Abstract. An epidemic of enterohemorrhagic colitis caused by Escherichia coli O157:H7 (EHEC-O157) occurred in a nursery school in a rural area of Japan in September 1996. The EHEC-O157 were isolated both from patients and houseflies collected at the school. The flies were suspected to be mechanical vectors of the pathogen. Feeding experiments of EHEC-O157 to houseflies showed that the ingested bacteria were harbored in the intestine of flies and continued to be excreted at least for 3 days after feeding. Scanning electron microscopy showed that a large number of EHEC-O157 adhered to the surface of the housefly mouthparts and actively proliferated in the minute spaces of the labellum. Food masses containing EHEC-O157 in the fly intestine were completely surrounded by a peritrophic membrane during digestion and discharged rapidly. The persistence of bacteria in the intestine and feces is mainly a result of proliferation in the mouthparts and accumulation in the crop. Our results strongly suggest that houseflies are not simple mechanical vectors of EHEC. The epidemiologic potential of houseflies to disseminate EHEC-O157 may be greater than initially suspected.The housefly (Musca domestica vicina) and flies in general are considered to be mechanical vectors of many kinds of pathogens such as bacteria, 1,2 protozoa, 3 viruses, 4 and helminth eggs. 5,6 In recent outbreaks of enterohemorrhagic colitis in nursery schools in Japan, the epidemiologic survey isolated enterohemorrhagic Escherichia coli O157:H7 (EHEC-O157) from both houseflies collected in the school and from patients. The DNA patterns and the type of verotoxin were identical in EHEC-O157 isolated from both flies and patients. 7,8 This result strongly indicated that houseflies in nursery schools disseminated EHEC-O157 to foods, drinks, plates, and utensils, although direct evidence of the transmission has not been clarified. The infective dose for EHEC-O157 is considered to be very low, similar to that of Shigella flexneri or S. dysenteriae. 9,10 There are many qualitative reports of microbial flora in flies, but there are no reports of the number of bacteria that are harbored in the intestine or crop or how long the potential for dissemination of bacteria persists. We investigated the vector potential of houseflies for EHEC-O157 by feeding the flies with bacteria and monitoring them for several days after feeding. We also used scanning electron microscopy to determine whether EHEC-O157 adhered to the surface of housefly mouthparts and transmission electron microscopy to determine whether bacteria proliferated and persisted in the alimentary canal of flies.
MATERIALS AND METHODS
Experimental feeding of EHEC-O157 to houseflies.Houseflies maintained in our insectary were used. Two strains of EHEC-O157 (verotoxin 1-or verotoxin 1Ϫ and 2Ϫproducing strains) were grown in trypticase soy broth (Becton Dickinson, Cockeysville, MD). The concentration of bacteria was approximately 10 9 colony-forming units (CFU)/ml. Adult (6-8-day old), female flies were allowed to fe...