Shiga toxin-producing Escherichia coli (STEC) infection is a bacterial infection caused by E. coli strains that produce Shiga toxins, which induce thrombogenic and inflammatory changes in microvascular endothelial cells. The infection primarily manifests as diarrhea, which is bloody in approximately 60% of patients, with a median incubation period of three days. In 5-15% of cases, infection progresses to HUS, defined by the triad of mechanical hemolytic anemia, thrombocytopenia, and acute renal injury [1].
Disease overview
BacterialShiga toxin-producing Escherichia coli infection
产志贺毒素大肠杆菌感染
Evidence-backed informationEN 5/7 applicable sections · ZH 5/7 applicable sectionsUpdated Sep 3, 2026
Shiga toxin-producing Escherichia coli (STEC) is the leading cause of hemolytic uremic syndrome (HUS) in children and has major outbreak potential. Since the early 2010s, STEC epidemiology has shifted from the historically predominant O157 serogroup to non-O157 STEC, particularly O26 and O80 in France. Infection occurs through ingestion of contaminated food or water, person-to-person transmission, or contact with ruminants and their environment. Diagnosis relies on biological screening for Shiga toxins and STEC in stools and serology, while treatment is mainly symptomatic as no specific drug has proven effective [1].
Read the full clinical and epidemiological profile6
The main symptom of STEC infection is diarrhea, which is bloody in approximately 60% of patients. Shiga toxins released by STEC induce a cascade of thrombogenic and inflammatory changes in microvascular endothelial cells. In 5-15% of cases, infection progresses to hemolytic uremic syndrome, characterized by the triad of mechanical hemolytic anemia, thrombocytopenia, and acute renal injury [1].
STEC is the leading cause of hemolytic uremic syndrome in children. Since the early 2010s, STEC epidemiology has been characterized by a decline of the historically predominant O157 serogroup and the emergence of non-O157 STEC, especially O26 and O80, particularly in France. The infection has major outbreak potential [1].
STEC contamination occurs through three main routes: ingestion of contaminated food or water, person-to-person transmission, and contact with ruminants or their contaminated environment [1].
No specific prophylaxis against STEC infection is established. Routine antibiotic use in individuals with STEC infection is not recommended, as evidence does not support a protective effect against progression to HUS [2]. Anti-complement therapy may be considered in life-threatening STEC-HUS cases, though evidence of benefit remains limited [3][4]. Investigational approaches such as microbiota-modulating agents have shown protective effects against STEC in preclinical models but are not yet clinically validated [5].
- 1Bruyand M et al. Hemolytic uremic syndrome due to Shiga toxin-producing Escherichia coli infection. Med Mal Infect. 2018 May. PMID: 29054297. doi: 10.1016/j.medmal.2017.09.012.PubMed: https://pubmed.ncbi.nlm.nih.gov/29054297/
- 2Freedman SB et al. Shiga Toxin-Producing Escherichia coli Infection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis. Clin Infect Dis. 2016 May 15. PMID: 26917812. doi: 10.1093/cid/ciw099.PubMed: https://pubmed.ncbi.nlm.nih.gov/26917812/
- 3Jokiranta TS et al. HUS and atypical HUS. Blood. 2017 May 25. PMID: 28416508. doi: 10.1182/blood-2016-11-709865.PubMed: https://pubmed.ncbi.nlm.nih.gov/28416508/
- 4Mortari G et al. Shiga toxin-producing Escherichia coli infection as a precipitating factor for atypical hemolytic-uremic syndrome. Pediatr Nephrol. 2025 Feb. PMID: 39347991. doi: 10.1007/s00467-024-06480-9.PubMed: https://pubmed.ncbi.nlm.nih.gov/39347991/
- 5Chaves LS et al. Cashew gum fractions protect intestinal mucosa against shiga toxin-producing Escherichia coli infection: Characterization and insights into microbiota modulation. Int J Biol Macromol. 2025 Jun. PMID: 40324507. doi: 10.1016/j.ijbiomac.2025.143916.PubMed: https://pubmed.ncbi.nlm.nih.gov/40324507/
- A04.3
- 1A03
Coverage
Reporting countries and regions
AustraliaAU
AustriaAT
BelgiumBE
BulgariaBG
CanadaCA
CroatiaHR
CyprusCY
CzechiaCZ
DenmarkDK
EstoniaEE
FinlandFI
FranceFR
GermanyDE
GreeceGR
Hong Kong, ChinaHK
HungaryHU
IcelandIS
IrelandIE
ItalyIT
JapanJP
LatviaLV
LiechtensteinLI
LithuaniaLT
LuxembourgLU
MaltaMT
NetherlandsNL
New ZealandNZ
NorwayNO
PolandPL
PortugalPT
RomaniaRO
SlovakiaSK
SloveniaSI
South KoreaKR
SpainES
SwedenSE
SwitzerlandCH
Taiwan, ChinaTW
United KingdomGB
United StatesUS
Trends by reporting country
Monthly patterns over time
Data access
Page dataset index with source links and update metadata.
