon, the E. coli serotype O157:H7 can naturally be found in the intestinal contents of some cattle, goats, and even sheep.[citation needed] The digestive tract of cattle lack the Shiga toxin receptor globotriaosylceramide, and thus, these can be asymptomatic carriers of the bacterium.[10] The prevalence of E. coli O157:H7 in North American feedlot cattle herds ranges from 0 to 60%.[11] Some cattle may also be so-called "super-shedders" of the bacterium. Super-shedders may be defined as cattle exhibiting rectoanal junction colonization and excreting >103 to 4 CFU g−1 feces. Super-shedders have been found to constitute a small proportion of the cattle in a feedlot (<10%) but they may account for >90% of all E. coli O157:H7 excreted.[12]

Transmission edit

Infection with E. coli O157:H7 can come from ingestion of contaminated food or water, or oral contact with contaminated surfaces. Examples of this can be undercooked ground beef but also leafy vegetables and raw milk. Fields often get contaminated with the bacterium through irrigation processes or contaminated water naturally entering the soil.[13] It is highly virulent, with a low infectious dose: an inoculation of fewer than 10 to 100 colony-forming units (CFU) of E. coli O157:H7 is sufficient to cause infection, compared to over a million CFU for other pathogenic E. coli strains.[14]

Diagnosis edit

A stool culture can detect the bacterium. The sample is cultured on sorbitol-MacConkey (SMAC) agar, or the variant cefixime potassium tellurite sorbitol-MacConkey agar (CT-SMAC[15]). On SMAC agar, O157:H7 colonies appear clear due to their inability to ferment sorbitol, while the colonies of the usual sorbitol-fermenting serotypes of E. coli appear red. Sorbitol non-fermenting colonies are tested for the somatic O157 antigen before being confirmed as E. coli O157:H7. Like all cultures, diagnosis is time-consuming with this method; swifter diagnosis is possible using quick E. coli DNA extraction method[16] plus polymerase chain reaction techniques. Newer technologies using fluorescent and antibody detection are also under development.[citation needed]

Prevention edit

Avoiding the consumption of, or contact with, unpasteurized dairy products, undercooked beef, uncleaned vegetables, and non disinfected water reduces the risk of an E. coli infection. Proper hand washing with water that has been treated with adequate levels of chlorine or other effective disinfectants after using the lavatory or changing a diaper, especially among children or those with diarrhea, reduces the risk of transmission.[17][18]

Surveillance edit

E. coli O157:H7 infection is a nationally reportable disease in the US, Great Britain, and Germany. It is also reportable in most states of Australia including Queensland.[19]

Treatment edit

While fluid replacement and blood pressure support may be necessary to prevent death from dehydration, most patients recover without treatment in 5–10 days. There is no evidence that antibiotics improve the course of disease, and treatment with antibiotics may precipitate hemolytic–uremic syndrome (HUS).[20] The antibiotics are thought to trigger prophage induction, and the prophages released by the dying bacteria infect other susceptible bacteria, converting them into toxin-producing forms. Antidiarrheal agents, such as loperamide (imodium), should also be avoided as they may prolong the duration of the infection.[citation needed]

Certain novel treatment strategies, such as the use of anti-induction strategies to prevent toxin production[21] and the use of anti-Shiga toxin antibodies,[22] have also been proposed.

History edit

United States edit

The United States Department of Agriculture banned the sale of ground beef contaminated with the O157:H7 strain in 1994.[23]

Culture and society edit

Costs edit

The pathogen results in an estimated 2,100 hospitalizations annually in the United States. The illness is often misdiagnosed; therefore, expensive and invasive diagnostic procedures may be performed. Patients who develop HUS often require prolonged hospitalization, dialysis, and long-term followup.[24]

