First Fatal Cases due to Escherichia coli O157 and Campylobacter jejuni subsp. jejuni Outbreak Occurred in Southern Brazil

In December 2019, four children of the same school were hospitalized due to severe diarrhea, vomiting, and fever, and the mother of one child was diagnosed with hemolytic uremic syndrome (HUS). Escherichia coli O157 NM was isolated from the stool of one child, whereas Campylobacter jejuni isolates were found in feces, raw foods, environmental samples, and tap water. In addition, the same pulsed-field gel electrophoresis profile was identified in C. jejuni isolated from feces and tap water. One child died of renal failure and another due to respiratory failure. Based on symptoms and bacterial isolation, the deaths were assigned to E. coli O157 NM, but coinfection with C. jejuni may have contributed to the severity of symptoms. These were the first deaths assigned to E. coli O157 NM registered in Brazil.