27 November 2007

Rare gastroenteritis suspected in NSW

Seven people in NSW, including three children are suspected to have contracted a rare form of bacterial gastroenteritis caused by Shiga toxigenic E coli (or STEC) infection.

The seven suspected cases, mostly from the Hunter New England region, have been reported to NSW Health in the last four weeks and at this stage public health officers investigating have found no link between the individuals. The cases may be part of a seasonal increase associated with warmer weather.

NSW Health Director of Communicable Diseases, Dr Jeremy McAnulty said STEC infection can be serious and can lead to kidney failure, anaemia and bleeding.

"Symptoms of STEC infection include diarrhoea that may have blood in it, abdominal cramps and nausea and vomiting. Symptoms can last five to 10 days and can be especially severe in children," said Dr McAnulty.

"If STEC infection leads to kidney problems, symptoms may then also include bruising or a rash of fine red spots and reduced urination. This complication is known as haemolytic uraemic syndrome.

"Long term complications of haemolytic uraemic syndrome can include kidney damage, high blood pressure and seizures," said Dr McAnulty.

Dr McAnulty urges anyone who develops diarrhoea with blood in it, to seek medical advice. Tests can help show whether there is a STEC infection present. People with haemolytic uraemic syndrome need urgent treatment.

"STEC can be carried by animals such as cattle. People are infected when they come into contact with the faeces of an infected animal or person, either directly or indirectly," Dr McAnulty said.

Some of the more common means of STEC infection transmission include:

• eating contaminated food (undercooked hamburgers, unwashed salad vegetables, and unpasteurised milk or milk products)
• drinking or swimming in contaminated water
• person-to-person contact, for example contact with faeces of an infected child when changing a nappy
• contact with infected animals on farms or at petting zoos.

Dr McAnulty said the most important ways to prevent infection with STEC are to:

• cook hamburgers and sausages thoroughly to at least 71 degrees Celsius - although colour alone is not necessarily a good indicator - do not eat them if there is any pink meat inside
• wash hands well after handling raw meat
• use different knives and cutting boards for raw meat preparation and other food preparation
• wash raw vegetables and fruits thoroughly
• refrigerate perishable food until ready to eat - don't let bacteria incubate out of the fridge
• wash hands well after touching animals or their faeces.

Shiga toxigenic E coli infection is a rare disease. Sixteen cases were reported in NSW in 2005 and 10 in 2006. Twelve have been reported so far in 2007.

Eleven cases of haemolytic uraemic syndrome were reported in NSW in each of 2005 and 2006. Nine have been reported so far in 2007.

Dr McAnulty said with people likely to have barbeques over the summer months there is a possibility that there will be more cases so it's important to maintain good hygiene practices to reduce the chance of contracting the bacteria.

For more information visit the NSW Health website for a fact sheet:
http://www.health.nsw.gov.au/factsheets/infectious/shigatoxigenic.html

For a range of health information, go online to www.health.nsw.gov.au