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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Epidemic diarrhea due to enterotoxigenic Escherichia coli
Clinical Infectious Diseases, Volume 42, No. 3, Year 2006
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Description
Background. In June 1998, we investigated one of the largest foodborne outbreaks of enterotoxigenic Escherichia coli gastroenteritis reported in the United States. Methods. We conducted cohort studies of 11 catered events to determine risk factors for illness. We used stool cultures, polymerase chain reaction, and serologic tests to determine the etiologic agent, and we conducted an environmental inspection to identify predisposing conditions and practices at the implicated establishment. Results. During 5-7 June, the implicated delicatessen catered 539 events attended by >16,000 people. Our epidemiological study of 11 events included a total of 612 attendees. By applying the median prevalence of illness (20%) among events with ill attendees to the total number of events with any ill attendees, we estimate that at least 3300 persons may have developed gastroenteritis during this outbreak. Multiple food items (potato salad, macaroni salad, egg salad, and watermelon) were associated with illness, all of which required extensive handling during preparation. Enterotoxigenic Escherichia coli serotypc O6:H16 producing heat-labile and heat-stable toxins was isolated from the stool specimens from 11 patients. Eight patients with positive stool culture results, 11 (58%) of 19 other symptomatic attendees, and 0 (0%) of 17 control subjects had elevated serum antibody titers to E coli O6 lipopolysaccharide. The delicatessen had inadequate hand-washing supplies, inadequate protection against back siphonage of wastewater in the potable water system, a poorly draining kitchen sink, and improper food storage and transportation practices. Conclusions. In the United States, where enterotoxigenic Escherichia coli is an emerging cause of foodborne disease, enterotoxigenic Escherichia coli should be suspected in outbreaks of gastroenteritis when common bacterial or viral enteric pathogens are not identified. © 2005 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Beatty, Mark Edward
Unknown Affiliation
Adcock, Penny M.
Unknown Affiliation
Smith, Stephanie W.
Unknown Affiliation
Quinlan, Kyran
Unknown Affiliation
Kamimoto, Laurie A.
Unknown Affiliation
Rowe, Samantha Y.
Unknown Affiliation
Scott, Karen
Unknown Affiliation
Conover, Craig
Unknown Affiliation
Varchmin, Thomas
Unknown Affiliation
Bopp, Cheryl A.
Unknown Affiliation
Greene, Katherine D.
Unknown Affiliation
Bibb, Bill
Unknown Affiliation
Slutsker, Laurence
Unknown Affiliation
Mintz, Eric Daniel
Unknown Affiliation
Statistics
Citations: 60
Authors: 14
Affiliations: 12
Identifiers
Doi:
10.1086/499246
ISSN:
10584838
Research Areas
Environmental
Food Security
Study Design
Cross Sectional Study
Cohort Study