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Risk Factors for Sporadic Infection With Escherichia coli 0157:H7
Paul S. Mead, MD, MPH;
Lyn Finelli, PhD;
Mary A. Lambert-Fair;
Deborah Champ, DVM;
John Townes, MD;
Lori Hutwagner, PhD;
Timothy Barrett, PhD;
Kenneth Spitalny, MD;
Eric Mintz, MD, MPH
Arch Intern Med. 1997;157(2):204-208.
Abstract
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Background
Little is known about risk factors for sporadic infection with Escherichia coli 0157:H7. In response to a sharp increase in reported cases in New Jersey during July 1994, we conducted a case-control study to identify principal sources of infection and contributing practices.
Methods
Standardized questionnaires were used to evaluate (1) potential exposures of case patients and matched controls and (2) knowledge, attitudes, and practices of food preparers in case and control households. Patient isolates were subtyped by pulsed-field gel electrophoresis.
Results
Patients with E coli 0157:H7 infection (N=23; median age, 9 years; 55% female) were more likely than healthy controls to have eaten a hamburger in the week preceding illness (matched odds ratio, undefined; P<.001); 80% of the hamburgers eaten by ill persons were prepared at home. Food preparers in case households were less likely than those in control households to report washing their hands (odds ratio, 8.5; P<.005) and work surfaces (odds ratio, 10.5;P<.05) after handling raw ground beef. Pulsed-field gel electrophoresis yielded 17 unique subtypes among the 23 patient isolates, indicating multiple sources of infection.
Conclusions
Hamburgers prepared at home are an important source of sporadic E coli 0157:H7 infections. We estimate that adequate hand washing by food preparers could have prevented 34% of E coli 0157:H7 infections in the study population.
Arch Intern Med. 1997;157:204-208
Author Affiliations
From the Foodborne and Diarrheal Disease Branch (Drs Mead, Champ, Townes, Barrett, and Mintz and Ms Lambert-Fair) and the Biostatistics and Information Management Branch (Dr Hutwagner), National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga; and the New Jersey Department of Health, Trenton (Drs Finelli and Spitalny).
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