{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T04:19:55Z","timestamp":1774325995790,"version":"3.50.1"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","issue":"15","license":[{"start":{"date-parts":[[2016,7,29]],"date-time":"2016-07-29T00:00:00Z","timestamp":1469750400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Shiga toxin-producing<jats:italic>Escherichia coli<\/jats:italic>(STEC) is an important cause of gastroenteritis (GE) and haemolytic uraemic syndrome (HUS). Incidence of STEC illness is largely underestimated in notification data, particularly of serogroups other than O157 (\u2018non-O157\u2019). Using HUS national notification data (2008\u20132012, excluding 2011), we modelled true annual incidence of STEC illness in Germany separately for O157 and non-O157 STEC, taking into account the groups\u2019 different probabilities of causing bloody diarrhoea and HUS, and the resulting difference in their under-ascertainment. Uncertainty of input parameters was evaluated by stochastic Monte Carlo simulations. Median annual incidence (per 100 000 population) of STEC-associated HUS and STEC-GE was estimated at 0\u00b711 [95% credible interval (CrI) 0\u00b708-0\u00b720], and 35 (95% CrI 12-145), respectively. German notification data underestimated STEC-associated HUS and STEC-GE incidences by factors of 1\u00b78 and 32\u00b73, respectively. Non-O157 STEC accounted for 81% of all STEC-GE, 51% of all bloody STEC-GE and 32% of all STEC-associated HUS cases. Non-O157 serogroups dominate incidence of STEC-GE and contribute significantly to STEC-associated HUS in Germany. This might apply to many other countries considering European surveillance data on HUS. Non-O157 STEC should be considered in parallel with STEC O157 when searching aetiology in patients with GE or HUS, and accounted for in modern surveillance systems.<\/jats:p>","DOI":"10.1017\/s0950268816001436","type":"journal-article","created":{"date-parts":[[2016,7,29]],"date-time":"2016-07-29T09:32:27Z","timestamp":1469784747000},"page":"3305-3315","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":38,"title":["Estimating true incidence of O157 and non-O157 Shiga toxin-producing<i>Escherichia coli<\/i>illness in Germany based on notification data of haemolytic uraemic syndrome"],"prefix":"10.1017","volume":"144","author":[{"given":"A.","family":"KUEHNE","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"BOUWKNEGT","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"HAVELAAR","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"GILSDORF","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"HOYER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"STARK","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"WERBER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"and the HUS active surveillance network Germany","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2016,7,29]]},"reference":[{"key":"S0950268816001436_ref25","doi-asserted-by":"publisher","DOI":"10.1086\/341457"},{"key":"S0950268816001436_ref32","doi-asserted-by":"publisher","DOI":"10.1111\/j.1863-2378.2011.01405.x"},{"key":"S0950268816001436_ref2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078180"},{"key":"S0950268816001436_ref26","unstructured":"European Centre for Disease Prevention and Control. 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