INITIAL TREATMENT AT AN OUTBREAK OF E. COLI O-157: H7 INFECTION: ESPECIALLY WITH RESPECT TO THERAPY IN THE EMERGENCY

Seikeikai Hospital (Director MAKOTO MINO) An outbreak of O-157: H7 diarrheal illnesses occurred in junior schools of Sakai-city, Osaka prefecture, in last July, 1996. At the beginning of the outbreak, many patients rushed to outpatient clinics. From the practical experiences, we examined the necessity of fluid therapy in patients regarding their initial clinical features. The risk factors for development of HUS were noted as presence of fever, WBC counts of more than 10,000/μl and more than 1.0mg/dl of CRP. During the prodoromal illness, administration with available antimicrobial agents would be advisable for high risk patients, while it would yet be remain to be further investigated. The majority of the patients with clinical manifestations showed neither signs for dehydration nor electrolyte abnormalities based on the blood examination data and biochemical analysis of the serum. Therefore, the fluid therapy did not appear necessary for majority of patients except a few high risk patients, when outpatient clinics were crowded with emergency patients.