We examined 1,266 fecal specimens from healthy cattle during the investigations of two sporadic cases of hemolytic uremic syndrome associated with raw milk consumption and an outbreak of gastroenteritis and hemolytic uremic syndrome caused by Escherichia coli serotype O157:H7. We collected specimens from heifers, calves, and adult cows on 22 farms, in a stockyard, and in a packing house. We also collected 3 raw hamburger specimens from a restaurant and 23 raw milk samples from two farms. All specimens were examined for E. coli O157:H7 by using sorbitol-MacConkey agar, H immobilization, O157 agglutination, and tissue culture cytotoxicity. E. coli O157:H7 was isolated from 16 heifers or calves and 1 adult cow on 22 farms, 1 stockyard calf, 2 beef specimens, and 1 raw milk sample. Selected fecal specimens were also examined for the presence of other Shiga-like-toxin-producing E. coli (SLTEC) by testing polymyxin B extracts of colony sweeps and then testing individual colonies for toxin production. SLTEC other than O157 was isolated from 8 of 10 farms investigated and from the stockyard; 8% of adult cows and 19% of heifers and calves were positive for SLTEC. Several animals were positive for SLTEC by colony sweep only. This investigation demonstrates that dairy cattle are a reservoir of E. coli O157:H7 and other SLTEC.
In September 1984, an outbreak of Escherichia coli O157:H7 infection occurred in a nursing home. It wasthe first recognized outbreak of this organism in the United States since 1982, when two outbreaks led to its recognition as a pathogen. Thirty-four of 101 residents developed a diarrheal illness; 14 were hospitalized with a severe illness characterized by crampy abdominal pain, marked abdominal distention, and grossly bloody diarrhea, and four died. The spectrum of illness associated with the infection was broad and included the following: asymptomatic infection, nonbloody diarrhea, hemorrhagic colitis, hemolytic uremic syndrome, and death. Clinical, radiographic, and postmortem pathological findings suggestedinvolvement of the cecum and right colon. No evidence of response to antimicrobial agents could be documented, and antidiarrheal agents may have aggravated the disease. This investigation implicated hamburger as the vehicle of transmission. Seventeen of 19 residents with hemorrhagic colitis, but only 28 of 67 healthy residents, had eaten hamburger on 13 September (P < .001, Fisher's two-tailed exact test; relative risk [RR] = 7.7). Infection with E. coli O157:H7 can cause a wide range of manifestations. In the elderly these can be particularly severe and may resemble ischemic colitis.
Journal Article Molecular Subtyping Of Toxigenic Vibrio Cholerae O139 Causing Epidemic Cholera In India And Bangladesh, 1992–1993 Get access Tanja Popovic, Tanja Popovic Reprints or correspondence: Dr. Tanja Popovic, Foodborne and Diarrheal Diseases Branch, NCID/DBMD, Centers for Disease Control and Prevention, 1600 Clifton Rd,, Bldg, 1, B303, MS C03, Atlanta, GA 30333. Search for other works by this author on: Oxford Academic PubMed Google Scholar Patricia I. Fields, Patricia I. Fields Search for other works by this author on: Oxford Academic PubMed Google Scholar Orjan Olsvik, Orjan Olsvik Search for other works by this author on: Oxford Academic PubMed Google Scholar Joy G. Wells, Joy G. Wells Search for other works by this author on: Oxford Academic PubMed Google Scholar Gracia M. Evins, Gracia M. Evins Search for other works by this author on: Oxford Academic PubMed Google Scholar Daniel N. Cameron, Daniel N. Cameron Search for other works by this author on: Oxford Academic PubMed Google Scholar J. J. Farmer, III, J. J. Farmer, III Search for other works by this author on: Oxford Academic PubMed Google Scholar Cheryl A. Bopp, Cheryl A. Bopp Search for other works by this author on: Oxford Academic PubMed Google Scholar Kaye Wachsmuth, Kaye Wachsmuth Search for other works by this author on: Oxford Academic PubMed Google Scholar R. Bradley Sack, R. Bradley Sack Search for other works by this author on: Oxford Academic PubMed Google Scholar ... Show more M. John Albert, M. John Albert Search for other works by this author on: Oxford Academic PubMed Google Scholar G. Balakrish Nair, G. Balakrish Nair Search for other works by this author on: Oxford Academic PubMed Google Scholar Toshio Shimada, Toshio Shimada Search for other works by this author on: Oxford Academic PubMed Google Scholar John C. Feeley John C. Feeley Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 171, Issue 1, January 1995, Pages 122–127, https://doi.org/10.1093/infdis/171.1.122 Published: 01 January 1995 Article history Received: 15 April 1994 Revision received: 02 August 1994 Published: 01 January 1995
This study sought to determine whether a multistate fast food hamburger-associated outbreak of Escherichia coli O157:H7 infection involved Las Vegas residents as well and, if so, why public health officials had not detected it.A matched case-control study was conducted among persons with bloody diarrhea and their healthy meal companions. Hamburger production, distribution, and cooking methods were reviewed. Unused hamburger patties were cultured, and E. coli O157:H7 isolates were characterized. Local laboratory stool culture practices were reviewed.Fifty-eight cases of bloody diarrhea were identified. Illness was associated with eating regular hamburgers (matched odds ratio [OR] = 9.0, 95% confidence interval [CI] = 1.02,433.4), but 25% of ill persons reported eating only jumbo hamburgers. Regular and jumbo hamburger patties yielded E. coli O157:H7 indistinguishable from the lone clinical isolate. No local laboratory cultured routinely for E. coli O157:H7 until after the outbreak.A large outbreak of E. coli O157:H7 infections escaped timely notice in Las Vegas because local laboratories did not culture for this pathogen. Health officials should encourage laboratories to screen at least all bloody stools on sorbitol-MacConkey medium.
