Waterborne outbreak of Norwalk-like virus gastroenteritis at a tourist resort, Italy.

In July 2000, an outbreak of gastroenteritis occurred at a tourist resort in the Gulf of Taranto in southern Italy. Illness in 344 people, 69 of whom were staff members, met the case definition. Norwalk-like virus (NLV) was found in 22 of 28 stool specimens tested. The source of illness was likely contaminated drinking water, as environmental inspection identified a breakdown in the resort water system and tap water samples were contaminated with fecal bacteria. Attack rates were increased (51.4%) in staff members involved in water sports. Relative risks were significant only for exposure to beach showers and consuming drinks with ice. Although Italy has no surveillance system for nonbacterial gastroenteritis, no outbreak caused by NLV has been described previously in the country

Production of the Subtilase AB5 Cytotoxin by Shiga Toxin-Negative Escherichia coli▿

The subtilase cytotoxin (SubAB) is an AB5 toxin described in certain Shiga toxin (Stx)-producing Escherichia coli (STEC) strains that usually lack the locus for enterocyte effacement (LEE). We report for the first time the production of SubAB by two Stx-negative E. coli strains, isolated from unrelated cases of childhood diarrhea. The characterization of the SubAB-coding genes showed a 90% nucleotide sequence similarity with that of the prototype subAB, located on the virulence plasmid of the STEC O113 strain 98NK2 (pO113). In both strains, subAB was physically associated with tia, an invasion genetic determinant of enterotoxigenic E. coli. The strains were negative for the saa gene, encoding an adhesin located on pO113 and present in many of the SubAB-positive strains described so far. PCR screening of 61 STEC and 100 Stx-negative E. coli strains in our collection revealed the presence of subAB in five LEE-negative STEC strains but not in the Stx-negative strains. subAB was contiguous to tia in three of the positive strains, which were all negative for saa. These results indicate that SubAB production is not restricted to STEC and suggest that a subAB-tia putative pathogenicity island is involved in the dissemination of subAB genes, as an alternative to plasmid pO113

Sorveglianza della sindrome emolitico-uremica in Italia

La Sindrome Emolitico Uremica (SEU) \ue8 la pi\uf9 comune causa di insufficienza renale acuta in et\ue0 pediatrica. Nella stragrande maggioranza dei casi \ue8 la pi\uf9 grave complicanza delle infezioni da E. coli produttori di verocitotossina (VTEC). La sorveglianza della SEU in Italia conferma la bassa incidenza della malattia in Italia in confronto ad altri paesi Europei. L\u2019Italia non ha sperimentato eventi epidemici negli ultimi 10 anni. A fronte di questi elementi, e dell\u2019assenza di chiari fattori di rischio nella popolazione pediatrica italiana, \ue8 da notare l\u2019emergenza e la frequenza di sierotipi diversi da O157. La sorveglianza della SEU rimane uno strumento importante per valutare variazioni dell\u2019epidemiologia delle infezioni da VTEC in Italia come in altri paesi esteri