Investigation of an outbreak of bloody diarrhea complicated with hemolytic uremic syndrome

Otar Chokoshvili; Khatuna Lomashvili; Naile Malakmadze; Marika Geleishvil; Jonas Brant; Paata Imnadze; Nazibrola Chitadze; Lia Tevzadze; Gvantsa Chanturia; Tea Tevdoradze; Tengiz Tsertsvadze; Deborah Talkington; Rajal K Mody; Nancy Strockbine; Russell A Gerber; Edmond Maes; Thomas Rush

doi:10.1016/j.jegh.2014.03.004

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Volume 4, Issue 4, December 2014, Pages 249 - 259

Investigation of an outbreak of bloody diarrhea complicated with hemolytic uremic syndrome

Authors

Otar Chokoshvili^a^{, c}^{, 1}^{, *}^,ochokoshvili@gmail.com, Khatuna Lomashvili^a^{, 1}, Naile Malakmadze^a^{, b}^{, 1}^{, 2}, Marika Geleishvil^a^{, 1}, Jonas Brant^b^{, 2}, Paata Imnadze^d^{, 4}, Nazibrola Chitadze^d^{, 4}, Lia Tevzadze^d^{, 4}, Gvantsa Chanturia^d^{, 4}, Tea Tevdoradze^d^{, 4}, Tengiz Tsertsvadze^c^{, 3}, Deborah Talkington^b^{, 2}, Rajal K Mody^b^{, 2}, Nancy Strockbine^b^{, 2}, Russell A Gerber^b^{, 2}, Edmond Maes^a^{, b}^{, 1}^{, 2}, Thomas Rush^a^{, b}^{, 1}^{, 2}

^aSouth Caucasus Field Epidemiology and Laboratory Training Program, 9 M. Asatiani Str., Tbilisi 0177, Georgia

^bU.S. Centers for Diseases Control and Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA

^cInfectious Diseases, AIDS and Clinical Immunology Research Center, 16 Al. Kazbegi Ave, Tbilisi 0160, Georgia

^dNational Center for Diseases Control and Public Health of Georgia, 9 M. Asatiani Str., Tbilisi 0177, Georgia

¹

Tel.: +995 32 224 46 60; fax: +995 32 22446 59.

²

Tel.: +404 639 2206.

³

Tel.: +995 32 398018.

⁴

Tel.: +231 17 54.

^*Corresponding author. Tel.: +995 32 398018.

Corresponding Author

Otar Chokoshviliochokoshvili@gmail.com

Received 11 October 2013, Revised 10 March 2014, Accepted 16 March 2014, Available Online 30 April 2014.

DOI: 10.1016/j.jegh.2014.03.004 How to use a DOI?
Keywords: Bloody diarrhea; Hemolytic uremic syndrome; HUS; E. coli; O104:H4; STEC
Abstract: In July–August 2009, eight patients with bloody diarrhea complicated by hemolytic uremic syndrome (HUS) were admitted to hospitals in Tbilisi, Georgia. We started active surveillance in two regions for bloody diarrhea and post-diarrheal HUS. Of 25 case-patients who developed HUS, including the initial 8 cases, half were ⩾15 years old, 67% were female and seven (28%) died. No common exposures were identified. Among 20 HUS case-patients tested, Shiga toxin was detected in the stools of 2 patients (one with elevated serum IgG titers to several Escherichia coli serogroups, including O111 and O104). Among 56 persons with only bloody diarrhea, we isolated Shiga toxin-producing E. coli (STEC) O104:H4 from 2 and Shigella from 10; 2 had serologic evidence of E. coli O26 infection. These cases may indicate a previously unrecognized burden of HUS in Georgia. We recommend national reporting of HUS and improving STEC detection capacity.
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Next Article In Issue>

Journal: Journal of Epidemiology and Global Health
Volume-Issue: 4 - 4
Pages: 249 - 259
Publication Date: 2014/04/30
ISSN (Online): 2210-6014
ISSN (Print): 2210-6006
DOI: 10.1016/j.jegh.2014.03.004 How to use a DOI?
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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ris enw bib

TY  - JOUR
AU  - Otar Chokoshvili
AU  - Khatuna Lomashvili
AU  - Naile Malakmadze
AU  - Marika Geleishvil
AU  - Jonas Brant
AU  - Paata Imnadze
AU  - Nazibrola Chitadze
AU  - Lia Tevzadze
AU  - Gvantsa Chanturia
AU  - Tea Tevdoradze
AU  - Tengiz Tsertsvadze
AU  - Deborah Talkington
AU  - Rajal K Mody
AU  - Nancy Strockbine
AU  - Russell A Gerber
AU  - Edmond Maes
AU  - Thomas Rush
PY  - 2014
DA  - 2014/04/30
TI  - Investigation of an outbreak of bloody diarrhea complicated with hemolytic uremic syndrome
JO  - Journal of Epidemiology and Global Health
SP  - 249
EP  - 259
VL  - 4
IS  - 4
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2014.03.004
DO  - 10.1016/j.jegh.2014.03.004
ID  - Chokoshvili2014
ER  -

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