title: A multistate outbreak of gastrointestinal illness caused by enterotoxigenic Escherichia coli in imported semisoft cheese.
abstract: In September 1983, three clusters of gastrointestinal illness with similar symptoms affected 45 persons in Washington, D.C., after office parties. The illness lasted a mean of 4.4 days and was characterized by watery diarrhea (91%), abdominal cramps (80%), headache (38%), nausea (38%), and subjective fever (20%). Illness was strongly associated with having eaten imported French Brie cheese one to six days before onset of illness (P less than .0001 by Fisher's two-tailed exact test). After publicity about these outbreaks, additional cheese-associated cases were identified over an eight-week period in Illinois, Wisconsin, Georgia, and Colorado. Stool specimens from ill persons in four states yielded Escherichia coli serotype O27:H20. These organisms produced heat-stable enterotoxin and had similar plasmid profiles. When commercially distributed foods are contaminated, enterotoxigenic E. coli can cause widespread disease even in a developed country, and the disease can easily escape correct diagnosis.
mesh_terms: D000293:Adolescent; D000328:Adult; D001427:Bacterial Toxins; D002611:Cheese / Q000506:poisoning*; D003120:Colorado; D004196:Disease Outbreaks; D004219:District of Columbia; D004768:Enterotoxins / Q000096:biosynthesis; D004926:Escherichia coli / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000378:metabolism; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D029968:Escherichia coli Proteins; D005243:Feces / Q000382:microbiology; D005260:Female; D005516:Food Microbiology; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology*; D005845:Georgia; D006801:Humans; D007087:Illinois; D008297:Male; D008875:Middle Aged; D010957:Plasmids; D014922:Wisconsin
chemical_list: D001427:Bacterial Toxins; D004768:Enterotoxins; D029968:Escherichia coli Proteins; C034151:heat stable toxin (E coli)