Kidney Week

Abstract: PUB470

Vacation in Egypt as Major Risk for Shiga Toxin Escherichia coli Infection in Children during 2023: Data from the ItalKid-HUS Network

Session Information

• Publication Only

Category: Pediatric Nephrology

• 1900 Pediatric Nephrology

Authors

• Ria, Thomas, Centro per la Cura e lo Studio della Sindrome Emolitica Uremica, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Thomas Ria, MD

• Ardissino, Gianluigi, Centro per la Cura e lo Studio della Sindrome Emolitica Uremica, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Gianluigi Ardissino, MD, PhD

• Mancuso, Maria Cristina, Centro per la Cura e lo Studio della Sindrome Emolitica Uremica, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Maria Cristina Mancuso, MD

• Daprai, Laura, SC Patologia Clinica, Laboratorio di Microbiologia, Fondazione IRCCS CA’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

Laura Daprai

• Gazzola, Alessandra, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Lodi, Italy

Alessandra Gazzola, APN

• Arnaboldi, Sara, Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna "Bruno Ubertini" (IZSLER), Brescia, Italy

Sara Arnaboldi, MS

• Luini, Mario Vittorio, Institute of Agricultural Biology and Biotechnology, National Research Council, Lodi, Italy

Mario Vittorio Luini, DVM

• Consonni, Dario, Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Dario Consonni

Background

Hemolytic uremic syndrome (HUS) is a severe thrombotic microangiopathy that may develop as a complication of Shiga toxin-producing Escherichia coli (STEC) infection. Although environmental sources of STEC are known, in individual cases the source of infection usually remains unknown. During 2023 we observed several cases of infection in children returning from vacations, thus we evaluated the association between the infection and travel patterns.

Methods

We analyzed all Shiga toxin genes-positive children with bloody diarrhea identified during 2023 by the ItalKid-HUS Network surveillance system in Northern Italy. Families of infected children were contacted and a short questionnaire regarding recent travels abroad was administered. The exposure time was considered since the 3rd day after the arrival abroad until the 5th day after the return home. A self-controlled case series (SCCS) design was used to calculate relative risk.

Results

Of 43 cases with STEC infection, 32 had uncomplicated infection while 11 developed HUS. Twenty-three subjects did not travel abroad, while 20 had travelled to several destinations. For 12 subjects (10 travelled to Egypt, 1 to Kosovo and 1 to Albania), we identified an association between infection and travelling. The relative risk associated to travelling to Egypt was 88-fold. Serotype analysis excluded the possibility of an epidemic given the variability of the strains found. Exposures analysis didn’t provide evidence of a single potential source of the infection.

Conclusion

There is an elevated risk of acquiring STEC infection (thus of HUS) associated with travelling to Egypt. Specific investigations to identify the source are needed to develop effective preventive measures.