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Epidemiology of a large restaurant-associated outbreak of Shiga toxin-producing Escherichia coli O111:NM

  • K. K. BRADLEY (a1), J. M. WILLIAMS (a1), L. J. BURNSED (a1), M. B. LYTLE (a1), M. D. McDERMOTT (a1), R. K. MODY (a2), A. BHATTARAI (a2), S. MALLONEE (a1), E. W. PIERCEFIELD (a3), C. K. McDONALD-HAMM (a1) and L. K. SMITHEE (a1)...
Abstract
SUMMARY

In August 2008, a large outbreak of Shiga toxin-producing Escherichia coli (STEC) O111:NM infections associated with a buffet-style restaurant in rural Oklahoma was identified. A case-control study of restaurant patrons and a retrospective cohort study of catered event attendees were conducted coupled with an environmental investigation to determine the outbreak's source and mode of transmission. Of 1823 persons interviewed, 341 (18·7%) met the outbreak case definition; 70 (20·5%) were hospitalized, 25 (7·3%) developed haemolytic uraemic syndrome, and one died. Multiple food items were significantly associated with illness by both bivariate and multivariate analyses, but none stood out as a predominant transmission vehicle. All water, food, and restaurant surface swabs, and stool cultures from nine ill employees were negative for the presence of Shiga toxin and E. coli O111:NM although epidemiological evidence suggested the outbreak resulted from cross-contamination of restaurant food from food preparation equipment or surfaces, or from an unidentified infected food handler.

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Corresponding author
*Author for correspondence: Dr K. K. Bradley, Office of the State Epidemiologist, Oklahoma State Department of Health, 1000 NE Tenth Street, Oklahoma City, OK 73117-1299, USA. (Email: kristyb@health.ok.gov)
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2.LW Riley , Hemorrhagic colitis associated with a rare Escherichia coli serotype. New England Journal of Medicine 1983; 308: 681685.

3.JM Rangel , Epidemiology of Escherichia coli O157:H7 outbreaks, United States, 1982–2002. Emerging Infectious Diseases 2005; 11: 603609.

4.Centers for Disease Control and Prevention. Escherichia coli O157:H7 infections in children associated with raw milk and raw colostrum from cows – California, 2006. Morbidity and Mortality Weekly Report 2008; 57: 625628.

5.BP Bell , A multistate outbreak of Escherichia coli O157: H7-associated bloody diarrhea and hemolytic uremic syndrome from hamburgers: the Washington experience. Journal of the American Medical Association 1994; 272: 13491353.

6.MS Friedman , Escherichia coli O157:H7 outbreak associated with an improperly chlorinated swimming pool. Clinical Infectious Diseases 1999; 29: 298303.

9.ML Ackers , An outbreak of Escherichia coli O157:H7 infections associated with leaf lettuce consumption. Journal of Infectious Diseases 1998; 177: 15881593.

10.ED Hilborn , A multistate outbreak of Escherichia coli O157:H7 infections associated with consumption of mesclun lettuce. Archives of Internal Medicine 1999; 159: 17581764.

11.SH Cody , An outbreak of Escherichia coli O157:H7 infection from unpasteurized commercial apple juice. Annals of Internal Medicine 1999; 130: 202209.

13.JT Brooks , Non-O157 Shiga toxin-producing Escherichia coli infections in the United States, 1983–2002. Journal of Infectious Diseases 2005; 192: 14221429.

14.Centers for Disease Control and Prevention. Laboratory-confirmed non-O157 Shiga toxin-producing Escherichia coli – Connecticut, 2000–2005. Morbidity and Mortality Weekly Report 2007; 56: 2931.

15.PD Fey , Prevalence of non-O157:H7 Shiga toxin-producing Escherichia coli in diarrheal stool samples from Nebraska. Emerging Infectious Diseases 2000; 6: 530533.

16.KE Johnson , CM Thorpe , CL Sears . The emerging clinical importance of non-O157 Shiga toxin-producing Escherichia coli. Clinical Infectious Diseases 2006; 43: 15871595.

17.EB Hedican , Characteristics of O157 versus non-O157 Shiga toxin-producing Escherichia coli infections in Minnesota, 2000–2006. Clinical Infectious Diseases 2009; 49: 358364.

18.S Lathrop , K Edge , J Bareta . Shiga toxin-producing Escherichia coli, New Mexico, USA, 2004–2007. Emerging Infectious Diseases 2009; 15: 12891291.

20.L Gallagher , Outbreak of Escherichia coli O157:H7 at a childcare center – Cook County, IL, 2009. Abstract ID 4278: 2009 Annual CSTE Conference. Buffalo, NY, June 2009.

21.EA Belongia , Transmission of Escherichia coli O157:H7 infection in Minnesota child day-care facilities. Journal of the American Medical Association 1993; 269: 883888.

22.JB Wilson , Verocytotoxigenic Escherichia coli infection in dairy farm families. Journal of Infectious Diseases 1996; 174: 10211027.

23. JMarsh , A restaurant-associated outbreak of E. coli O157 infection. Journal of Public Health Medicine 1992 Mar; 14; 7883.

24.CL Baylis , Survival of Escherichia coli O157:H7, O111:H- and O26: H11 in artificially contaminated chocolate and confectionary products. International Journal of Food Microbiology 2004; 96: 3548.

26. JTBrooks , Outbreak of Shiga toxin-producing Escherichia coli O111:H8 infections among attendees of a high school cheerleading camp. Clinical Infectious Diseases 2004; 38: 190198.

28.FG Coronado , A large outbreak of cryptosporidiosis and Escherichia coli O111 infections associated with consumption of unpasteurized apple cider – New York, 2004, p. 37. Abstract: 54th Epidemic Intelligence Service Conference, Atlanta, April 2005.

29.B Boudailliez , Possible person-to-person transmission of Escherichia coli O111-associated hemolytic uremic syndrome. Pediatric Nephrology 1997; 11: 3639.

32.B Tserenpuntsag , Hemolytic uremic syndrome risk and E. coli O157:H7. Emerging Infectious Diseases 2005; 11: 19551957.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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