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An outbreak of Escherichia coli O157[ratio ]H7 infections and haemolytic uraemic syndrome associated with consumption of unpasteurized apple cider

Published online by Cambridge University Press:  01 February 2000

E. D. HILBORN ,
P. A. MSHAR ,
T. R. FIORENTINO ,
Z. F. DEMBEK ,
T. J. BARRETT ,
R. T. HOWARD  and
M. L. CARTTER
E. D. HILBORN
Affiliation:
Centers for Disease Control and Prevention, Epidemiology Program Office, Atlanta, Georgia, USA
P. A. MSHAR
Affiliation:
Connecticut Department of Public Health, Epidemiology Program, Hartford, Connecticut, USA
T. R. FIORENTINO
Affiliation:
Connecticut Emerging Infectious Program, Yale University School of Public Health, New Haven, Connecticut, USA
Z. F. DEMBEK
Affiliation:
Connecticut Department of Public Health, Epidemiology Program, Hartford, Connecticut, USA
T. J. BARRETT
Affiliation:
National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
R. T. HOWARD
Affiliation:
Connecticut Department of Public Health, Laboratory Division, Hartford, Connecticut, USA
M. L. CARTTER
Affiliation:
Connecticut Department of Public Health, Epidemiology Program, Hartford, Connecticut, USA
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Abstract

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During October 1996, an outbreak of Escherichia coli O157[ratio ]H7 infections among Connecticut residents occurred. An epidemiologic investigation included enhanced surveillance and a case-control study. Clinical isolates of Escherichia coli O157[ratio ]H7 were typed by pulsed-field gel electrophoresis (PFGE). Implicated cider samples were analysed by culture and polymerase chain reaction (PCR). Consumption of implicated cider was associated with illness; (matched odds ratio = undefined, 95% confidence interval = 3·5–infinity). Ultimately, a total of 14 outbreak-associated patients were identified. All isolates analysed by PFGE yielded the outbreak-associated subtype. Escherichia coli O157[ratio ]H7 was not cultured from three cider samples; PCR analysis detected DNA fragments consistent with Escherichia coli O157[ratio ]H7 in one. This outbreak was associated with drinking one brand of unpasteurized apple cider. PFGE subtyping supported the epidemiologic association. PCR analysis detected microbial contaminants in the absence of live organisms. Washing and brushing apples did not prevent cider contamination.

Type
Research Article
Information
Epidemiology & Infection , Volume 124 , Issue 1 , February 2000 , pp. 31 - 36
Copyright
© 2000 Cambridge University Press