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E. coli O157 phage type 21/28 outbreak in North Cumbria associated with pasteurized milk

Published online by Cambridge University Press:  10 January 2003

S. GOH ,
C. NEWMAN ,
M. KNOWLES ,
F. J. BOLTON ,
V. HOLLYOAK ,
S. RICHARDS ,
P. DALEY ,
D. COUNTER ,
H. R. SMITH  and
N. KEPPIE
S. GOH
Affiliation:
North Cumbria Health Authority, Wavell Drive, Rosehill, Carlisle, Cumbria CA1 2SE
C. NEWMAN
Affiliation:
PHLS CDSC Northern & Yorkshire, BridlePath, Leeds, LS15 7TR
M. KNOWLES
Affiliation:
Carlisle Public Health Laboratory, Cumberland Infirmary, Carlisle, CA2 7HY
F. J. BOLTON
Affiliation:
Food Safety Microbiology Laboratory, Central Public Health Laboratory, 61 Colindale Avenue, London, NW9 5HT
V. HOLLYOAK
Affiliation:
PHLS CDSC Northern & Yorkshire, BridlePath, Leeds, LS15 7TR
S. RICHARDS
Affiliation:
West Cumberland Hospital, Whitehaven, CA28 8JG
P. DALEY
Affiliation:
Environmental Health Department, Allerdale Borough Council, Allerdale House, Workington, CA14 3YJ
D. COUNTER
Affiliation:
Veterinary Laboratories Agency (MAFF), Merrythought, Penrith
H. R. SMITH
Affiliation:
Laboratory of Enteric Pathogens, Central PHL, 61 Colindale Avenue, London, NW9 5HT
N. KEPPIE
Affiliation:
PHLS CDSC Northern & Yorkshire, BridlePath, Leeds, LS15 7TR
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Abstract

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In March 1999, a large community outbreak of Escherichia coli O157 infection occurred in North Cumbria. A total of 114 individuals were reported to the Outbreak Control Team (OCT); 88 had laboratory confirmed E. coli O157. Twenty-eight (32%) of the confirmed cases were admitted to hospital, including three children (3·4%) with haemolytic uraemic syndrome. There were no deaths. A case-control study found that illness was strongly associated with drinking pasteurized milk from a local farm (P=<0·0001) on single variable analysis. Microbiological investigations at the farm revealed E. coli O157 phage type (PT) 21/28 VT 2 which was indistinguishable from the human isolates by pulsed field gel electrophoresis. At the time of occurrence this was the largest E. coli O157 outbreak in England and Wales and the first E. coli O157 PT 21/28 VT 2 outbreak associated with pasteurized milk. This outbreak highlights lessons to be learnt regarding on-farm pasteurization.

Type
Research Article
Information
Epidemiology & Infection , Volume 129 , Issue 3 , December 2002 , pp. 451 - 457
Copyright
2002 Cambridge University Press