See also edit

References edit

  1. ^ Gally DL, Stevens MP (January 2017). "Microbe Profile: Escherichia coli O157:H7 - notorious relative of the microbiologist's workhorse" (PDF). Microbiology. 163 (1): 1–3. doi:10.1099/mic.0.000387. PMID 28218576.
  2. ^ Karch H, Tarr PI, Bielaszewska M (October 2005). "Enterohaemorrhagic Escherichia coli in human medicine". International Journal of Medical Microbiology. 295 (6–7): 405–18. doi:10.1016/j.ijmm.2005.06.009. PMID 16238016.
  3. ^ "Reports of Selected E. coli Outbreak Investigations". CDC.gov. 2019-11-22.
  4. ^ Ciccarelli S, Stolfi I, Caramia G (October 2013). "Management strategies in the treatment of neonatal and pediatric gastroenteritis". Infection and Drug Resistance. 6: 133–61. doi:10.2147/IDR.S12718. PMC 3815002. PMID 24194646.
  5. ^ Roos V, Ulett GC, Schembri MA, Klemm P (January 2006). "The asymptomatic bacteriuria Escherichia coli strain 83972 outcompetes uropathogenic E. coli strains in human urine". Infection and Immunity. 74 (1): 615–24. doi:10.1128/IAI.74.1.615-624.2006. PMC 1346649. PMID 16369018.
  6. ^ O'Brien AD, Newland JW, Miller SF, Holmes RK, Smith HW, Formal SB (November 1984). "Shiga-like toxin-converting phages from Escherichia coli strains that cause hemorrhagic colitis or infantile diarrhea". Science. 226 (4675): 694–96. Bibcode:1984Sci...226..694O. doi:10.1126/science.6387911. PMID 6387911.
  7. ^ Strockbine NA, Marques LR, Newland JW, Smith HW, Holmes RK, O'Brien AD (July 1986). "Two toxin-converting phages from Escherichia coli O157:H7 strain 933 encode antigenically distinct toxins with similar biologic activities". Infection and Immunity. 53 (1): 135–40. doi:10.1128/IAI.53.1.135-140.1986. PMC 260087. PMID 3522426.
  8. ^ Lim JY, Yoon J, Hovde CJ (January 2010). "A brief overview of Escherichia coli O157:H7 and its plasmid O157". Journal of Microbiology and Biotechnology. 20 (1): 5–14. doi:10.4014/jmb.0908.08007. PMC 3645889. PMID 20134227.
  9. ^ Brunder W, Schmidt H, Karch H (November 1996). "KatP, a novel catalase-peroxidase encoded by the large plasmid of enterohaemorrhagic Escherichia coli O157:H7". Microbiology. 142 ( Pt 11) (11): 3305–15. doi:10.1099/13500872-142-11-3305. PMID 8969527.
  10. ^ Pruimboom-Brees IM, Morgan TW, Ackermann MR, Nystrom ED, Samuel JE, Cornick NA, Moon HW (September 2000). "Cattle lack vascular receptors for Escherichia coli O157:H7 Shiga toxins". Proceedings of the National Academy of Sciences of the United States of America. 97 (19): 10325–29. Bibcode:2000PNAS...9710325P. doi:10.1073/pnas.190329997. PMC 27023. PMID 10973498.
