Austrian Syndrome Associated with Pandemic (H1N1) 2009 in Child

isolate of serotype O123:H– is recorded in the database of the World Health Organization Collaborating Centre for Reference and Research on Escherichia and Klebsiella (F. Scheutz, pers. comm.). Two strains of STEC O123:H– stx2d were isolated from asymptomatic persons in Germany during 1996– 2000 (8). A study in Australia in 2003 reported using a strain of O123:H– stx1 stx2 ehxA from Switzerland that had been isolated from a person with diarrhea (9). We report foodborne transmission of STEC O123:H– that resulted in a cluster of clinical cases of infection. Eating ground beef is a well-established mode of STEC transmission, particularly for serotype O157:H7. STEC serotype O123:H– has been isolated from feces of healthy lambs and sheep in Spain (10) and in southwestern Australia (9) and is considered to be among the predominant ovine STEC serotypes in these countries. This family outbreak shows that STEC serotype O123:H–, albeit rarely described as causing human illness, can cause severe human infection. This serotype can also cause clusters of STEC infections and be transmitted by ingestion of undercooked ground beef.