Ostroff S M, Kobayashi J M, Lewis J H
Division of Field Services, Centers for Disease Control, Atlanta, Ga 30333.
JAMA. 1989 Jul 21;262(3):355-9.
In 1987, Washington became the first state to require that infection with Escherichia coli serotype O157:H7 be reported. In the first year of surveillance, 93 cases were reported, yielding an annual incidence of 2.1 cases per 100,000 population. The median age of case patients was 14 years (range, 11 months to 78 years), with the highest attack rate among children younger than 5 years (6.1 cases per 100,000 population per year). Bloody diarrhea was present in 95% of reported cases, 12% of patients developed either hemolytic-uremic syndrome or thrombotic thrombocytopenic purpura, and one patient died. Suspected secondary cases were seen in 5% of households. Fifty-six (60%) cases occurred during June through September, as did 73% of the cases of hemolytic-uremic syndrome or thrombotic thrombocytopenic purpura. Cases reported during the summer months were more likely than cases reported at other times of the year to be in children younger than 10 years. Medications, including antimicrobial medications, did not influence the duration of symptoms, nor did they appear to alter the risk of developing hemolytic-uremic syndrome or thrombotic thrombocytopenic purpura. This newly established surveillance system in Washington demonstrates that E coli O157:H7 is an important and common cause of bloody diarrhea in the United States.
1987年，华盛顿州成为首个要求报告感染大肠杆菌O157:H7病例的州。在监测的第一年，共报告了93例病例，年发病率为每10万人口2.1例。病例患者的中位年龄为14岁（范围为11个月至78岁），5岁以下儿童的发病率最高（每年每10万人口6.1例）。95%的报告病例出现血性腹泻，12%的患者发生了溶血尿毒综合征或血栓性血小板减少性紫癜，1例患者死亡。5%的家庭出现了疑似二代病例。56例（60%）病例发生在6月至9月，溶血尿毒综合征或血栓性血小板减少性紫癜病例的73%也发生在这一时期。夏季报告的病例比一年中其他时间报告的病例更有可能是10岁以下的儿童。包括抗菌药物在内的药物并未影响症状持续时间，也似乎未改变发生溶血尿毒综合征或血栓性血小板减少性紫癜的风险。华盛顿州新建立的监测系统表明，大肠杆菌O157:H7是美国血性腹泻的一个重要且常见的病因。
