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Infections have been reported worldwide and are most often linked to the consumption of raw or undercooked beef, unpasteurized dairy products, inadequately washed vegetables, and contaminated water\u2014all reflecting the organism\u2019s persistence across the farm-to-fork continuum. This review summarizes recent advances in the epidemiology, molecular pathogenesis, and prevention of EHEC infection to provide an updated understanding of its transmission and control. It integrates data from surveillance systems, outbreak investigations, and molecular studies to bridge clinical, environmental, and food-safety perspectives. Temporal and geographical trends in EHEC prevalence are examined, highlighting variations in surveillance capacity, diagnostic accessibility, and hygiene standards that influence global prevalence estimates. The review further underscores the increasing contribution of non-O157 serotypes (O26, O103, O111, O145, O45, and O121) in several regions and the substantial economic burden associated with major outbreaks. The pathogen\u2019s complex virulence mechanisms are explored, focusing on the locus of enterocyte effacement and the Shiga toxins (Stx1 and Stx2), which mediate intestinal colonization and systemic complications such as hemolytic\u2013uremic syndrome (HUS). Current treatment approaches are discussed, emphasizing the lack of safe antibiotic options, the importance of early supportive therapy, and emerging alternatives including monoclonal antibodies, probiotics, and vaccine-based interventions. Preventive strategies\u2014such as Hazard Analysis and Critical Control Points (HACCP) systems, Good Agricultural Practices (GAP), and cattle vaccination\u2014are outlined within a One Health framework. Understanding the molecular and epidemiological aspects of EHEC infection is essential for developing sustainable prevention and control policies through continued interdisciplinary research and international collaboration.\n                  <\/jats:p>","DOI":"10.1177\/15353141261479164","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T06:45:52Z","timestamp":1787208352000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enterohemorrhagic\n                    <i>Escherichia coli<\/i>\n                    : A Persistent Foodborne Pathogen and Ongoing Public Health Challenge"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9234-8896","authenticated-orcid":false,"given":"Ghadah S.","family":"Alsharif","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia."},{"name":"Experimental Biochemistry Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/bios13070741"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.4161\/bact.1.2.15845"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/adma.202504796"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13099-024-00641-9"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-30486-2"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1422986112"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjbs.2015.02.019"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-2153"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vetmic.2023.109754"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/bios15100690"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/JB.187.23.7918-7930.2005"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-540-75418-3_12"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1462-2920.12019"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfp.2024.100273"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1106482"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/mmi.14989"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2958.2001.02209.x"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.devcel.2004.07.004"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-87544-w"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.01852-16"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2018.04.019"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0604343103"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2015.00568"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.66.9.4355-4366.1998"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro1526"},{"key":"e_1_3_2_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-48933-7"},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aca.2023.342028"},{"key":"e_1_3_2_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11434-012-5613-1"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tifs.2025.105072"},{"key":"e_1_3_2_31_1","doi-asserted-by":"publisher","DOI":"10.3389\/fvets.2018.00014"},{"key":"e_1_3_2_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrd.2017.23"},{"key":"e_1_3_2_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jam.13124"},{"key":"e_1_3_2_34_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2958.1998.00783.x"},{"key":"e_1_3_2_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9258(18)47538-2"},{"key":"e_1_3_2_36_1","doi-asserted-by":"publisher","DOI":"10.4315\/0362-028X-70.10.2426"},{"key":"e_1_3_2_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2025.107713"},{"key":"e_1_3_2_38_1","volume-title":"STEC infection cases. 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