Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Epidemiol Infect. 2011 Feb;139(2):309-16. doi: 10.1017/S0950268810000920. Epub 2010 Apr 30.
A multistate outbreak of Escherichia coli O157:H7 infections occurred in the USA in November-December 2006 in patrons of restaurant chain A. We identified 77 cases with chain A exposure in four states - Delaware, New Jersey, New York, and Pennsylvania. Fifty-one (66%) patients were hospitalized, and seven (9%) developed haemolytic uraemic syndrome; none died. In a matched analysis controlling for age in 31 cases and 55 controls, illness was associated with consumption of shredded iceberg lettuce [matched odds ratio (mOR) 8·0, 95% confidence interval (CI) 1·1-348·1] and shredded cheddar cheese (mOR 6·2, CI 1·7-33·7). Lettuce, an uncooked ingredient, was more commonly consumed (97% of patients) than cheddar cheese (84%) and a single source supplied all affected restaurants. A single source of cheese could not explain the regional distribution of outbreak cases. The outbreak highlights challenges in conducting rapid multistate investigations and the importance of incorporating epidemiological study results with other investigative findings.
2006 年 11 月至 12 月，美国一家连锁餐厅 A 的顾客中爆发了大肠杆菌 O157:H7 感染疫情。我们在四个州（特拉华州、新泽西州、纽约州和宾夕法尼亚州）发现了 77 例与 A 连锁餐厅接触的病例。51 名（66%）患者住院，7 名（9%）患者发展为溶血性尿毒综合征；无人死亡。在一项针对 31 例病例和 55 例对照的年龄匹配分析中，发病与食用碎冰山生菜（匹配比值比 [mOR] 8.0，95%置信区间 [CI] 1.1-348.1）和碎切达干酪（mOR 6.2，CI 1.7-33.7）有关。生菜是一种未煮熟的食材，比切达干酪更常食用（97%的患者），而所有受影响的餐厅都使用了单一来源的食材。单一来源的奶酪无法解释疫情病例的区域分布。此次疫情突显了快速进行多州调查所面临的挑战，以及将流行病学研究结果与其他调查结果结合起来的重要性。
