Commission Implementing Decision (EU) 2018/945Show full title

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.