What is it all about?
    Verocytotoxin-producing Escherichia coli (VTEC) infection is considered a zoonosis* because the gastro-intestinal tract of ruminants, particularly cattle and buffalo, is the natural reservoir of these bacteria. E. coli O157 is included among the agents of foodborne toxins, although the epidemiology of VTEC infections, compared with more classical toxins, has some distinctive features.
     There are numerous VTEC serogroups of which, the best known and most widespread, is E. coli O157. Serogroups O26, O111 and O145 are also very common in our country.

      *Zoonoses are diseases caused by agents transmitted directly or indirectly from animals to humans. The agents responsible for zoonoses include bacteria, viruses, parasites, fungi and other biological entities. Zoonoses pose a threat to human and animal health, with important social and economic repercussions as well.

How does the transmission take place?
   La transmission to humans occurs predominantly through food, through the ingestion of foodstuffs of animal origin contaminated during production or processing (contaminated meat that has not been fully cooked, raw milk, unpasteurized dairy products) but also through vegetables and fruits grown on land fertilized or irrigated with effluent from infected cattle farms. Among the potential sources of infection, an increasingly important role is attributed to water sources, whether for civil, agricultural or bathing purposes. Finally, direct contact with animals belonging to reservoir species and person-to-person transmission (via the fecal-oral route) may play a role in the spread of infection. The incubation period of VTEC infection is between 1 and 5 days.


How can we identify it?
   Microbiological investigations for VTECs require special techniques that are generally not available in clinical and hospital laboratories.
Selective/differential media and agglutination assays for E.coli O157 are commercially available that may allow initial identification. Strains so identified must be confirmed by a reference laboratory, verifying the strain's ability to produce toxin (cell culture cytotoxicity test) and/or the presence of the genes coding for the toxin itself. For diagnostics of VTECs belonging to the other serogroups, referral to specialized laboratories is essential.


How is the problem being handled in Italy?
    Since 1988, the Istituto Superiore di Sanità (ISS) has been coordinating a surveillance system for VTEC infections and the Italian network of the European surveillance system Enter-Net, to which the reference laboratories in the country belong.
In collaboration with the Superior Institute of Health (ISS), the Italian Society of Pediatric Nephrology (SiNePe) has adopted the Italian Registry of Hemolytic Uremic Syndrome (SEU), in which it collects information on cases of the disease occurring in Italy, recording information on patients, clinical features of the disease and causes.

Information extracted from the site: https://www.epicentro.iss.it/seu/vtec

        Rapporto 1 Luglio 2023 / 30 Giugno 2024
excerpt from: https://www.epicentro.iss.it/seu/epidemiologia-italia
     Sixty-eight cases of HUS were registered in Italy between July 1, 2023 and June 30, 2024. The patients came from 18 regions (two cases had residence abroad), while for six cases the disease occurred upon return from a trip abroad. As also largely expected during the period under review, the majority of cases of HUS were reported in pediatric patients (<15 years of age) with 67 cases (98.5 percent of the total).
(...)The highest values were found in Valle d'Aosta (one case reported to the registry), although the majority of cases were reported in Puglia (9 cases), Campania (7 cases) and Veneto (7 cases). In the past 12 months, regions where the rate of reporting of SEU cases was higher than the national average included P.A. Bolzano, Puglia, Basilicata, Friuli-Venezia Giulia, P.A. Trento, Abruzzo, Piemonte, Veneto, and Emilia-Romagna.