title: A nationwide case-control study of Escherichia coli O157:H7 infection in the United States.
abstract: Risk factors for Escherichia coli O157:H7 infection were investigated in a case-control study at 10 medical centers throughout the United States. Among 73 case-patients and 142 matched controls, exposures in the 7 days before illness associated with E. coli O157:H7 infection in univariate analysis included consumption of hamburger (matched odds ratio [MOR], 3.8; 95% confidence interval [CI], 1.9-7.9), undercooked hamburger (MOR, 4.5; 95% CI, 1.6-12.2), or hot dogs (MOR, 2.2; 95% CI, 1.1-4.4); eating at a fast-food restaurant (MOR, 2.3; 95% CI, 1.1-4.6); drinking unchlorinated well water (MOR, 2.4; 95% CI, 1.1-5.7); swimming in a pond (MOR, 5.4; 95% CI, 1.1-26.0); and having a household member with diarrhea (MOR, 11.9; 95% CI, 2.7-53.5). In multivariate analysis, only eating undercooked hamburger remained associated with infection. Seven (8%) of 93 patients developed hemolytic uremic syndrome and 1 died. Prevention strategies aimed at modifying risk factors may help to reduce the risk of infection with E. coli O157:H7.
authors.affiliation: Foodborne and Diarrheal Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. lms5@cdc.gov
authors.forename: L
authors.initials: L
authors.lastname: Slutsker
authors.forename: A A
authors.initials: AA
authors.lastname: Ries
authors.forename: K
authors.initials: K
authors.lastname: Maloney
authors.forename: J G
authors.initials: JG
authors.lastname: Wells
authors.forename: K D
authors.initials: KD
authors.lastname: Greene
authors.forename: P M
authors.initials: PM
authors.lastname: Griffin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000382:microbiology; D018562:Disease Transmission, Infectious; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D019453:Escherichia coli O157; D005243:Feces / Q000382:microbiology; D005260:Female; D005511:Food Handling; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008460:Meat / Q000382:microbiology; D008875:Middle Aged; D015999:Multivariate Analysis; D012147:Restaurants; D012307:Risk Factors; D013550:Swimming; D014481:United States / Q000453:epidemiology; D014871:Water Microbiology; D014881:Water Supply