  11. ^ Jeon SJ, Elzo M, DiLorenzo N, Lamb GC, Jeong KC (2013). "Evaluation of animal genetic and physiological factors that affect the prevalence of Escherichia coli O157 in cattle". PLOS ONE. 8 (2): e55728. Bibcode:2013PLoSO...855728J. doi:10.1371/journal.pone.0055728. PMC 3566006. PMID 23405204.
  12. ^ Chase-Topping M, Gally D, Low C, Matthews L, Woolhouse M (December 2008). "Super-shedding and the link between human infection and livestock carriage of Escherichia coli O157". Nature Reviews. Microbiology. 6 (12): 904–12. doi:10.1038/nrmicro2029. PMC 5844465. PMID 19008890.
  13. ^ Scutti, Susan. "Why deadly E. coli loves leafy greens". CNN. Retrieved 2018-09-20.
  14. ^ J.D. Greig, E.C.D. Todd, C. Bartleson, and B. Michaels. March 25, 2010. "Infective Doses and Pathen Carriage 2010-10-16 at the Wayback Machine", pp. 19–20, USDA 2010 Food Safety Education Conference.
  15. ^ (PDF). Archived from the original (PDF) on 2011-07-16. Retrieved 2010-12-11.
  16. ^ . Archived from the original on 2014-07-17. Retrieved 2014-07-11.
  17. ^ "Viruses, Bacteria, and Parasites in the Digestive Tract - Health Encyclopedia - University of Rochester Medical Center". www.urmc.rochester.edu. Retrieved 2020-01-17.
  18. ^ "Preventing Foodborne Illness: Escherichia coli O157:H7". wonder.cdc.gov. Retrieved 2023-11-28.
  19. ^ "Journal".
  20. ^ Walterspiel JN, Ashkenazi S, Morrow AL, Cleary TG (1992). "Effect of subinhibitory concentrations of antibiotics on extracellular Shiga-like toxin I". Infection. 20 (1): 25–29. doi:10.1007/BF01704889. PMID 1563808. S2CID 39513818.
  21. ^ Keen EC (December 2012). "Paradigms of pathogenesis: targeting the mobile genetic elements of disease". Frontiers in Cellular and Infection Microbiology. 2: 161. doi:10.3389/fcimb.2012.00161. PMC 3522046. PMID 23248780.
  22. ^ Tzipori S, Sheoran A, Akiyoshi D, Donohue-Rolfe A, Trachtman H (October 2004). "Antibody therapy in the management of shiga toxin-induced hemolytic uremic syndrome". Clinical Microbiology Reviews. 17 (4): 926–41, table of contents. doi:10.1128/CMR.17.4.926-941.2004. PMC 523565. PMID 15489355.
  23. ^ "Ban on E. Coli in Ground Beef Is to Extend to 6 More Strains". The New York Times. September 12, 2011. Retrieved 2011-10-08.
  24. ^ Berkenpas, E.; Millard, P.; Pereira da Cunha, M. (2005-12-13). "Detection of Escherichia coli O157:H7 with langasite pure shear horizontal surface acoustic wave sensors". Biosensors and Bioelectronics. 21 (12): 2255–2262. doi:10.1016/j.bios.2005.11.005. PMID 16356708.

