Epidemiology and Infection

Research Article

Risk factors for sporadic Shiga toxin-producing Escherichia coli O157 infections in FoodNet sites, 1999–2000

A. C. VOETSCHa1 c1, M. H. KENNEDYa1, W. E. KEENEa2, K. E. SMITHa3, T. RABATSKY-EHRa4, S. ZANSKYa5, S. M. THOMASa6, J. MOHLE-BOETANIa7, P. H. SPARLINGa8, M. B. McGAVERNa9 and P. S. MEADa1

a1 Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

a2 Office for Disease Prevention and Epidemiology, Oregon Department of Human Services, Portland, OR, USA

a3 Minnesota Department of Health, Minneapolis, MN, USA

a4 Connecticut Emerging Infection Program, New Haven, CT, USA

a5 New York State Department of Health, Albany, NY, USA

a6 Georgia Division of Public Health, Atlanta, GA, USA

a7 California Department of Health Services, Richmond, CA, USA

a8 Food Safety and Inspection Service, United States Department of Agriculture, Athens, GA, USA

a9 Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA

SUMMARY

To monitor risk factors for illness, we conducted a case-control study of sporadic Shiga toxin-producing Escherichia coli O157 (STEC O157) infections in 1999–2000. Laboratory-confirmed cases of STEC O157 infection were identified through active laboratory surveillance in all or part of seven states. Patients and age-matched controls were interviewed by telephone using a standard questionnaire. Information was collected on demographics, clinical illness, and exposures to food, water, and animals in the 7 days before the patient's illness onset. During the 12-month study, 283 patients and 534 controls were enrolled. STEC O157 infection was associated with eating pink hamburgers, drinking untreated surface water, and contact with cattle. Eating produce was inversely associated with infection. Direct or indirect contact with cattle waste continues to be a leading identified source of sporadic STEC O157 infections.

(Accepted October 28 2006)

(Online publication December 06 2006)

Correspondence:

c1 Author for correspondence: Dr A. C. Voetsch, Centers for Disease Control and Prevention, Mailstop E46, 1600 Clifton Road, Atlanta, GA 30333, USA. (Email: avoetsch@cdc.gov)

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