title: E. coli O157 phage type 21/28 outbreak in North Cumbria associated with pasteurized milk.
abstract: In March 1999, a large community outbreak of Escherichia coli O157 infection occurred in North Cumbria. A total of 114 individuals were reported to the Outbreak Control Team (OCT); 88 had laboratory confirmed E. coli O157. Twenty-eight (32%) of the confirmed cases were admitted to hospital, including three children (3.4%) with haemolytic uraemic syndrome. There were no deaths. A case-control study found that illness was strongly associated with drinking pasteurized milk from a local farm (P = <0.0001) on single variable analysis. Microbiological investigations at the farm revealed E. coli O157 phage type (PT) 21/28 VT 2 which was indistinguishable from the human isolates by pulsed field gel electrophoresis. At the time of occurrence this was the largest E. coli O157 outbreak in England and Wales and the first E. coli O157 PT 21/28 VT 2 outbreak associated with pasteurized milk. This outbreak highlights lessons to be learnt regarding on-farm pasteurization.
authors.affiliation: North Cumbria Health Authority, Wavell Drive, Rosehill, Carlisle, Cumbria CAI 2SE.
authors.forename: S
authors.initials: S
authors.lastname: Goh
authors.forename: C
authors.initials: C
authors.lastname: Newman
authors.forename: M
authors.initials: M
authors.lastname: Knowles
authors.forename: F J
authors.initials: FJ
authors.lastname: Bolton
authors.forename: V
authors.initials: V
authors.lastname: Hollyoak
authors.forename: S
authors.initials: S
authors.lastname: Richards
authors.forename: P
authors.initials: P
authors.lastname: Daley
authors.forename: D
authors.initials: D
authors.lastname: Counter
authors.forename: H R
authors.initials: HR
authors.lastname: Smith
authors.forename: N
authors.initials: N
authors.lastname: Keppie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000383:Agriculture; D000818:Animals; D016022:Case-Control Studies; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D003612:Dairying; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004739:England / Q000453:epidemiology; D019453:Escherichia coli O157 / Q000235:genetics / Q000472:pathogenicity*; D005260:Female; D005506:Food Contamination; D005519:Food Preservation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008892:Milk / Q000382:microbiology*; D013242:Sterilization