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Public health implications of a case of haemolytic–uraemic syndrome associated with a concomitant outbreak of mild gastroenteritis in a small rural community

Published online by Cambridge University Press:  29 July 2005

L. BUSANI
Affiliation:
Istituto Superiore di Sanità, Rome, Italy
D. BOCCIA
Affiliation:
Istituto Superiore di Sanità, Rome, Italy
A. CAPRIOLI
Affiliation:
Istituto Superiore di Sanità, Rome, Italy
F. M. RUGGERI
Affiliation:
Istituto Superiore di Sanità, Rome, Italy
S. MORABITO
Affiliation:
Istituto Superiore di Sanità, Rome, Italy
F. MINELLI
Affiliation:
Istituto Superiore di Sanità, Rome, Italy
S. LANA
Affiliation:
Istituto Superiore di Sanità, Rome, Italy
G. RIZZONI
Affiliation:
Ospedale Pediatrico Bambino Gesù, Rome, Italy
F. GIOFRÈ
Affiliation:
Azienda Unità Sanitaria Locale n. 8, Regione Calabria, Vibo Valentia, Italy
M. MAZZEO
Affiliation:
Azienda Unità Sanitaria Locale n. 8, Regione Calabria, Vibo Valentia, Italy
A. E. TOZZI
Affiliation:
Ospedale Pediatrico Bambino Gesù, Rome, Italy
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Abstract

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The concomitant occurrence of a case of haemolytic–uraemic syndrome (HUS) and 62 cases of mild gastroenteritis in schools of a small rural community in southern Italy induced the health authorities to suspect a foodborne outbreak of shiga-toxin-producing Escherichia coli (STEC) infection. The schools were closed and the catering service involved was investigated. However, STEC were not isolated from the HUS case or from the 56 cases of gastroenteritis examined, and the HUS case and the outbreak of gastroenteritis were probably just coincidental. A retrospective cohort study failed to show any correlation with consumption of school meals and suggested that the outbreak probably started outside the school setting and then spread within the schools by person-to-person transmission. All the cases examined were negative for common enteric pathogens and the responsible agent for the cases of gastroenteritis was not identified. The concern raised in the small community by the occurrence of a severe case of HUS and the lack of a rapid epidemiological assessment excluding the occurrence of a STEC outbreak, turned an epidemic episode of mild gastroenteritis into a public health emergency with relevant socioeconomic consequences. Prompt intervention in outbreaks following timely and effective risk communication are crucial for taking the most appropriate control measures and avoiding the spread of fear and panic in the community.

Type
Research Article
Copyright
2005 Cambridge University Press