Escherichia coli O157:H7, an emerging gastrointestinal pathogen. Results of a one-year, prospective, population-based study.
To examine the incidence of Escherichia coli O157:H7 enteric infections in the United States and to evaluate the vehicles of transmission for sporadic cases, we conducted a one-year, population-based study at a large health maintenance organization (HMO) in the Puget Sound area of Washington State. All stool specimens submitted for culture to the HMO laboratory were screened for E coli O157:H7; the organism was identified in 25 (0.4%) of 6485 stool specimens. All patients with E coli O157:H7 identified had diarrhea; 24 patients (96%) had bloody diarrhea. Exposure histories demonstrated that rare ground beef was consumed more often by patients (21%) than by age-matched control subjects (4%) in the week before onset of illness. Raw milk also was consumed by two patients but by none of the control subjects. Incidence rates for laboratory-confirmed enteric infections in the HMO population were as follows: Campylobacter, 50/100,000 person-years; Salmonella, 21/100,000 person-years; E coli O157:H7, 8/100,000 person-years; and Shigella, 7/100,000 person-years. The organism is a more common pathogen in the United States than is generally recognized, and the diagnosis should be considered for patients with suspected enteric infection.
MacDonald
K L
KL
Division of Bacterial Diseases, Centers for Disease Control, Atlanta, GA 30333.
O'Leary
M J
MJ
Cohen
M L
ML
Norris
P
P
Wells
J G
JG
Noll
E
E
Kobayashi
J M
JM
Blake
P A
PA
D000293:Adolescent; D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology*; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008460:Meat / Q000009:adverse effects; D008875:Middle Aged; D008892:Milk / Q000009:adverse effects; D011446:Prospective Studies; D011897:Random Allocation; D014861:Washington
D000900:Anti-Bacterial Agents