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Clinical manifestations

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  • Usually 2-4 days for STEC O157 and similar for most strains of non-O157 STEC

  • Gastroenteritis:
    • May be asymptomatic
    • Non-bloody diarrhoea, fever, abdominal cramps and vomiting
    • Bloody diarrhoea and severe abdominal pain in more severe disease
    • Usually self-limiting with recovery in around 10 days
  • Haemolytic uraemic syndrome (HUS): - Approximately 10% of STEC O157 cases develop HUS
    • Characterised by acute renal failure, thrombocytopenia and microangiopathic haemolytic anaemia
    • Children aged less than 5 years are at greatest risk of developing HUS, usually 1 week after onset of bloody diarrhoea
    • Around 50% may develop chronic renal complications. Mortality is between 3-5%

Non-O157 infections show a similar spectrum of illness but several strains have been associated with more severe disease (bloody diarrhoea and HUS) including O26, O45 and others


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