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Shiga toxin-producing Escherichia coli (STEC) are a group of food-borne bacteria associated with outbreaks worldwide. They cause human illnesses ranging from common diarrhea to hemolytic-uremic syndrome (HUS), a life-threatening complication. Various virulence factors are involved in STEC pathogenesis, and Shiga toxins (Stxs) are the most important factors. There are two types of Stxs produced by STEC strains, Stx1 and Stx2, and they consist of a similar structure, an A-subunit associated with five identical B-subunits. The A-subunit is an enzymatically active N-glycosidase that inhibits protein synthesis by cleavage of an adenine base from the 28S rRNA component of the eukaryotic ribosomal 60S subunit, resulting in cell death. The B-subunit recognizes receptors on target cells and binds to them, leading to the internalization of the toxin. Epidemiological and molecular typing studies indicate that STEC strains expressing Stx2 have been associated more closely with severe HUS and hemorrhagic colitis (HC) than STEC producing Stx1 or Stx1 and Stx2. Strains expressing both Stx1 and Stx2 are less toxic than those expressing only Stx2.