E.coli infections rise 174% this year

The number of people infected by a bug that causes anything from mild tummy upset to kidney failure has jumped dramatically this year, according to the latest disease surveillance report.

Public health officials have recorded a 174% rise in the rate of Verotoxigenic e.coli (VTEC) infection, which can cause severe bloody diarrhoea and stomach cramps. The implications for young children and the elderly are even more serious — a weak immune system can give rise to a complication called haemolytic uraemic syndrome (HUS), in which the red blood cells are destroyed and the kidneys fail. This happens in up to 10% of child cases.

Paul McKeown, a consultant in public health medicine, described the statistic as “worrying” but said doctors here were quick to react, and there hadn’t been any child deaths as a result of HUS for a number of years. HUS is the principal cause of acute kidney failure in children, and the majority of cases are caused by e.coli O157.

By Oct 12 this year, 497 cases of VTEC infection (including e.coli 0157) had been notified to the Health Protection Surveillance Centre, compared to an average of 181 notifications over the same period in each of the preceding three years. Dr McKeown said Ireland is now “the European leader” in terms of VTEC infection, down to a number of factors including:

* the natural evolution of the bug meaning infection had become more and more common;

* very high rainfall amounts leading to flooding and run-off from the land carrying contaminated soil and faeces into drinking water supplies;

* extended testing means detection rates are high.

Dr McKeown said in a country with seven million cattle, where 5% to 10% have VTEC in their bowels “and with cattle squirting it out their back end on a regular basis” it was imperative that private water supplies were constructed to protect against contamination.

“We see cases in children in Dublin who visit family down the county and drink the pure well water but have no immunity to VTEC and develop infection as a result, while grandad, who has been drinking the water all his life, is fine because he has developed immunity,” Dr McKeown said.

He said most of us have partial immunity to VTEC infection but the very young and very old are susceptible.

“It only takes one or two VTEC bugs to cause disease in a small baby or child, compared to salmonella where it takes 1,000 bugs to produce disease,” Dr McKeown said.

Of the 95 VTEC outbreaks reported so far this year, 76 were reported as family outbreaks and 19 as general outbreaks (including 11 which were associated with childcare facilities).

The most commonly reported transmission route was person-to-person spread. The second most common transmission route this year so far is waterborne transmission.

People who use private water supplies needed to take proper precautions including boiling water if necessary, Dr McKeown said, and making sure wells are properly constructed.

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