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Enterohaemorrhagic Escherichia coli has since the last 2 decades been known to cause severe and bloody diarrhoea as well as haemorrhagic colitis (HC) and haemorrhagic uraemic syndrome (HUS) especially among children. The importance of screening for EHEC among children and older patients with severe symptoms is apparent. Production of the verocytotoxins VT1 and VT2 are the main features of EHEC, and the VT types and mode of action during human infection is described. There are, however, other features adding to the pathogenicity. In this review we deal with the importance of properties such as fimbriae and adhesins as well as systems to meet the bacterial need for iron during infection. These factors are probably important for the establishment of EHEC in the gut and add to the bacterial virulence. It has now become evident that VT producing E. coli, irrespective of serogroup, might be human pathogens. We conclude that knowledge of the different possible virulence factors adds to the possibility of separating more virulent from less virulent isolates.