APH 1997, 55, 279-288:

E. coli O157:H7 and other V.T.E.C.: epidemiology in Belgium.

D. Pierard, and S. Lauwers

Keywords: verocytotoxines, hemolytic uremic syndrom, Escherichia coli O157

Verocytotoxin-producing Escherichia coli (V.T.E.C.) not only cause diarrhoea but also the haemolytical uremic syndrome (H.U.S.). Epidemics with over a thousand cases have been described. In the U. S.A. and Great Britain transmission happens mainly via contaminated food products, mainly (minced) meat. Transmission from person to person occurs also, as can be expected from an organism with a low infective dose.

Sources of infection in Belgium aren't clear and untill now, no epidemic has been reported.  A P.C.R. search for V.T.E.C. in faeces at the Academic Hospital of the V.U.B. revealed 1,02% of the faecal samples to be positive. O157 V.T.E.C. was isolated in 0,17 % of the samples and other serotypes in 0,66 % of the samples. V.T.E.C. are less frequent than Salmonella or Campylobacter, but when combining all V.T.E.C. serotypes, more frequent than Yersinia or Shigella. The O157 V.T.E.C. represents one fifth to one fourth of all V.T.E.C. H.U.S was in 1996 notified among 4/100 000 children < 5 years old and 1,5/100 000 children > 16 years old. These numbers are comparable with other countries.  In Belgium, O157 V.T.E.C. is responsible for the majority of the H.U.S. cases but non-O157 V.T.E.C. can also cause this syndrome. Other V.T.E.C. serotypes should not be neglected.

The clinical laboratories must be encouraged to look for O157 V.T.E.C. by using sorbitol-Mac Conckey agar. In H.U.S. cases faeces samples could be sent to the V.T.E.C. reference laboratory in order to detect the other serotypes.