External links edit

  • genomes and related information at PATRIC, a Bioinformatics Resource Center funded by NIAID
  • For more information about reducing your risk of foodborne illness, visit the US Department of Agriculture's Food Safety and Inspection Service website or The Partnership for Food Safety Education | Fight BAC!
  • briandeer.com, report from The Sunday Times on a UK outbreak, May 17, 1998

February 15, 2024
escherichia, coli, o157, serotype, bacterial, species, escherichia, coli, shiga, like, toxin, producing, types, coli, cause, disease, typically, foodborne, illness, through, consumption, contaminated, food, including, milk, undercooked, ground, beef, infection. Escherichia coli O157 H7 is a serotype of the bacterial species Escherichia coli and is one of the Shiga like toxin producing types of E coli It is a cause of disease typically foodborne illness through consumption of contaminated and raw food including raw milk and undercooked ground beef 1 2 Infection with this type of pathogenic bacteria may lead to hemorrhagic diarrhea and to kidney failure these have been reported to cause the deaths of children younger than five years of age of elderly patients and of patients whose immune systems are otherwise compromised Escherichia coli O157 H7Topographical images of colonies of E coli O157 H7 strains A 43895OW curli non producing and B 43895OR curli producing grown on agar for 48 h at 28 CSpecialtyInfectious diseaseTransmission is via the fecal oral route and most illness has been through distribution of contaminated raw leaf green vegetables undercooked meat and raw milk 3 Contents 1 Signs and symptoms 2 Bacteriology 2 1 Natural habitat 3 Transmission 4 Diagnosis 5 Prevention 5 1 Surveillance 6 Treatment 7 History 7 1 United States 8 Culture and society 8 1 Costs 9 See also 10 References 11 External linksSigns and symptoms editE coli O157 H7 infection often causes severe acute hemorrhagic diarrhea although nonhemorrhagic diarrhea is also possible and abdominal cramps Usually little or no fever is present and the illness resolves in 5 to 10 days 4 It can also sometimes be asymptomatic 5 In some people particularly children under five years of age persons whose immunologies are otherwise compromised and the elderly the infection can cause hemolytic uremic syndrome HUS in which the red blood cells are destroyed and the kidneys fail About 2 7 of infections lead to this complication In the United States HUS is the principal cause of acute kidney failure in children and most cases of HUS are caused by E coli O157 H7 citation needed Bacteriology edit nbsp E coli O157 H7Like the other strains of the E coli O157 H7 is gram negative and oxidase negative Unlike many other strains it does not ferment sorbitol which provides a basis for clinical laboratory differentiation of the strain Strains of E coli that express Shiga and Shiga like toxins gained that ability via infection with a prophage containing the structural gene coding for the toxin and nonproducing strains may become infected and produce shiga like toxins after incubation with shiga toxin positive strains The prophage responsible seems to have infected the strain s ancestors fairly recently as viral particles have been observed to replicate in the host if it is stressed in some way e g antibiotics 6 7 All clinical isolates of E coli O157 H7 possess the plasmid pO157 8 The periplasmic catalase is encoded on pO157 and may enhance the virulence of the bacterium by providing additional oxidative protection when infecting the host 9 E coli O157 H7 non hemorrhagic strains are converted to hemorrhagic strains by lysogenic conversion after bacteriophage infection of non hemorrhagic cells citation needed Natural habitat edit While it is relatively uncommon the E coli serotype O157 H7 can naturally be found in the intestinal contents of some cattle goats and even sheep citation needed The digestive tract of cattle lack the Shiga toxin receptor globotriaosylceramide and thus these can be asymptomatic carriers of the bacterium 10 The prevalence of E coli O157 H7 in North American feedlot cattle herds ranges from 0 to 60 11 Some cattle may also be so called super shedders of the bacterium Super shedders may be defined as cattle exhibiting rectoanal junction colonization and excreting gt 103 to 4 CFU g 1 feces Super shedders have been found to constitute a small proportion of the cattle in a feedlot lt 10 but they may account for gt 90 of all E coli