Holton D, Wilson J, Ellis A, Haldane D, April N, Grimsrud K, Friesen B, Spika J
Bureau of Infectious Diseases, Laboratory Centre for Disease Control, Health Canada, Ottawa;
Can J Infect Dis. 1999 Mar;10(2):117-21. doi: 10.1155/1999/606342.
To evaluate further risk factors for Escherichia coli 0157:H7 infection including consumer preferences related to the consumption of ground beef and the role of person-to-person transmission of this infection.
A case-control study of sporadic E coli 0157:H7 infection was undertaken in five Canadian cites from June to December 1991. One hundred cases of E coli 0157:H7 infection were age- and sex-matched to 200 neighbourhood controls. Cases and controls were interviewed face-to-face to obtain information on potential risk factors for infection and health outcomes. Daycare providers of case and control children were interviewed regarding risk factors for infection at the institutional level. Contacts of cases and controls who reported diarrhea in the seven days before the case onset date were also interviewed about their symptoms and risk factors.
All cases had diarrhea during the course of their illness and 90 (90%) reported bloody diarrhea. Four (4%) were reported to have developed hemolytic uremic syndrome; however, there were no fatalities. Sixty-one (61%) of patients were hospitalized. Two variables were associated with infection in the final conditional logistic regression model: eating pink hamburger patties (odds ratio = 12.4, P=0.0001, population attributable fraction =40.2%) and contact with a nonhousehold member suffering from diarrhea (odds ratio = 7.0, P=0.0054, population attributable fraction = 10.3%) in the seven days before illness. Forty per cent of cases and controls who indicated that they prefer well done hamburgers said they would eat a 'pink' hamburger if served to them rather than ask that the hamburger be cooked longer.
Health care workers should remain vigilant in their efforts to educate the public as to the risks associated with the consumption of ground beef that is inadequately cooked, and the importance of personal hygiene in the prevention of enteric illness.
进一步评估大肠杆菌O157:H7感染的风险因素，包括消费者对食用绞碎牛肉的偏好以及该感染的人际传播作用。
1991年6月至12月在加拿大五个城市开展了一项散发性大肠杆菌O157:H7感染的病例对照研究。100例大肠杆菌O157:H7感染病例与200名社区对照进行年龄和性别匹配。对病例和对照进行面对面访谈，以获取感染潜在风险因素和健康结果的信息。就机构层面的感染风险因素对病例和对照儿童的日托提供者进行访谈。对在病例发病日期前7天内报告腹泻的病例和对照的接触者，也询问了他们的症状和风险因素。
所有病例在患病过程中均出现腹泻，90例（90%）报告有血性腹泻。据报告4例（4%）发生了溶血尿毒综合征；然而，无死亡病例。61例（61%）患者住院治疗。在最终的条件逻辑回归模型中，有两个变量与感染相关：在发病前7天内食用粉红色汉堡肉饼（比值比=12.4，P=0.0001，人群归因分数=40.2%）以及与患腹泻的非家庭成员接触（比值比=7.0，P=0.0054，人群归因分数=10.3%）。表示更喜欢熟透汉堡的病例和对照中，40%的人说如果提供给他们“粉红色”汉堡，他们会吃而不会要求把汉堡再煮久一点。
医护人员应继续保持警惕，努力教育公众认识食用未熟透绞碎牛肉相关的风险，以及个人卫生在预防肠道疾病中的重要性。