Official sourcesAuthority, cadence, notes54
Austria AGES Radar for Infectious Diseases
Austria
AGES Radar monthly national source. Internal ingestion retains native categories; public release is disabled pending licence review.
Australia NINDSS
Australia
Australian national notifiable diseases surveillance dashboard.
Australia NINDSS — Australian Capital Territory
Australian Capital Territory, Australia
Australian NINDSS monthly state/territory notifications for Australian Capital Territory, kept separate from the Australia national aggregate.
Australia NINDSS — New South Wales
New South Wales, Australia
Australian NINDSS monthly state/territory notifications for New South Wales, kept separate from the Australia national aggregate.
Australia NINDSS — Northern Territory
Northern Territory, Australia
Australian NINDSS monthly state/territory notifications for Northern Territory, kept separate from the Australia national aggregate.
Australia NINDSS — Queensland
Queensland, Australia
Australian NINDSS monthly state/territory notifications for Queensland, kept separate from the Australia national aggregate.
Australia NINDSS — South Australia
South Australia, Australia
Australian NINDSS monthly state/territory notifications for South Australia, kept separate from the Australia national aggregate.
Australia NINDSS — Tasmania
Tasmania, Australia
Australian NINDSS monthly state/territory notifications for Tasmania, kept separate from the Australia national aggregate.
Australia NINDSS — Victoria
Victoria, Australia
Australian NINDSS monthly state/territory notifications for Victoria, kept separate from the Australia national aggregate.
Australia NINDSS — Western Australia
Western Australia, Australia
Australian NINDSS monthly state/territory notifications for Western Australia, kept separate from the Australia national aggregate.
ECDC Surveillance Atlas — Belgium Annual Baseline
Belgium
Belgium annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Bulgaria Annual Baseline
Bulgaria
Bulgaria annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Canada PHAC CNDSS Annual
Canada
Canada is the national jurisdiction; subdivision feeds are registered separately.
Public Health Ontario IDTO Monthly
Ontario, Canada
Ontario-level current-year preliminary monthly case counts from Public Health Ontario's IDTO report.
Switzerland FOPH IDD
Switzerland
Switzerland FOPH/BAG IDD mandatory reporting API normalized to national case rows. Monthly series may use the dashboard CHFL aggregate where CH-only monthly series are not exposed.
ECDC Surveillance Atlas — Cyprus Annual Baseline
Cyprus
Cyprus annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Czechia Annual Baseline
Czechia
Czechia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Germany RKI SurvStat 2.0
Germany
RKI SurvStat national weekly notification export; raw ZIP exports are retained and recent weeks are overwritten for revisions.
