"Shiga Toxin producing E.Coli and Foodborne Infections"

Abstract

One of the most important emerging foodborne infections that constitute a major public health problem worldwide, are those caused by strains of the bacterium Escheichia coli that produce Shiga toxins (Stx) (Shiga toxin - producing E.coli- (STEC), the pathogenic action of which is enhanced-determined by additional virulence factors, with the symptomatology of the resulting infection ranging from mild diarrhea to severe and sometimes fatal complications, most notably hemolytic uremic syndrome (HUS), and end-stage renal disease (ESRD). Although cattle and other ruminants are considered the main reservoirs of STEC, strains of STEC have now been isolated from other animals as well. Therefore, the source of contamination extends to a wide range of foods, not only beef products but also fresh produce, water, unpasteurized dairy products, fruits and vegetables, which are contaminated by animal excreta. As modes of transmission of STEC include direct contact with vectors and a variety of environmental exposures, it is necessary to approach the problem from a holistic health perspective that will involves collaboration between scientists from different fields to better understand the different routes of STEC transmission and develop effective control measures to anticipate/treat all potential sources of contamination. The possibility of causing epidemics, the increasing tendency of the prevalence of the disease, the appearance of emerging serotypes, but also the financial burden of managing the disease require an optimal approach and management, with the study and understanding of new epidemiological data, the use of modern diagnostic methods, the continuous and effective surveillance, in order to implement correct prevention and control policies, aiming to minimize the incidence of cases in the future. This review attempts to update and highlight newer data on the epidemiology and disease severity of STEC infection, surveillance methods and modern diagnostic methods, highlighting the need for appropriate control measures to prevent, avoid or at least minimize incidence of similar cases in the future.