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Swimming-associated haemorrhagic colitis due to Escherichia coli O157[ratio ]H7 infection: evidence of prolonged contamination of a fresh water lake

Published online by Cambridge University Press:  01 August 1997

D. ACKMAN
Affiliation:
The Epidemiology Program Office and the Epidemic Intelligence Service, Division of Field Epidemiology, Centers for Disease Control and Prevention, Atlanta, GA Bureau of Communicable Disease Control, Office of Public Health, New York State Department of Health, Albany, NY
S. MARKS
Affiliation:
Dutchess County Department of Health, Poughkeepsie, NY
P. MACK
Affiliation:
Dutchess County Department of Health, Poughkeepsie, NY
M. CALDWELL
Affiliation:
Dutchess County Department of Health, Poughkeepsie, NY
T. ROOT
Affiliation:
Wadsworth Center, New York State Department of Health, Albany, NY
G. BIRKHEAD
Affiliation:
Bureau of Communicable Disease Control, Office of Public Health, New York State Department of Health, Albany, NY School of Public Health, University at Albany, State University of New York, Albany, NY
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Abstract

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We describe an Escherichia coli O157[ratio ]H7 outbreak associated with a fresh water lake at a county park. Campers were surveyed for diarrhoeal illness within 10 days of their visit, and a case-control study of day visitors was conducted. A confirmed case was a symptomatic person with a stool culture positive for E. coli O157[ratio ]H7 and a probable case was a person with bloody diarrhoea. Clinical isolates of E. coli O157 were subtyped by pulsed field gel electrophoresis (PFGE). In the camper survey, 12 (38%) of 32 swimmers had a diarrhoeal illness (relative risk [RR]=12·4; 95% confidence interval [RR]=1·7–89·7). For the case-control study, the 12 cases were more likely than controls to have purposefully ingested lake water (odds ratio [OR]=6·9, 95% CI=0·9–55·8). The PFGE patterns of six clinical isolates were indistinguishable. This report further demonstrates that contaminated fresh-water lakes can be the source of community outbreaks of E. coli O157[ratio ]H7.

Type
Research Article
Copyright
© 1997 Cambridge University Press

Footnotes

Presented in part at the 35th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Sept. 17–20, 1995, San Francisco, CA.