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National Enteric Disease Surveillance: STEC Surveillance Overview
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01/27/2012
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Description:Surveillance System Overview: National Shiga toxin-producing Escherichia coli (STEC) Surveillance
Shiga toxin-producing Escherichia coli (STEC) are estimated to cause more than 265,000 illnesses each year in the United States, with more than 3,600 hospitalizations and 30 deaths (1). STEC infections often cause diarrhea, sometimes bloody. Some patients with STEC infection develop hemolytic uremic syndrome (HUS), a severe complication characterized by renal failure, hemolytic anemia, and thrombocytopenia that can be fatal. Most outbreaks of STEC infection and most cases of HUS in the United States have been caused by STEC O157. Non- O157 STEC have also caused US outbreaks. Although all STEC infections are nationally notifiable, for several reasons many cases are likely not recognized (2). Not all persons ill with STEC infection seek medical care, healthcare providers may not obtain a specimen for laboratory diagnosis, or the clinical diagnostic laboratory may not perform the necessary diagnostic tests. Accounting for under-diagnosis and under-reporting, an estimated 96,534 STEC O157 and 168,698 non-O157 infections occur each year. STEC transmission occurs through consumption of contaminated foods, ingestion of contaminated water, or direct contact with infected persons (e.g., in child-care settings) or animals or their environments.
National STEC surveillance data are collected through passive surveillance of laboratory-confirmed human STEC isolates in the United States. Clinical diagnostic laboratories submit STEC O157 isolates and Shiga toxin-positive broths to state and territorial public health laboratories, where they are further characterized. State and territorial public health laboratories send reports of these STEC isolates electronically to the Centers for Disease Control and Prevention (CDC) using a variety of mechanisms. Data are collected into the Laboratory-based Enteric Disease Surveillance (LEDS) system, which is maintained by the Division of Foodborne, Waterborne, and Environmental Diseases (DFWED) in the National Center for Emerging and Zoonotic Infectious Diseases. Annual summaries of these data are the national source of serotype information for STEC. Unusual or untypable isolates or Shiga toxin-positive samples from which no STEC can be isolated by the state or territorial public health laboratory are forwarded to CDC’s National Escherichia and Shigella Reference Laboratory in the Enteric Diseases Laboratory Branch (EDLB) in DFWED; results are reported back to the referring public health laboratory.
Recommended citation: Centers for Disease Control and Prevention (CDC). National Shiga toxin-producing Escherichia coli (STEC) Surveillance Overview. Atlanta, Georgia: US Department of Health and Human Services, CDC, 2012.
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