{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T15:20:07Z","timestamp":1759159207872},"reference-count":30,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2008,11,21]],"date-time":"2008-11-21T00:00:00Z","timestamp":1227225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2009,3]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>An outbreak of haemolytic uraemic syndrome (HUS) among children caused by infection with sorbitol-fermenting enterohaemorrhagic<jats:italic>Escherichia coli<\/jats:italic>O157:H<jats:sup>\u2212<\/jats:sup>(SF EHEC O157:H<jats:sup>\u2212<\/jats:sup>) occurred in Germany in 2002. This pathogen has caused several outbreaks so far, yet its reservoir and routes of transmission remain unknown. SF EHEC O157:H<jats:sup>\u2212<\/jats:sup>is easily missed as most laboratory protocols target the more common sorbitol non-fermenting strains. We performed active case-finding, extensive exploratory interviews and a case-control study. Clinical and environmental samples were screened for SF EHEC O157:H<jats:sup>\u2212<\/jats:sup>and the isolates were subtyped by pulsed-field gel electrophoresis. We identified 38 case-patients in 11 federal states. Four case-patients died during the acute phase (case-fatality ratio 11%). The case-control study could not identify a single vehicle or source. Further studies are necessary to identify the pathogen's reservoir(s). Stool samples of patients with HUS should be tested with an adequate microbiological set-up to quickly identify SF EHEC O157:H<jats:sup>\u2212<\/jats:sup>.<\/jats:p>","DOI":"10.1017\/s0950268808001465","type":"journal-article","created":{"date-parts":[[2008,11,21]],"date-time":"2008-11-21T10:08:56Z","timestamp":1227262136000},"page":"389-395","source":"Crossref","is-referenced-by-count":42,"title":["Sorbitol-fermenting enterohaemorrhagic<i>Escherichia coli<\/i>O157:H<sup>\u2212<\/sup>causes another outbreak of haemolytic uraemic syndrome in children"],"prefix":"10.1017","volume":"137","author":[{"given":"K.","family":"ALPERS","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"WERBER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"FRANK","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"KOCH","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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Abstracts of the 6th International Symposium on Shiga Toxin (Verocytotoxin)-Producing Escherichia coli Infections. 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