O157 H7 excreted 12 Transmission editInfection with E coli O157 H7 can come from ingestion of contaminated food or water or oral contact with contaminated surfaces Examples of this can be undercooked ground beef but also leafy vegetables and raw milk Fields often get contaminated with the bacterium through irrigation processes or contaminated water naturally entering the soil 13 It is highly virulent with a low infectious dose an inoculation of fewer than 10 to 100 colony forming units CFU of E coli O157 H7 is sufficient to cause infection compared to over a million CFU for other pathogenic E coli strains 14 Diagnosis editA stool culture can detect the bacterium The sample is cultured on sorbitol MacConkey SMAC agar or the variant cefixime potassium tellurite sorbitol MacConkey agar CT SMAC 15 On SMAC agar O157 H7 colonies appear clear due to their inability to ferment sorbitol while the colonies of the usual sorbitol fermenting serotypes of E coli appear red Sorbitol non fermenting colonies are tested for the somatic O157 antigen before being confirmed as E coli O157 H7 Like all cultures diagnosis is time consuming with this method swifter diagnosis is possible using quick E coli DNA extraction method 16 plus polymerase chain reaction techniques Newer technologies using fluorescent and antibody detection are also under development citation needed Prevention editAvoiding the consumption of or contact with unpasteurized dairy products undercooked beef uncleaned vegetables and non disinfected water reduces the risk of an E coli infection Proper hand washing with water that has been treated with adequate levels of chlorine or other effective disinfectants after using the lavatory or changing a diaper especially among children or those with diarrhea reduces the risk of transmission 17 18 Surveillance edit E coli O157 H7 infection is a nationally reportable disease in the US Great Britain and Germany It is also reportable in most states of Australia including Queensland 19 Treatment editWhile fluid replacement and blood pressure support may be necessary to prevent death from dehydration most patients recover without treatment in 5 10 days There is no evidence that antibiotics improve the course of disease and treatment with antibiotics may precipitate hemolytic uremic syndrome HUS 20 The antibiotics are thought to trigger prophage induction and the prophages released by the dying bacteria infect other susceptible bacteria converting them into toxin producing forms Antidiarrheal agents such as loperamide imodium should also be avoided as they may prolong the duration of the infection citation needed Certain novel treatment strategies such as the use of anti induction strategies to prevent toxin production 21 and the use of anti Shiga toxin antibodies 22 have also been proposed History editUnited States edit The United States Department of Agriculture banned the sale of ground beef contaminated with the O157 H7 strain in 1994 23 Culture and society editCosts edit The pathogen results in an estimated 2 100 hospitalizations annually in the United States The illness is often misdiagnosed therefore expensive and invasive diagnostic procedures may be performed Patients who develop HUS often require prolonged hospitalization dialysis and long term followup 24 See also edit1993 Jack in the Box E coli outbreak 1996 Odwalla E coli outbreak 2011 Germany E coli O104 H4 outbreak Escherichia coli O104 H4 Escherichia coli O121 Food induced purpura List of foodborne illness outbreaks Walkerton E coli outbreakReferences edit Gally DL Stevens MP January 2017 Microbe Profile Escherichia coli O157 H7 notorious relative of the microbiologist s workhorse PDF Microbiology 163 1 1 3 doi 10 1099 mic 0 000387 PMID 28218576 Karch H Tarr PI Bielaszewska M October 2005 Enterohaemorrhagic Escherichia coli in human medicine International Journal of Medical Microbiology 295 6 7 405 18 doi 10 1016 j ijmm 2005 06 009 PMID 16238016 Reports of Selected E coli Outbreak Investigations CDC gov 2019 11 22 Ciccarelli S Stolfi I Caramia G October 2013 Management strategies in the treatment of neonatal and pediatric gastroenteritis Infection and Drug Resistance 6 133 61 doi 10 2147 IDR S12718 PMC 3815002 PMID 24194646 Roos V Ulett GC Schembri MA Klemm P January 2006 The asymptomatic bacteriuria Escherichia coli strain 83972 outcompetes uropathogenic E coli strains in human urine Infection and Immunity 74 1 615 24 doi 10 1128 IAI 74 1 615 624 2006 PMC 1346649 