A Severe Outbreak ofEscherichia coliO157:H7–Associated Hemorrhagic Colitis in a Nursing Home

Abstract

In September 1985, an outbreak of Escherichia coli O157:H7 enteritis affected 55 of 169 residents and 18 of 137 staff members at a nursing home. The outbreak was characterized by two phases: a primary wave whose source was probably a contaminated sandwich meal and a secondary wave compatible with person-to-person transmission of infection. Among the elderly residents, the incubation period was 4 to 9 days (mean, 5.7 +/- 1.2). Older age and previous gastrectomy increased the risk of acquiring the infection (P = 0.01 and 0.03, respectively). Antibiotic therapy during exposure was associated with acquiring a secondary infection (P = 0.001). Hemolytic uremic syndrome developed in 12 affected residents (22 percent), 11 of whom died. Overall, 19 (35 percent) of the affected residents died, 17 (31 percent) from causes attributable to their infection. Antibiotic therapy after the onset of symptoms was associated with a higher case fatality rate in the more severe cases, possibly because patients with more severe disease tended to be treated with antibiotics. There were no complications or deaths among the affected members of the staff. Evidence of infection by verotoxin-producing E. coli O157:H7 was detected in 30 of 70 cases on the basis of isolation of this organism or demonstration of free verotoxin in stools. All isolates belonged to the same phage type. The high morbidity and mortality associated with this condition emphasize the need for proper food hygiene, rapid identification of outbreaks of disease, and prompt institution of infection-control techniques among the institutionalized elderly.

A christening party outbreak of haemorrhagic colitis and haemolytic uraemic syndrome associated with Escherichia coli O 157. H7

“…The attack rate (28 %) was comparable with other outbreaks (2, 4, 5). The modal incubation period of 2 days was shorter than reported elsewhere (1,5) and similar to that reported for enterotoxigenic E. coli. Excretion of the organism was identified up to 16 days after the reception and up to 14 days after onset of illness.…”

“…Subsequently, outbreaks and sporadic cases have been reported from North America (2-7) and Japan (8). Some cases have developed haemolytic uraemic syndrome (HUS) (3)(4)(5)9). In England and Wales sporadic cases of HUS (10) and HC (8) and one outbreak of HC in East Anglia in 1985 (11) (12,13).…”

A longitudinal study of Vero cytotoxin producing Escherichia coli in cattle calves in Sri Lanka

“…The epidemiology of V'TEC in cattle is relevant not only from a veterinary point of view, but also because VTEC associated outbreaks of human disease have often been food borne [4,12]. Many VTEC outbreaks have been attributed to the serotype 0 157.H7, and therefore many epidemiological studies have been focused exclusively on this serotype.…”

Common infectious enteritides - Part 2: Treatment

“…Z. kontrovers diskutiert. Einige Studien zeigten eine Verschlechterung der Erkrankung durch eine antibiotische Behandlung (16,17). Dies wurde auch durch eine neuere grö-ßere prospektive Studie bestätigt (18).…”