Epidemiology of escherichioses

The main source of escherichiosis is patients with latent forms of the disease, while convalescents and carriers play a lesser role. The importance of the latter increases if they work in enterprises preparing and selling food products. According to some data, the source of the pathogen in enterohemorrhagic escherichiosis (0157) is cattle. People become infected when eating food that has not been sufficiently heat-treated. The transmission mechanism is fecal-oral, which is carried out through food, less often - water and household. According to WHO, enterotoxigenic and enteroinvasive escherichiosis are typically transmitted through food, and enteropathogenic - through household contact.

Among food products, the most common transmission factors are dairy products, prepared meat products, and drinks (kvass, compote, etc.).

In children's groups, the infection can spread through toys, contaminated household items, and the hands of sick mothers and staff. Less frequently, waterborne transmission of escherichiosis is recorded. The most dangerous contamination of open water bodies occurs as a result of the discharge of untreated domestic wastewater, especially from children's institutions and infectious disease hospitals.

Susceptibility to escherichiosis is high, especially among newborns and weakened children. About 35% of children who have been in contact with the source of infection become carriers. In adults, susceptibility increases due to moving to another climate zone, with a change in diet, etc. ("traveler's diarrhea"). After the disease, a short-term, fragile type-specific immunity is formed.

The epidemic process caused by different E. coli pathogens may differ. Diseases caused by ETEC are more often registered in developing countries of tropical and subtropical regions as sporadic cases, and group cases - among children aged 1-3 years. Escherichia coli infections caused by EIEC are registered in all climatic zones, but they predominate in developing countries. Most often, the diseases are of a group nature among children aged 1-2 years in the summer-autumn period. EIEC causes sporadic morbidity in all climatic zones, more often among children under one year who were bottle-fed. Escherichia coli infections caused by EHEC and EAEC have been identified in North America and Europe among adults and children over 1 year old; summer-autumn seasonality is typical. Outbreaks among adults were more often registered in nursing homes. Group outbreaks have been registered in recent years in Canada, the USA, Japan, Russia and other countries.

The basis for the prevention of escherichiosis is measures to suppress the transmission routes of the pathogen. It is especially important to comply with sanitary and hygienic requirements at public catering and water supply facilities; prevent contact-household transmission in children's institutions, maternity hospitals, and hospitals (use of individual sterile diapers, treat hands with disinfectant solutions after working with each child, disinfect dishes, pasteurize, boil milk and formula). Ready-to-eat and raw foods should be cut on different boards with separate knives. Dishes in which food is transported should be treated with boiling water.

If escherichiosis is suspected, pregnant women, women in labor, women in labor, and newborns must be examined.

Contacts in the outbreak area are observed for 7 days. Children who have been in contact with a patient with E. coli disease at their place of residence are admitted to child care facilities after separation from the patient and three negative results of bacteriological examination of feces.

When patients with escherichiosis are identified in children's institutions and maternity hospitals, admission of incoming children and women in labor is stopped. Personnel, mothers, children who have been in contact with the patient, as well as children discharged home shortly before the disease, are examined three times (bacteriological examination of feces is carried out). If individuals with positive examination results are identified, they are isolated. Patients who have had escherichiosis are observed for 3 months with monthly clinical and bacteriological examination in the KIZ. Before removal from the register - two bacteriological examination of feces with an interval of 1 day.

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