ASSOCIATED WITH A RARE ESCHERICHIA COLI SEROTYPE.
Lee W. Riley, MD, Robert S Remis MD, MPH, Steven D Helgerson, MD,
MPH, Harry B McGee, MPH, Joy G Wells, MS, Betty R Davis, MS,
Richard J Herbert MD, Ellen S Olcott, RN, Linda M Johnson, RN, MS,
Nancy T Hargrtett, PhD, Paul A Blake, MD, MPH and Mithchell L
In 1982, in Oregon and Michigan in the USA, O157:H7 existed in
We investigated two outbreaks of an unusual gastrointestinal illness that
affected at least 47 people in Oregon and Michigan in February through March
and May through June 1982. The illness was characterized by severe crampy
abdominal pain, initially watery diarrhoea followed by grossly bloody
diarrhoea, and little or no fever. It was associated with eating at
restaurants belonging to the same fast food restaurant chain in Oregon (P
less than 0.005) and Michigan (P=0.0005) (ie. McDonald's) and with eating
any of three sandwiches containing three ingredients in common (beef patty,
rehydrated onions and pickles). Stool cultures did not yield previously
recognized pathogens. However a rare Escherichia coli serotype, 0157:H7 that
was not invasive or toxigenic by standard tests was isolated from 9 of 12
stools collected within four days of onset of illness in both outbreaks
combined, and from a beef patty from a suspected lot of meat in Michigan.
The only known previous isolation of this serotype was from a sporadic case
of haemorrhagic colitis in 1975. This report describes a clinically
distinctive gastrointestinal illness associated with E. coli 0157:h7,
apparently transmitted by undercooked meat (N Engl J Med 1983; 308:681-5).