Enterohaemorrhagic Escherichia coli O104:H4: are we prepared now?

It is over. The outbreak of the enterohaemorrhagic Escherichia coli (EHEC) O104:H4 infection that had its major focus in Germany [1] and affected people in many other European countries has officially come to an end [2]. While the media coverage has been decreasing, the scientific community has been working to understand the reason why this dramatic outbreak occurred. We have learnt that the pathogen is not a totally new clone, but is a slight variant of a known – although rarely described – EHEC, called HUSEC-41 [3] with an extended-spectrum beta-lactamase (ESBL) resistance. Furthermore, the strain carries genes typically found in two types of pathogenic E. coli, the enteroaggregative E. coli (EAEC) and EHEC [4,5]. It specifically carries the genes for the classical haemolytic uraemic syndrome (HUS)-associated Shiga toxin 2.