Riley L W, Remis R S, Helgerson S D, McGee H B, Wells J G, Davis B R, Hebert R J, Olcott E S, Johnson L M, Hargrett N T, Blake P A, Cohen M L
N Engl J Med. 1983 Mar 24;308(12):681-5. doi: 10.1056/NEJM198303243081203.
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 diarrhea followed by grossly bloody diarrhea, 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) 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, O157: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 hemorrhagic colitis in 1975. This report describes a clinically distinctive gastrointestinal illness associated with E. coli O157:H7, apparently transmitted by undercooked meat.
1982年2月至3月以及5月至6月期间，我们对两起异常胃肠道疾病的爆发进行了调查，这两起疫情分别影响了俄勒冈州和密歇根州的至少47人。该疾病的特征为严重的痉挛性腹痛，起初是水样腹泻，随后是明显的血性腹泻，且几乎没有发热症状。它与在俄勒冈州（P<0.005）和密歇根州（P = 0.0005）同一家快餐连锁店的餐厅就餐有关，也与食用含有三种共同成分（牛肉饼、复水洋葱和泡菜）的三种三明治中的任何一种有关。粪便培养未检出先前公认的病原体。然而，在两起疫情发病四天内采集的12份粪便样本中，有9份分离出一种罕见的大肠杆菌血清型O157:H7，该血清型通过标准测试不具有侵袭性或产毒性，并且在密歇根州一个可疑批次的牛肉饼中也分离出了该血清型。此前已知的该血清型唯一一次分离是在1975年从一例散发性出血性结肠炎病例中获得。本报告描述了一种与大肠杆菌O157:H7相关的具有临床特征的胃肠道疾病，显然是由未煮熟的肉类传播的。
