Verotoxigenic Escherichia coli infection (Verotoxin producing Escherichia coli)

Clinical criteria
VTEC
Any person with at least one of the following three:
- Diarrhoea
- Abdominal pain
- Haemolytic-uraemic syndrome (HUS)

HUS
Any person with acute renal failure AND at least one of the following two:
- Microangiopatic haemolytic anaemia
- Thrombocytopenia

Laboratory criteria
At least one of the following three:
- Isolation of an E. coli strain that produces verotoxin or harbours vt1 or vt2 gene(s)
- Direct detection of vt1 or vt2 gene(s) nucleic acid (without strain isolation)
- Detection of free verotoxin in faeces
Only for HUS the following can be used as laboratory criterion to confirm VTEC:
- E.coli serogroup-specific (LPS) antibody response
Isolation of a VTEC strain and additional characterisation by serotype, phage type,
eae genes, and subtypes of vt1/vt2 should be performed if possible.

Epidemiological criteria
At least one of the following two:
- Human to human transmission
- Exposure to a common source

Case classification
A. Possible case
Any person meeting the clinical criteria for HUS (see note 1)
B. Probable case
Any person meeting the clinical criteria for VTEC and with an epidemiological link OR a laboratory confirmed case not meeting the clinical criteria, e.g. asymptomatic (see note 2)
C. Confirmed case
Any person meeting the clinical and the laboratory criteria 

Note 1:
A person whose presentation meets the definition of HUS above, but whose condition is demonstrated to have been caused by another infectious agent, is not notifiable as a possible case of VTEC. Where that alternative infectious disease is notifiable, notification should be made according to that case definition.

Note 2:
Where no clinical information is available, laboratory confirmed cases should be notified as confirmed cases 

Current as of: 22 January 2019