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The role of heightened surveillance in an outbreak of Escherichia coli O157. H7

Published online by Cambridge University Press:  15 May 2009

C. L. Roberts*
Affiliation:
Connecticut Department of Public Health and Addiction Services, Epidemiology Program, Hartford, CT Centers for Disease Control, Division of Field Epidemiology, Epidemic Intelligence Service, Atlanta, GA
P. A. Mshar
Affiliation:
Connecticut Department of Public Health and Addiction Services, Epidemiology Program, Hartford, CT
M. L. Cartter
Affiliation:
Connecticut Department of Public Health and Addiction Services, Epidemiology Program, Hartford, CT
J. L. Hadler
Affiliation:
Connecticut Department of Public Health and Addiction Services, Epidemiology Program, Hartford, CT
D. M. Sosin
Affiliation:
Centers for Disease Control, Division of Field Epidemiology, Atlanta, GA
P. S. Hayes
Affiliation:
Centers for Disease Control, Foodborne and Diarrheal Diseases Branch, Atlanta, GA
T. J. Barrett
Affiliation:
Centers for Disease Control, Foodborne and Diarrheal Diseases Branch, Atlanta, GA
*
* Address correspondence to: Dr Christine Roberts, National Centre for Epidemiology and Population Health. The Australian National University, Canberra. ACT 0200, Australia.
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After instituting laboratory screening for Escherichia coli O157. H7, a Connecticut hospital isolated the organism from four persons in September 1993. As a result, an outbreak of E. coli O157.H7 associated with a country club was detected. The club had served hamburger from the same shipment at two picnics. Attendees of two picnics were interviewed, stool cultures were obtained from symptomatic persons, and the remaining hamburger was cultured. Twenty (22%) of 89 persons who ate hamburger became ill, compared with 1 of 60 who did not eat hamburger (relative risk = 13·5, 95% confidence interval 3·2–56·3). Among persons who ate hamburgers, illness was strongly associated with eating hamburger that was not thoroughly cooked (P < 0·001). All 20 samples from 5 remaining boxes of patties yielded E. coli O157.H7. Isolates from hamburger and case-patients were indistinguishable by pulsed-field gel electrophoresis. Heightened surveillance can rapidly identify outbreaks and may mitigate their impact. However, continued review of food safety issues is necessary if E. coli O157.H7 outbreaks are to be prevented.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1995

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