Epidemiology and Infection



Human Escherichia coli O157[ratio]H7 infection associated with the consumption of unpasteurized goat's milk


M. BIELASZEWSKA a1c1, J. JANDA a2, K. BLÁHOVÁ a2, H. MINARÍKOVÁ a3, E. JÍKOVÁ a4, M. A. KARMALI a5, J. LAUBOVÁ a6, J. ŠIKULOVÁ a7, M. A. PRESTON a8, R. KHAKHRIA a9, H. KARCH a10, H. KLAZAROVÁ a1 and O. NYC a1
a1 Institute of Medical Microbiology, The 2nd Medical Faculty, Charles University, Prague, Czech Republic
a2 1st Clinic of Paediatrics, University Hospital Motol, Prague, Czech Republic
a3 District Public Health Institute, Teplice, Czech Republic
a4 Regional Public Health Institute, Ústí n.Labem, Czech Republic
a5 Division of Microbiology, The Hospital for Sick Children, Toronto, Ontario, Canada
a6 Department of Paediatrics, Masaryk Hospital, Ústí nad Labem, Czech Republic
a7 Animal Health Service, Teplice, Czech Republic
a8 Central Public Health Laboratory, Ministry of Health, Toronto, Ontario, Canada
a9 National Laboratory for Enteric Pathogens, Laboratory Centre for Disease Control, Ottawa, Ontario, Canada
a10 Institut für Hygiene und Mikrobiologie der Universität Würzburg, Würzburg, Germany

Abstract

A cluster of four cases of haemolytic uraemic syndrome in children occurred in Northern Bohemia, Czech Republic, between 15 June and 7 July, 1995. All the cases had significantly elevated titres of anti-O157 lipopolysaccharide (LPS) antibodies as detected by the indirect haemagglutination assay. All but one of them had drunk unpasteurized goat's milk from the same farm within the week before the disease. Evidence of E. coli O157 infection was subsequently found in 5 of 15 regular drinkers of the farm's raw goat's milk; four of them were asymptomatic, 1 had mild diarrhoea at the end of June. Verocytotoxin 2-producing E. coli O157[ratio]H7 strains of phage type 2 and of identical pulsed-field gel electrophoresis patterns were isolated from 1 of 2 farm goats and from 1 of the asymptomatic goat's milk drinkers. The frequency of anti-O157 LPS antibodies found among regular drinkers of the farm's raw goat's milk (33%; 5 of 15) was significantly higher than that found in control population (0%; none of 45) (P=0·0005; Fisher's exact test). Our findings indicate that goats may be a reservoir of E. coli O157[ratio]H7 and a source of the infection for humans; raw goat's milk may serve as a vehicle of the pathogen transmission.

(Accepted August 5 1997)


Correspondence:
c1 Author for correspondence: Dr M. Bielaszewska, Institute of Medical Microbiology, The 2nd Medical Faculty, Charles University, V úvalu 84, 150 06 Praha 5-Motol, Czech Republic.


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