Epidemic Profile of Shiga-Toxin–Producing Escherichia coli O104:H4 Outbreak in Germany

An epidemic of foodborne infection with Escherichia coli associated with a high rate of the hemolytic–uremic syndrome and caused by a novel E. coli strain (O104:H4) recently occurred in Germany. This final report updates epidemiologic, clinical, and microbiologic information. On May 19, 2011, the Robert Koch Institute, Germany's national-level public health authority, was informed about a cluster of three cases of the hemolytic–uremic syndrome in children admitted on the same day to the university hospital in the city of Hamburg. On May 20, a team from the Robert Koch Institute arrived in Hamburg to assist with the public health investigation. It quickly became clear that the case numbers were continuing to rise, that there were also cases in adults, and that other areas of Germany, especially northern Germany, were also affected. An investigation of the outbreak involving all levels . . .