ECDC Surveillance Atlas — Denmark Annual Baseline
Denmark
Denmark annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Estonia Annual Baseline
Estonia
Estonia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Spain Annual Baseline
Spain
Spain annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Finland THL Infectious Diseases Register
Finland
Finland THL Infectious Diseases Register national monthly case counts. The current month is ingested as provisional and the latest three months are refreshed for source revisions.
ECDC Surveillance Atlas — France Annual Baseline
France
France annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — United Kingdom Annual Baseline
United Kingdom
United Kingdom annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Greece Annual Baseline
Greece
Greece annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Hong Kong, China CHP Notifiable Diseases
Hong Kong, China
Hong Kong, China CHP annual notifiable infectious disease CSVs normalized to national monthly totals
ECDC Surveillance Atlas — Croatia Annual Baseline
Croatia
Croatia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Hungary Annual Baseline
Hungary
Hungary annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Ireland HPSC Notifiable Diseases Hub
Ireland
Ireland HPSC national weekly notifiable-disease totals from the official ArcGIS FeatureServer. Internal ingestion is enabled; public release remains disabled pending written redistribution permission.
Iceland Directorate of Health Annual Dashboard
Iceland
National annual case notifications by disease. Published values can be revised retrospectively and remain annual period totals.
Iceland Directorate of Health STI Dashboard
Iceland
Monthly STI diagnosis facts from laboratory and registry surveillance; the official dashboard is published on a quarterly schedule.
Iceland Directorate of Health Respiratory Dashboard
Iceland
ISO-week respiratory diagnosis counts. Hospitalizations, samples, and vaccination indicators are separate measures and are not counted as diagnoses.
Iceland Directorate of Health Historical Registry
Iceland
Historical official registry tables for 1997–2021, with annual totals and disease-specific monthly notification facts retained at source grain.
Iceland Directorate of Health Legacy ICD Monthly
Iceland
Historical Saga EHR ICD encounter counts for 1997–2020. This clinical measure is non-comparable with registry notifications and is kept separate.
ECDC Surveillance Atlas — Italy Annual Baseline
Italy
Italy annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
JP NIID Weekly
Japan
Japan weekly infectious disease surveillance via NIID/JIHS.
Korea KDCA EID
South Korea
Korea KDCA notifiable infectious disease OpenAPI or portal/KOSIS downloads aggregated to national monthly notification counts.
ECDC Surveillance Atlas — Liechtenstein Annual Baseline
Liechtenstein
Liechtenstein annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Lithuania Annual Baseline
Lithuania
Lithuania annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Luxembourg Annual Baseline
Luxembourg
Luxembourg annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Latvia Annual Baseline
Latvia
Latvia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Malta Annual Baseline
Malta
Malta annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Netherlands Annual Baseline
Netherlands
Netherlands annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Norway FHI MSIS Statistics Bank
Norway
Norway FHI MSIS national monthly notifications from the official Allvis frontend API; adapter contract checks guard the unversioned endpoint.
New Zealand PHF Science Monthly Notifiable Diseases
New Zealand
PHF Science (formerly ESR) monthly notifiable disease surveillance data via internal globalID2 crawler
ECDC Surveillance Atlas — Poland Annual Baseline
Poland
Poland annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Portugal Annual Baseline
Portugal
Portugal annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Romania Annual Baseline
Romania
Romania annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Sweden Public Health Agency SmiNet
Sweden
Sweden SmiNet national monthly reported cases from the official Public Health Agency statistics pages; public release is enabled with closed-month publication and revisable recent-month refreshes.
ECDC Surveillance Atlas — Slovenia Annual Baseline
Slovenia
Slovenia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Slovakia Annual Baseline
Slovakia
Slovakia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Taiwan, China CDC NIDSS
Taiwan, China
Taiwan, China monthly notifiable infectious disease open-data CSV feed.
US CDC NNDSS
United States
CDC National Notifiable Diseases Surveillance System provisional data.
US CDC NHSS HIV
United States
CDC NNDSS weekly data plus NHSS annual national HIV diagnoses