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Signs and symptoms of Shiga toxin-producing Escherichia coli (STEC) serogroup O157H7 infection range from mild gastrointestinal to bloody diarrhea and hemolytic uremic syndrome (HUS). We assessed the association between Shiga toxin gene (stx) subtype and disease severity for »3,000 patients with STEC O157H7 in England during 2009-2019. Odds of bloody diarrhea, HUS, or both, were significantly higher for patients infected with STEC O157H7 possessing stx2a only or stx2a combined with other stx subtypes. Odds of severe signs/symptoms were
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