In summer 2009, four boys living in the same suburb in Germany developed diarrhea-associated hemolytic uremic syndrome: three were infected by STEC O157:H- and one died.
Writing in Zoonoses and Public Health, researchers screened the stools of 220 persons which led to the identification of only four additional cases: two asymptomatic carriers and two diarrheal cases.
HUS was strongly associated with visiting a local playground in July, particularly on 16th July (odds ratio = 42.7, P = 0.002). No other commonality, including food, was identified, and all environmental samples (n = 24) were negative. In this localized non-foodborne outbreak, the place of likely infection was a local playground.
The complete abstract is available at http://onlinelibrary.wiley.com/doi/10.1111/j.1863-2378.2011.01405.x/abstract