Document Detail

A cluster of Escherichia coli O157:H7 infections with the hemolytic-uremic syndrome and death in California. A mandate for improved surveillance.
MedLine Citation:
PMID:  8855679     Owner:  NLM     Status:  MEDLINE    
In mid-January 1993, an outbreak of Escherichia coli O157:H7 infections associated with eating hamburger patties at a fast-food restaurant chain (chain A) was reported in Washington State. From mid-December to mid-January, 9 cases of E coli O157:H7-associated bloody diarrhea and the hemolytic-uremic syndrome had been reported in San Diego County, California. A total of 34 persons had bloody diarrhea, the hemolytic-uremic syndrome, or E coli O157:H7 organisms isolated from stool during the period November 15, 1992, through January 31, 1993. Organisms of E coli O157:H7 identified from 6 persons were indistinguishable from those of the Washington outbreak strain. Illness was associated with eating at chain A restaurants in San Diego (odds ratio, 13; 95% confidence interval, 1.7, 99) and with eating regular-sized hamburgers (odds ratio, undefined; lower-limit 95% confidence interval, 1.3). Improved surveillance by mandating laboratory- and physician-based reporting of cases of E coli O157:H7 infection and the hemolytic-uremic syndrome might have alerted health officials to this outbreak sooner, which could have resulted in earlier investigation and the institution of measures to prevent more cases.
A M Shefer; D Koo; S B Werner; E D Mintz; R Baron; J G Wells; T J Barrett; M Ginsberg; R Bryant; S Abbott; P M Griffin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Western journal of medicine     Volume:  165     ISSN:  0093-0415     ISO Abbreviation:  West. J. Med.     Publication Date:    1996 Jul-Aug
Date Detail:
Created Date:  1996-11-07     Completed Date:  1996-11-07     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0410504     Medline TA:  West J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  15-9     Citation Subset:  AIM; IM    
Division of Field Epidemiology, National Center For Infectious Diseases, Atlanta, Georgia, USA.
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MeSH Terms
California / epidemiology
Case-Control Studies
Cause of Death*
Child, Preschool
Confidence Intervals
Diarrhea / epidemiology,  microbiology
Disease Notification
Disease Outbreaks
Escherichia coli Infections / epidemiology*,  mortality
Escherichia coli O157* / isolation & purification
Feces / microbiology
Gastrointestinal Hemorrhage / epidemiology,  microbiology
Hemolytic-Uremic Syndrome / epidemiology*,  mortality
Meat / microbiology
Middle Aged
Odds Ratio
Population Surveillance*
Washington / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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