A MULTISTATE OUTBREAK OF ESCHERICHIA-COLI-O157-H7 ASSOCIATED BLOODY DIARRHEA AND HEMOLYTIC-UREMIC-SYNDROME FROM HAMBURGERS - THE WASHINGTON EXPERIENCE
A MULTISTATE OUTBREAK OF ESCHERICHIA-COLI-O157-H7 ASSOCIATED BLOODY DIARRHEA AND HEMOLYTIC-UREMIC-SYNDROME FROM HAMBURGERS - THE WASHINGTON EXPERIENCE
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DOI：
10.1001/jama.272.17.1349
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发表时间：
1994-11-02
影响因子：
120.7
通讯作者：
KOBAYASHI, J
中科院分区：
文献类型：
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作者：
BELL, BP;GOLDOFT, M;KOBAYASHI, J
目的：确定和描述华盛顿州O157：H7大肠杆菌感染大爆发的来源和描述。设计-病例对照研究；环境调查；基于提供者的O157：H7感染监测。设置。-连锁快餐店、医院、医生办公室、当地实验室和当地卫生部门。参与者。-腹泻患者和邻里控制。病例被定义为1992年12月1日至1993年2月28日华盛顿州一名居民发生的经培养确认的O157：H7感染的腹泻或腹泻后溶血性尿毒症综合征(HUS)。对照组是前16名患者的年龄和邻居匹配的朋友。干预。-向公众宣布；召回涉及的汉堡批次。主要结果衡量标准。-O157：H7大肠杆菌暴发的减少。结果：感染与症状开始前10天在快餐连锁店(A连锁店)进食有关。16例患者中有12例(75%)在A链上进食(匹配优势比未定；较低的95%可信区间，3.5；P
Objective.-To determine the source of and describe a large outbreak of Escherichia coli O157:H7 infections in Washington State.Design.-Case-control study; environmental investigation; provider-based surveillance for E coli O157:H7 infections.Setting.-Chain of fast-food restaurants, hospitals, physician offices, local laboratories, and local health departments.Participants.-Patients with diarrhea and neighborhood controls. A case was defined as diarrhea with culture-confirmed E coli O157:H7 infection or postdiarrheal hemolytic uremic syndrome (HUS) occurring from December 1, 1992, through February 28, 1993, in a Washington State resident. Controls were age- and neighborhood-matched friends of the first 16 case patients.Interventions.-Announcement to the public; recall of implicated hamburger lots.Main Outcome Measure.-Abatement of outbreak due to E coli O157:H7.Results.-Infection was associated with eating at a fast-food chain (chain A) in the 10 days before symptoms began. Twelve (75%) of 16 case patients but no controls had eaten at chain A (matched odds ratio undefined; lower 95% confidence interval, 3.5; P