title: Escherichia coli O157:H7 outbreak linked to salami, British Columbia, Canada, 1999.
abstract: An outbreak of E. coli O157:H7 infections was identified in November 1999 with a fivefold increase in the occurrence of laboratory-confirmed cases of E. coli O157:H7 infection. A matched case-control study was conducted. Samples of food from cases and from retailers were analysed for the presence of E. coli O157:H7. A total of 143 cases were identified over a 12-week period with the same pulsed-field gel electrophoresis (PFGE) pattern. The case-control study found that Company A salami was significantly associated with illness (Mantel-Haenszel matched odds ratio 10.0%, 95% CI 1.4-434, P=0.01). Company A salami tested positive for E. coli O157:H7 and isolates had the same PFGE pattern as case isolates. An immediate voluntary national recall of Company A dry fermented meat products took place. Findings from the investigation of this outbreak suggest that the hold-and-test option may not be adequate to prevent shiga-toxigenic Escherichia coli (STEC) infection in salami consumers.
authors.affiliation: Health Canada, Population and Public Health Branch, Field Epidemiology Training Program, Ottawa, Canada.
authors.forename: D M
authors.initials: DM
authors.lastname: MacDonald
authors.forename: M
authors.initials: M
authors.lastname: Fyfe
authors.forename: A
authors.initials: A
authors.lastname: Paccagnella
authors.forename: A
authors.initials: A
authors.lastname: Trinidad
authors.forename: K
authors.initials: K
authors.lastname: Louie
authors.forename: D
authors.initials: D
authors.lastname: Patrick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004927:Escherichia coli Infections / Q000453:epidemiology*; D019453:Escherichia coli O157; D005260:Female; D005516:Food Microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011634:Public Health