PMID 16369018 O Brien AD Newland JW Miller SF Holmes RK Smith HW Formal SB November 1984 Shiga like toxin converting phages from Escherichia coli strains that cause hemorrhagic colitis or infantile diarrhea Science 226 4675 694 96 Bibcode 1984Sci 226 694O doi 10 1126 science 6387911 PMID 6387911 Strockbine NA Marques LR Newland JW Smith HW Holmes RK O Brien AD July 1986 Two toxin converting phages from Escherichia coli O157 H7 strain 933 encode antigenically distinct toxins with similar biologic activities Infection and Immunity 53 1 135 40 doi 10 1128 IAI 53 1 135 140 1986 PMC 260087 PMID 3522426 Lim JY Yoon J Hovde CJ January 2010 A brief overview of Escherichia coli O157 H7 and its plasmid O157 Journal of Microbiology and Biotechnology 20 1 5 14 doi 10 4014 jmb 0908 08007 PMC 3645889 PMID 20134227 Brunder W Schmidt H Karch H November 1996 KatP a novel catalase peroxidase encoded by the large plasmid of enterohaemorrhagic Escherichia coli O157 H7 Microbiology 142 Pt 11 11 3305 15 doi 10 1099 13500872 142 11 3305 PMID 8969527 Pruimboom Brees IM Morgan TW Ackermann MR Nystrom ED Samuel JE Cornick NA Moon HW September 2000 Cattle lack vascular receptors for Escherichia coli O157 H7 Shiga toxins Proceedings of the National Academy of Sciences of the United States of America 97 19 10325 29 Bibcode 2000PNAS 9710325P doi 10 1073 pnas 190329997 PMC 27023 PMID 10973498 Jeon SJ Elzo M DiLorenzo N Lamb GC Jeong KC 2013 Evaluation of animal genetic and physiological factors that affect the prevalence of Escherichia coli O157 in cattle PLOS ONE 8 2 e55728 Bibcode 2013PLoSO 855728J doi 10 1371 journal pone 0055728 PMC 3566006 PMID 23405204 Chase Topping M Gally D Low C Matthews L Woolhouse M December 2008 Super shedding and the link between human infection and livestock carriage of Escherichia coli O157 Nature Reviews Microbiology 6 12 904 12 doi 10 1038 nrmicro2029 PMC 5844465 PMID 19008890 Scutti Susan Why deadly E coli loves leafy greens CNN Retrieved 2018 09 20 J D Greig E C D Todd C Bartleson and B Michaels March 25 2010 Infective Doses and Pathen Carriage Archived 2010 10 16 at the Wayback Machine pp 19 20 USDA 2010 Food Safety Education Conference MACCONKEY SORBITOL AGAR CT SMAC PDF Archived from the original PDF on 2011 07 16 Retrieved 2010 12 11 Quick E coli DNA extraction filter paper card Archived from the original on 2014 07 17 Retrieved 2014 07 11 Viruses Bacteria and Parasites in the Digestive Tract Health Encyclopedia University of Rochester Medical Center www urmc rochester edu Retrieved 2020 01 17 Preventing Foodborne Illness Escherichia coli O157 H7 wonder cdc gov Retrieved 2023 11 28 Journal Walterspiel JN Ashkenazi S Morrow AL Cleary TG 1992 Effect of subinhibitory concentrations of antibiotics on extracellular Shiga like toxin I Infection 20 1 25 29 doi 10 1007 BF01704889 PMID 1563808 S2CID 39513818 Keen EC December 2012 Paradigms of pathogenesis targeting the mobile genetic elements of disease Frontiers in Cellular and Infection Microbiology 2 161 doi 10 3389 fcimb 2012 00161 PMC 3522046 PMID 23248780 Tzipori S Sheoran A Akiyoshi D Donohue Rolfe A Trachtman H October 2004 Antibody therapy in the management of shiga toxin induced hemolytic uremic syndrome Clinical Microbiology Reviews 17 4 926 41 table of contents doi 10 1128 CMR 17 4 926 941 2004 PMC 523565 PMID 15489355 Ban on E Coli in Ground Beef Is to Extend to 6 More Strains The New York Times September 12 2011 Retrieved 2011 10 08 Berkenpas E Millard P Pereira da Cunha M 2005 12 13 Detection of Escherichia coli O157 H7 with langasite pure shear horizontal surface acoustic wave sensors Biosensors and Bioelectronics 21 12 2255 2262 doi 10 1016 j bios 2005 11 005 PMID 16356708 External links editHaemolytic Uraemic Syndrome Help HUSH a UK based charity E coli Protecting yourself and your family from a sometimes deadly bacterium Escherichia coli O157 H7 genomes and related information at PATRIC a Bioinformatics Resource Center funded by NIAID For more information about reducing your risk of foodborne illness visit the US Department of Agriculture s Food Safety and Inspection Service website or The Partnership for Food Safety Education Fight BAC briandeer com report from The Sunday Times on a UK outbreak May 17 1998 CBS5 report on September 2006 outbreak Retrieved from https en wikipedia org w index php title Escherichia coli O157 H7 amp oldid 1207042107, wikipedia, wiki, book, books, library,

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