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Swimming-associated outbreak of Escherichia coli O157[ratio ]H7

Published online by Cambridge University Press:  01 February 1999

M. PAUNIO ,
R. PEBODY ,
M. KESKIMÄKI ,
M. KOKKI ,
P. RUUTU ,
S. OINONEN ,
V. VUOTARI ,
A. SIITONEN ,
E. LAHTI  and
P. LEINIKKI
M. PAUNIO
Affiliation:
University of Helsinki, Department of Public Health, Mannerheimintie 172, P.O. Box 41 (00014 University of Helsinki), Finland
R. PEBODY
Affiliation:
National Public Health Institute, Department of Infectious Disease Epidemiology, Mannerheimintie 166, (00300 Helsinki 30) Finland
M. KESKIMÄKI
Affiliation:
National Public Health Institute, Laboratory of Enteric Pathogens, Mannerheimintie 166, (00300 Helsinki 30), Finland
M. KOKKI
Affiliation:
National Public Health Institute, Department of Infectious Disease Epidemiology, Mannerheimintie 166, (00300 Helsinki 30) Finland
P. RUUTU
Affiliation:
National Public Health Institute, Department of Infectious Disease Epidemiology, Mannerheimintie 166, (00300 Helsinki 30) Finland
S. OINONEN
Affiliation:
Central Hospital of Seinäjoki, Hanneksenrinne 7, 60220 Seinäjoki, Finland
V. VUOTARI
Affiliation:
Alavus Health Centre, Salmentie 10, 63300 Alavus, Finland
A. SIITONEN
Affiliation:
National Public Health Institute, Laboratory of Enteric Pathogens, Mannerheimintie 166, (00300 Helsinki 30), Finland
E. LAHTI
Affiliation:
National Veterinary and Food Research Institute P.O. Box 368, 00231 Helsinki 23, Finland
P. LEINIKKI
Affiliation:
National Public Health Institute, Department of Infectious Disease Epidemiology, Mannerheimintie 166, (00300 Helsinki 30) Finland
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Abstract

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In 1997 the first outbreak of Escherichia coli O157[ratio ]H7 infections involving 14 cases occurred in Finland. A case was defined as a resident of Alavus with an episode of diarrhoea between 5 and 17 July 1997, and from whom E. coli O157[ratio ]H7 was isolated from stool. The investigation included case searching and a population-based case control study. Five primary and eight symptomatic secondary cases of E. coli O157[ratio ]H7 illness were detected. In the 10 days before the outbreak, all 5 primary patients (aged 3–8 years), but only 6 of 32 population controls from the same age range (Fisher's test, P<0·001) and 4 of 10 sibling controls (P<0·05) had visited (but had not necessarily bathed in) a shallow beach popular among young children. Four out of 5 primary cases had remained within 5 m of the beach while swimming and had swallowed lake water compared to 1 of 5 population controls. These analytical epidemiologic findings incriminated fresh lake water as the vehicle of E. coli O157[ratio ]H7 transmission.

Type
Research Article
Information
Epidemiology & Infection , Volume 122 , Issue 1 , February 1999 , pp. 1 - 5
Copyright
© 1999 Cambridge University Press