An outbreak of Escherichia coli O157:H7 infections associated with leaf lettuce consumption.
In July 1995, 40 Montana residents were identified with laboratory-confirmed Escherichia coli O157:H7 infection; 52 residents had bloody diarrhea without laboratory confirmation. The median age of those with laboratory-confirmed cases was 42 years (range, 4- 86); 58% were female. Thirteen patients were hospitalized, and 1 developed hemolytic-uremic syndrome. A case-control study showed that 19 (70%) of 27 patients but only 8 (17%) of 46 controls reported eating purchased (not home-grown) leaf lettuce before illness (matched odds ratio, 25.3; 95% confidence interval, 3.9-1065.6). Pulsed-field gel electrophoresis identified a common strain among 22 of 23 isolates tested. Implicated lettuce was traced to two sources: a local Montana farm and six farms in Washington State that shipped under the same label. This outbreak highlights the increasing importance of fresh produce as a vehicle in foodborne illness. Sanitary growing and handling procedures are necessary to prevent these infections.
Ackers
M L
ML
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Mahon
B E
BE
Leahy
E
E
Goode
B
B
Damrow
T
T
Hayes
P S
PS
Bibb
W F
WF
Rice
D H
DH
Barrett
T J
TJ
Hutwagner
L
L
Griffin
P M
PM
Slutsker
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D016022:Case-Control Studies; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004812:Epidemiologic Methods; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D019453:Escherichia coli O157; D005260:Female; D006801:Humans; D018545:Lactuca / Q000506:poisoning*; D008070:Lipopolysaccharides / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D018515:Plant Leaves; D012756:Sheep
D008070:Lipopolysaccharides