NC Division of Public Health (DPH) officials are investigating a cluster of E. coli O157 infections and hemolytic uremic syndrome (HUS) cases that have been identified during the past two weeks, according to a memo sent to physicians and other health care providers on October 25, 2011, by State Epidemiologist Megan Davies, MD. Investigations continue to determine the source of infection.
State health officials reported today that they were investigating 26 cases of E. coli, with 10 confirmed cases and 16 cases still being evaluated. Of the 26 cases under investigation, 13 are adults (18 years old or older) and 13 are children (under 18). Five people remain hospitalized: four children and one adult. Current patient interview information shows that 23 of the 26 persons involved in the investigation report having attended the State Fair, and cases have been reported from Durham, Wake, Johnston, Franklin, Cleveland, Orange, Wilson and Sampson counties.
Updated information on case numbers in the investigation will be posted daily by 4 p.m., beginning on Friday 10/28, at http://epi.publichealth.nc.gov/gcdc/ecoli.html
Dr. Davies issued the memo to make physicians and other providers aware of the outbreak and to encourage reporting of suspected E. coli O157 infections among patients seen in their practices. The memo also cites recent literature on nephroprotection to prevent hemolytic uremic syndrome in susceptible individuals (Ake JA et al. Relative Nephroprotection During Escherichia coli O157:H7 Infections: Association with Intravenous Volume Expansion. Pediatrics. 2006;115:e673-680).
Read the memo here.
The memo covers clinical, laboratory and public health issues and reminds providers that early recognition and IV hydration may help prevent renal failure. By law, all suspected shiga toxin-producing E. coli infections and HUS cases must be reported within 24 hours to the local health department. Dr. Davies reminds providers that they should report suspected cases and not wait for laboratory confirmation.
To report suspected cases, contact your local health department or contact the epidemiologist on call at 919-733-3419.
