Food Protection Trends - February 2011 - (Page 88)

ARTICLES Copyright© 2011, International Association for Food Protection 6200 Aurora Ave., Suite 200W, Des Moines, IA 50322-2864 Food Protection Trends, Vol. 31, No. 2, Pages 88–92 An Outbreak of Escherichia coli O157:H7 Infection Linked to Unpasteurized Apple Cider in Oklahoma, 1999 MAMADOU O. DIALLO1*, KRISTY K. BRADLEY2, JAMES M. CRUTCHER3, MIKE LYTLE4, ANTHONY LEE2 and RONALD L. MOOLENAAR5 1 Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; 2Communicable Disease Division, Oklahoma State Dept. of Health, Oklahoma City, OK 73117, USA; 3State Epidemiologist, Oklahoma State Dept. of Health, Oklahoma City, OK 73117, USA; 4Public Health Laboratory, Oklahoma State Dept. of Health, Oklahoma City, OK 73117, USA; 5Epidemiology Program Office, Center for Disease Control and Prevention, Atlanta, GA 30333, USA INTRODUCTION In 1982, Riley et al. (22) investigated two outbreaks of an unusual gastrointestinal illness that affected 47 or more persons. They determined that the outbreak was caused by a rare E. coli serotype, O157:H7, apparently transmitted by undercooked meat. During the following decades, multiple E. coli O157:H7 outbreaks were associated with consumption of raw or undercooked ground meat, meat products, and unpasteurized milk (2, 3, 15, 16, 17). After the 1990s, an increased number of reported outbreaks were associated with fresh vegetables (e.g., lettuce, spinach, sprouts) or unpasteurized apple juice (1, 4, 5, 6, 8, 11, 12, 13, 19, 24). In 1999, Mead et al. (18), from the Centers for Disease Control and Prevention (CDC), estimated that E. coli O157:H7 accounted for 73,480 illnesses annually in the United States, including 2,000 hospitalizations and 60 deaths, as a direct result of E. coli O157:H7 infections and its complications. Despite progress in making food safer in the United States, E. coli O157:H7 associated with animal products and fresh produce remains a public health challenge putting a large number of persons at risk ABSTRACT During the fall of 1999, an outbreak with 16 cases (11 confirmed and five probable) of Escherichia coli O157:H7 infections was identified in Oklahoma. Nine persons (82%) experienced bloody diarrhea, six (54%) required hospitalization, and three (27%) developed hemolytic uremic syndrome (HUS). Twelve of the sixteen (75%) cases were children from 2 to 13 years old. All nine available E. coli O157:H7 isolates had an identical pulsed-field gel electrophoresis pattern. Ten of the 11 confirmed patients and none of the 24 control subjects had drunk unpasteurized apple cider from Orchard A (matched odds ratio undefined; P < 0.00001). All environmental specimen cultures were negative. Orchard A was in compliance with U.S. Food and Drug Administration requirements for product warning labels on unpasteurized products, although only one of eight patients (or surrogates) interviewed recalled having read the label. This outbreak raises questions about whether the current practice of requiring warning labels for unpasteurized cider provides sufficient protection for vulnerable populations, especially children. A peer-reviewed article Author for correspondence: +1 347.488.4881; Fax: +1 347.920.4771 E-mail: mouda92@hotmail.com * 88 FOOD PROTECTION TRENDS | FEBRUARY 2011 http://www.foodprotection.org/files/food-protection-trends/Feb-11-Diallo.pdf

Table of Contents for the Digital Edition of Food Protection Trends - February 2011

Food Protection Trends - February 2011
Contents
Sustaining Members
Reflections of Your President
Commentary from the Executive Director
An Outbreak of Escherichia coli O157:H7 Infection Linked to Unpasteurized Apple Cider in Oklahoma, 1999
Examining the Exam: Implications for Participants and Policy Makers of the Food Manager Certification Exam
General Interest Paper: Recipe Websites: A Novel Medium for Disseminating Food Safety and Origin Information
IAFP 2011–2012 Secretary Election
IAFP 2011 Award Nominations
New Members
What's Happening in Food Safety
Industry Products
Activities
General Information
Registration Form
Coming Events
Advertising Index
Journal of Food Protection Table of Contents
Booklet Order Form
Membership Application
Celebrating 100 Years of IAFP Journals: 1940s

Food Protection Trends - February 2011