Crump John A, Braden Christopher R, Dey Meghan E, Hoekstra R Michael, Rickelman-Apisa Janet M, Baldwin David A, De Fijter Sietske J, Nowicki Scott F, Koch Elizabeth M, Bannerman Tammy L, Smith Forrest W, Sarisky John P, Hochberg Natasha, Mead Paul S
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Epidemiol Infect. 2003 Dec;131(3):1055-62. doi: 10.1017/s0950268803001237.
Escherichia coli O157 infections cause an estimated 60 deaths and 73 000 illnesses annually in the United States. A marked summer peak in incidence is largely unexplained. We investigated an outbreak of E. coli O157 infections at an agricultural fair in Ohio and implicated consumption of beverages made with fairground water and sold by a geographically localized group of vendors who were all on the same branch of the fairground water distribution system. To examine county fair attendance as a risk factor for infection, we conducted two further epidemiological studies. In the first, we enhanced surveillance for E. coli O157 infections in 15 Northeast Ohio counties during the 2000 agricultural fair season and showed increased risk of E. coli O157 infection among fair attendees. In the second study, we examined Ohio Public Health Laboratory Information Service (PHLIS) data for 1999 using a time-varying covariate proportional hazards model and demonstrated an association between agricultural fairs and E. coli O157 infections, by county. Agricultural fair attendance is a risk factor for E. coli O157 infection in the United States and may contribute to the summer peak in incidence. Measures are needed to reduce transmission of enteric pathogens at agricultural fairs.
在美国，每年估计有60人死于大肠杆菌O157感染，7.3万人患病。发病率在夏季出现明显高峰，其原因很大程度上尚不清楚。我们调查了俄亥俄州一次农业展览会上的大肠杆菌O157感染疫情，发现感染源与饮用由展览场地供水系统同一分支上的一群地理位置集中的摊贩出售的、用展览场地的水制成的饮料有关。为了检验参加乡村集市作为感染风险因素，我们又进行了两项流行病学研究。在第一项研究中，我们在2000年农业展览季节加强了对俄亥俄州东北部15个县大肠杆菌O157感染的监测，结果显示参加展览会的人感染大肠杆菌O157的风险增加。在第二项研究中，我们使用时变协变量比例风险模型分析了1999年俄亥俄州公共卫生实验室信息服务（PHLIS）的数据，并按县证明了农业展览会与大肠杆菌O157感染之间的关联。在美国，参加农业展览会是感染大肠杆菌O157的一个风险因素，可能导致发病率夏季高峰。需要采取措施减少农业展览会上肠道病原体的传播。
