Epidemiology of Escherichiosis
Last reviewed: 23.04.2024
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The main source of escherichiosis is patients with erased forms of the disease, convalescents and carriers play a lesser role. The significance of the latter increases if they work at enterprises for the preparation and sale of food products. According to some sources, the source of the pathogen in enterohemorrhagic escherichiosis (0157) is cattle. Infection of people occurs with the use of products that have not been thermally processed. The mechanism of transmission is fecal-oral, which is carried out by food, less often by water and by household means. According to WHO, enterotoxigenic and enteroinvasive escherichia is characterized by food, and for enteropathogenic - household way.
Of food products, dairy products, ready-made meat products, drinks (kvass, compote, etc.) are more often the transfer factor.
In children's groups, the infection can spread through toys, contaminated household items, the hands of sick mothers and staff. Less often register the waterway transmission of escherichiosis. The most dangerous is the contamination of open water bodies, which occurs as a result of the discharge of untreated domestic wastewater, especially from children's institutions and infectious diseases hospitals.
Susceptibility to Escherichia is high, especially among newborns and weakened children. About 35% of children who communicated with the source of infection become carriers. In adults, the susceptibility rises due to moving to another climatic zone, changing the nature of nutrition, etc. ("Traveler's diarrhea"). After the transferred disease, a short-term, impermanent type-specific immunity is formed.
The epidemic process caused by different E. Coli pathogens may be different. Diseases caused by ETCP are more often recorded in developing countries of tropical and subtropical regions in the form of sporadic cases, and group cases among children 1-3 years. Escherichiosis caused by EHEC is recorded in all climatic zones, but they predominate in developing countries. More often the diseases are of a group nature among children 1-2 years in the summer-autumn period. EPPC causes sporadic morbidity in all climatic zones, more often among children under one year who were on artificial feeding. Escherichiosis caused by EHEC and EACC was detected in North America and Europe among adults and children over 1 year old; summer-autumn seasonality is characteristic. Outbreaks among adults were more often recorded in nursing homes. Group outbreaks have been reported in recent years in Canada, the US, Japan, Russia and other countries.
The basis for the prevention of escherichiosis are measures to curb the pathways of transmission of the pathogen. It is especially important to comply with sanitary and hygienic requirements at public catering facilities, water supply; to prevent contact and everyday way of infection in children's institutions, maternity hospitals, hospitals (use of individual sterile diapers, treatment of hands with disinfectant solutions after work with each child, disinfection of dishes, pasteurization, boiling milk, milk mixtures). Products ready for use, and raw, you need to cut on different boards with separate knives. The dishes in which the food is transported must be treated with boiling water.
If suspected of escherichiosis, pregnant women should be examined before delivery, childbirth, puerperas and newborns.
Contact in the outbreak is observed for 7 days. Children who are in contact with a patient with escherichiosis at the place of residence are admitted to children's institutions after separation from the patient and triple negative results of bacteriological examination of stool.
When patients with escherichiosis are diagnosed in children's institutions and maternity hospitals, they stop receiving admission and childbirth. Staff, mothers, children who were in contact with the patient, as well as children discharged home shortly before the disease, are examined three times (carry out a bacteriological study of feces). When identifying people with positive results of the survey, they are isolated. Patients who underwent escherichiosis are observed for 3 months with a monthly clinical and bacteriological examination in the KIZ. Before taking this into account, a twofold bacteriological study of stool with an interval of 1 day.
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