Escherichia coli O157:H7 Infections Associated With Consumption of Locally Grown Strawberries Contaminated by Deer
| Autor: | Kimberly K. Repp, Trevor Hostetler, Mathieu Tourdjman, Matthew R. Laidler, Richard Leman, Mansour Samadpour, Genevieve L. Buser, William E. Keene |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Microbiology (medical) Veterinary medicine Adolescent Biology Escherichia coli O157 medicine.disease_cause Fragaria Microbiology Foodborne Diseases Feces Young Adult Pulsed-field gel electrophoresis medicine Animals Humans Child Escherichia coli Escherichia coli Infections Aged Disease Reservoirs Aged 80 and over Deer Outbreak Middle Aged Contamination Subtyping Fecal coliform Infectious Diseases Child Preschool Food Microbiology Female |
| Zdroj: | Clinical Infectious Diseases. 57:1129-1134 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/cit468 |
| Popis: | Background An outbreak of Escherichia coli O157:H7 was identified in Oregon through an increase in Shiga toxin-producing E. coli cases with an indistinguishable, novel pulsed-field gel electrophoresis (PFGE) subtyping pattern. Methods We defined confirmed cases as persons from whom E. coli O157:H7 with the outbreak PFGE pattern was cultured during July-August 2011, and presumptive cases as persons having a household relationship with a case testing positive for E. coli O157:H7 and coincident diarrheal illness. We conducted an investigation that included structured hypothesis-generating interviews, a matched case-control study, and environmental and traceback investigations. Results We identified 15 cases. Six cases were hospitalized, including 4 with hemolytic uremic syndrome (HUS). Two cases with HUS died. Illness was significantly associated with strawberry consumption from roadside stands or farmers' markets (matched odds ratio, 19.6; 95% confidence interval, 2.9-∞). A single farm was identified as the source of contaminated strawberries. Ten of 111 (9%) initial environmental samples from farm A were positive for E. coli O157:H7. All samples testing positive for E. coli O157:H7 contained deer feces, and 5 tested farm fields had ≥ 1 sample positive with the outbreak PFGE pattern. Conclusions The investigation identified fresh strawberries as a novel vehicle for E. coli O157:H7 infection, implicated deer feces as the source of contamination, and highlights problems concerning produce contamination by wildlife and regulatory exemptions for locally grown produce. A comprehensive hypothesis-generating questionnaire enabled rapid identification of the implicated product. Good agricultural practices are key barriers to wildlife fecal contamination of produce. |
| Databáze: | OpenAIRE |
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