title: An outbreak of diarrhea due to verotoxin-producing Escherichia coli in the Canadian Northwest Territories.
abstract: In the summer of 1991 a large outbreak of Escherichia coli O157:H7 associated diarrhea occurred in 6 Inuit communities in the Canadian Northwest Territories. The total population of these communities is 5,292. Of the 521 individuals who developed diarrhea, 152 (29%) were positive for E. coli O157:H7 on stool culture or positive by verotoxin analysis. Median age was 6 years. The attack rate for children < 1 year was 43% in the major affected community of Arviat. Hemolytic-uremic syndrome (HUS) developed in 22 cases, and 2 patients died. Asymptomatic stool carriage of verotoxin-producing E. coli (VTEC) 2-5 weeks after diarrheal illness was noted in 4/28 persons followed prospectively. Epidemic curves, case-control studies and phage type testing suggested person-to-person transmission. The original source of infection was not identified, though a food source was suspected. VTEC were detected in 6 food samples (minced beef and caribou) taken from retail outlets and homes. Primary prevention of infection through health education and promotion activities, as well as long-term follow-up of HUS survivors, are indicated in this population.
authors.affiliation: Department of Medical Microbiology, University of Manitoba, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Orr
authors.forename: B
authors.initials: B
authors.lastname: Lorencz
authors.forename: R
authors.initials: R
authors.lastname: Brown
authors.forename: R
authors.initials: R
authors.lastname: Kielly
authors.forename: B
authors.initials: B
authors.lastname: Tan
authors.forename: D
authors.initials: D
authors.lastname: Holton
authors.forename: H
authors.initials: H
authors.lastname: Clugstone
authors.forename: L
authors.initials: L
authors.lastname: Lugtig
authors.forename: C
authors.initials: C
authors.lastname: Pim
authors.forename: S
authors.initials: S
authors.lastname: MacDonald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001427:Bacterial Toxins / Q000009:adverse effects / Q000096:biosynthesis; D002648:Child; D002675:Child, Preschool; D003603:Cytotoxins / Q000009:adverse effects / Q000096:biosynthesis; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D004926:Escherichia coli / Q000302:isolation & purification / Q000378:metabolism; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D005243:Feces / Q000382:microbiology; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015873:Northwest Territories / Q000453:epidemiology; D011446:Prospective Studies; D022622:Shiga Toxin 1
chemical_list: D001427:Bacterial Toxins; D003603:Cytotoxins; D022622:Shiga Toxin 1