National case definition: Verotoxigenic Escherichia coli infection

Date of last revision/review: May 2008

National notification 

Only confirmed cases of disease should be notified.

Type of surveillance

Routine case-by-case notification to the federal level

Case classification

Confirmed case

Laboratory confirmation of infection with or without clinical illness:

• isolation of verotoxin producing E. coli from an appropriate clinical specimen (e.g. feces, urine, blood)

     or

• detection of verotoxin antigen or nucleic acid

Probable case

Clinical illness in a person who is epidemiologically linked to a confirmed case, which would include persons with hemolytic uremic syndrome (HUS)

Laboratory comments

Further strain characterization, including phagetyping and molecular typing (e.g. PFGE typing), is indicated for epidemiologic, public health and control purposes.

Clinical evidence

Clinical illness is characterized by diarrhea (often bloody) and abdominal cramps; fever is often absent. Illness may be complicated by hemolytic uremic syndrome (HUS), thrombocytopenic purpura (TTP) or pulmonary edema. Asymptomatic infections may also occur, and the microorganism may cause extra-intestinal infections.

ICD code(s)

ICD-10 code(s)

A04.3 Enterohaemorrhagic Escherichia coli infection (includes VTEC)

ICD-9/ICD-9CM code(s)

008.04 Enterohaemorrhagic Escherichia coli infection (includes VTEC)

Comments

VTEC includes non-O157 E. Coli.

Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes.