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Abstract

Background

Haemolytic uremic syndrome (HUS) is a severe complication of infection with Shiga toxin-producing (STEC). Although the reservoirs of STEC are known, the source of the infection of sporadic cases is often unknown. In 2023, we observed several cases of bloody diarrhoea with STEC infection in children and adolescents returning from vacations.

Aim

We aimed to explore the association between travel and bloody diarrhoea with STEC infection in children and adolescents.

Methods

We included all children and adolescents with bloody diarrhoea with STEC infection identified in 2023 by the ItalKid-HUS Network surveillance system in northern Italy. We interviewed children’s families and sent a questionnaire on recent travels abroad. The exposure time was between 3 days after arrival abroad and 5 days after return home. A self-controlled case series (SCCS) design was used in the analysis.

Results

Of the 43 cases, 11 developed HUS. Twenty-three cases did not travel abroad, while 20 had travelled to several destinations. The incidence rate ratio (IRR) associated with travel to Egypt was 88.6 (95% confidence interval (CI): 17.0–462). Serotype analysis excluded the possibility of a single strain causing the infections. We did not find the source of the infections.

Conclusion

There is an elevated risk of acquiring STEC infection with bloody diarrhoea and HUS associated with travel to Egypt. Specific investigations to identify the source are needed to implement effective preventive measures.

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2024-07-25
2024-12-14
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.30.2400056
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