SUMMARY Epidemic cholera reached Guatemala in July 1991. By mid-1993, Guatemala ranked third in the hemisphere in reported cases of cholera. We conducted a case-control study with two age-, sex-, and neighbourhood-matched controls per patient in periurban Guatemala City. Twenty-six patients hospitalized for cholera and 52 controls were enrolled. Seven (47%) of 15 stool cultures obtained after admission yielded toxigenic Vibrio cholerae Ol. All seven were resistant to furazolidone, sulfisoxazole, and streptomycin, and differed substantially by pulsed-field gel electrophoresis from the Latin American epidemic strain dominant in the hemisphere since 1991. In univariate analysis, illness was associated with consumption of left-over rice (odds ratio [OR] = 7·0, 95% confidence interval [CI] = 1·4–36), flavored ices (‘helados’) (OR = 3·6, CI = 1·1–12), and street-vended non-carbonated beverages (OR = 3·8, CI = 1·2–12) and food items (OR = 11·0, CI = 2·3–54). Street-vended food items remained significantly associated with illness in multivariate analysis (OR = 6·5, CI = 1·4–31). Illness was not associated with drinking municipal tap water. Maintaining water safety is important, but slowing the epidemic in Guatemala City and elsewhere may also require improvement in street vendor food handling and hygiene.
Journal Article Enteric Disease in Rabbits Inoculated with Stool Filtrates from Persons with Chronic Diarrhea Get access Lyle L. Myers, Lyle L. Myers 1 Please address requests for reprints to Dr. Lyle Myers, Veterinary Research Laboratory, Agricultural Experiment Station, Montana State University, Bozeman, Montana 59717. Search for other works by this author on: Oxford Academic PubMed Google Scholar Douglas S. Shoop, Douglas S. Shoop Search for other works by this author on: Oxford Academic PubMed Google Scholar Morris E. Parter, Morris E. Parter Search for other works by this author on: Oxford Academic PubMed Google Scholar Joy G. Wells Joy G. Wells Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 159, Issue 1, January 1989, Pages 133–135, https://doi.org/10.1093/infdis/159.1.133 Published: 01 January 1989 Article history Received: 04 April 1988 Revision received: 25 July 1988 Published: 01 January 1989
Since the Latin American cholera epidemic began in 1991, 447 isolates of Vibrio cholerae O1 from the Western Hemisphere have been assayed by multilocus enzyme electrophoresis (MEE) to determine allelic variation among 16 enzyme-encoding genes. Two electrophoretic types (ETs) were identified among toxigenic isolates from Latin America: 323 were ET 4, the ET associated with the Latin American epidemic, and 29 were ET 3. Twenty-three of these ET 3 isolates had a distinctive antimicrobial resistance pattern also seen in isolates imported into the United States from Latin America and Southeast Asia. These resistant isolates had an identical ribotype and nearly identical pulsed-field gel electrophoresis (PFGE) patterns. Most nontoxigenic isolates analyzed were not precursors or descendants of toxigenic epidemic strains. MEE provided a population genetic frame-work for the interpretation of PFGE and ribotype data from the isolates in this study. All three methods identified 2 distinct strains of toxigenic V. cholerae O1 currently epidemic in Latin America.
All strains of Escherichia coli isolated from cases of hemorrhagic colitis and sent to the Centers for Disease Control, Atlanta, Ga., over a 3-year period were assayed for toxicity in Vero cell cultures. Strains that produced moderate or high levels of verotoxin were characterized by serotype, biotype, antimicrobial resistance, plasmid profile, and adherence to HeLa cells. Over 200 isolates were typical O157:H7 strains. Six isolates were atypical O157:H7 strains; two were resistant to antimicrobial agents; one was indole negative, two were citrate positive, and one was urea positive. Six isolates were nonmotile O157 strains. All of these isolates were similar to typical O157:H7 strains by plasmid profile and negative or slow sorbitol fermentation. Eleven other verotoxigenic isolates did not possess the O157 antigen, had a variety of plasmid profiles, and were sorbitol positive. Two of the eleven were enteropathogenic serotypes (O111:NM and O26:H11), yet none were adherent to HeLa cells. We conclude that verotoxigenic E. coli associated with hemorrhagic colitis includes atypical O157 strains and other serotypes. Hence, investigators should use current screening methods with caution.
Recovery of Shigella spp. from fecal specimens transported in buffered glycerol saline and Cary-Blair media held at frozen, refrigerated, or room temperature was compared with recovery by direct plating of fecal specimens. Buffered glycerol saline was the better transport medium for the recovery of Shigella spp. Refrigerated or frozen transport temperatures were superior to room temperature for recovery from either medium.
